Sex differences in HPA axis responses to stress: a review

The International Society for Developmental Psychobiology annual meeting symposium: Impact of early life experiences on brain and behavioral development

Decades of research in the area of developmental psychobiology have shown that early life experience alters behavioral and brain development, which canalizes development to suit different environments. Recent methodological advances have begun to identify the mechanisms by which early life experiences cause these diverse adult outcomes. Here we present four different research programs that demonstrate the intricacies of early environmental influences on behavioral and brain development in both pathological and normal development. First, an animal model of schizophrenia is presented that suggests prenatal immune stimulation influences the postpubertal emergence of psychosis-related behavior in mice. Second, we describe a research program on infant rats that demonstrates how early odor learning has unique characteristics due to the unique functioning of the infant limbic system. Third, we present work on the rodent Octodon degus, which shows that early paternal and/or maternal deprivation alters development of limbic system synaptic density that corresponds to heightened emotionality. Fourth, a juvenile model of stress is presented that suggests this developmental period is important in determining adulthood emotional well being. The approach of each research program is strikingly different, yet all succeed in delineating a specific aspect of early development and its effects on infant and adult outcome that expands our understanding of the developmental impact of infant experiences on emotional and limbic system development. Together, these research programs suggest that the developing organism's developmental trajectory is influenced by environmental factors beginning in the fetus and extending through adolescence, although the specific timing and nature of the environmental influence has unique impact on adult mental health.

The effect of acute stress on memory depends on word valence

The present study investigated the effect of acute stress on working memory and memory for neutral, emotionally negative, and emotionally positive words in healthy undergraduates. Participants (N=60) were exposed to either the Trier Social Stress Test (stress group) or a non-stressful task (control group). Analyses of salivary cortisol samples taken throughout the study showed elevated glucocorticoid levels after the experimental manipulation in the stress group, but not in the control group. Recall performance was impaired in the stress group, but only so for neutral words. No differences between the stress and control group were found on working memory measures. For the stress group, digit span forward and digit span total scores were associated with correct recall of neutral words. All in all, this study lends further support to the notion that the memory effects of exposure to acute stress depend on the valence of the memory material.

A momentary assessment study of the relationship between affective and adrenocortical stress responses in daily life

The tendency to experience negative emotions in the face of stress may lead to repeated overactivation of the hypothalamic-pituitary-adrenal axis. In a sample of 556 women, this study used the Experience Sampling Method to assess different daily stressors, current mood, and salivary cortisol, 10 times daily for 5 days. Multilevel analyses estimated the contributions of stressors and mood states as predictors of salivary cortisol secretion. Results showed that minor stressors were associated with decreased positive affect and increased negative affect, agitation, and cortisol. Of the mood states, only negative affect was independently associated with cortisol. Negative affect also mediated effects of daily stressors on cortisol. Although further research is needed to clarify: (i) the causal pathways between daily stress, mood, and cortisol and (ii) the importance of daily stress reactivity as a prospective risk factor, these findings confirm that minor daily stressors can influence emotional and biological processes involved in subjective well-being.

Glucocorticoid release and memory consolidation in men and women

Glucocorticoid hormones have been shown to enhance memory consolidation when applied at low doses posttraining, but are ineffective or impair memory at high doses. In a test of whether this quadratic relationship also exists for endogenously released glucocorticoids, healthy men and women received cold-pressor stress (CPS) or a control procedure immediately after reading a relatively neutral story and were tested for retention 1 week later. Cortisol levels in response to the stressor were assayed from saliva. CPS significantly elevated salivary cortisol in both sexes, but enhanced memory only in male subjects. Among CPS-treated male subjects, there was a significant quadratic correlation between cortisol release posttraining and subsequent memory. Thus, these findings represent the first demonstration of an inverted-U relationship between activity of endogenous stress hormones and human memory.

Sexual dimorphism of the intracellular heat shock protein 72 response

The majority of previous work examining stress responses has been done in males. Recently, it has become clear that the impact of stressor exposure is modulated by sex. One stress response that may be affected by sex is the induction of intracellular heat shock protein (HSP) 72, which is a stress- responsive molecular chaperone that refolds denatured proteins and promotes cellular survival. The following study compared HSP72 in males and females and also examined whether the estrous cycle altered HSP72 induction in females. We hypothesized that females compared with males would have a constrained HSP72 response after an acute stressor and that the stress-induced HSP72 response in females would fluctuate with the estrous cycle. Male and female F344 rats were either left in their home cage or exposed to acute tail-shock stress (8–10/group). Immediately following stressor, trunk blood was collected and tissues were flash frozen. Vaginal smear and estrogen enzyme immunoassay were used to categorize the phase of estrous. Results show that female rats had a greater corticosterone response than males, that both males and females exhibit a stress-induced release of progesterone, and that males and females had equal levels of stress-induced circulating norepinephrine. Sexual dimorphism of the HSP72 (ELISA) response existed in pituitary gland, mesenteric lymph nodes, and liver such that female rats had an attenuated HSP72 response compared with males after stress. The adrenal glands, spleen, and heart did not exhibit sexual dimorphism of the HSP72 response. The estrous cycle did not have a significant effect on basal or stress-induced HSP72 in females.

Stress reactivity: biological and subjective responses to the cold pressor and Trier Social stressors

The cold pressor test (CPT) and Trier Social Stress Test (TSST) have been shown to reliably increase HPA activity; however, little research has compared responses to these stressors. In this study, biological (plasma cortisol and ACTH levels) and subjective (e.g., stress and mood) responses were compared in 31 subjects administered both the CPT and TSST. Subjects were diagnosed with alcohol dependence and post-traumatic stress disorder (PTSD) (n = 11), alcohol dependence without PTSD (n = 10), PTSD without alcohol use disorder (n = 4), and neither PTSD nor alcohol use disorder (n = 6). All subjects completed both the CPT and TSST. In all groups, the TSST elicited higher levels of ACTH and cortisol than the CPT, and the response time course differed between tasks. The TSST also produced lower mood ratings than the CPT. A comparison of all diagnosed groups with normal controls revealed group differences in ACTH responding for the CPT but not the TSST. The results suggest that the TSST results in a greater HPA response than the CPT; however, the CPT may have utility in diagnostically heterogeneous patients.

A path model of the effects of spirituality on depressive symptoms and 24-h urinary-free cortisol in HIV-positive persons

OBJECTIVE

The present investigation examined the associations among spirituality, positive reappraisal coping, and benefit finding as they relate to depressive symptoms and 24-h urinary-free-cortisol output.

METHODS

Following an initial screening appointment, 264 human-immunodeficiency-virus-positive men and women on highly active antiretroviral therapy provided 24-h urine samples and completed a battery of psychosocial measures.

RESULTS

Spirituality was associated with higher positive reappraisal coping and greater benefit finding. Benefit finding and positive reappraisal coping scores were, in turn, both related to lower depressive symptoms. Finally, we determined that benefit finding was uniquely predictive of decreased 24-h urinary-free cortisol output.

CONCLUSION

Positive reappraisal coping and benefit finding may co-mediate the effect of spirituality on depressive symptoms, and benefit finding may uniquely explain the effect of spirituality on 24-h cortisol output.

Urocortin 2-deficient mice exhibit gender-specific alterations in circadian hypothalamus-pituitary-adrenal axis and depressive-like behavior

Gender differences in hypothalamus-pituitary-adrenal (HPA) axis activation and the prevalence of mood disorders are well documented. Urocortin 2, a recently identified member of the corticotropin-releasing factor family, is expressed in discrete neuroendocrine and stress-related nuclei of the rodent CNS. To determine the physiological role of urocortin 2, mice null for urocortin 2 were generated and HPA axis activity, ingestive, and stress-related behaviors and alterations in expression levels of CRF-related ligands and receptors were examined. Here we report that female, but not male, mice lacking urocortin 2 exhibit a significant increase in the basal daily rhythms of ACTH and corticosterone and a significant decrease in fluid intake and depressive-like behavior. The differential phenotype of urocortin 2 deficiency in female and male mice may imply a role for urocortin 2 in these gender differences.

Sex hormones, central nervous system and pain

The aim of the present review, which highlights some relationships between sex hormones, the CNS and pain, is to provide reference points for discussion on one of the most intriguing aspects of pain pathophysiology: the presence of sex differences in the response threshold to phasic painful stimuli and in the incidence of chronic pain syndromes. The first part of the review deals with sex steroids and their mechanisms of action. In the second part, the connections between sex steroids, the CNS and pain are illustrated to introduce possible areas of discussion in the study of sex differences in experimental and clinical pain.

PTSD and the HPA axis: differences in response to the cold pressor task among individuals with child vs. adult trauma

Hypothalamic pituitary adrenal (HPA) axis and subjective stress response to a cold-water immersion task, the cold pressor task (CPT), in individuals (N=89) with post-traumatic stress disorder (PTSD) were examined. All tests were conducted at 08:00h after an overnight hospital stay. Plasma adrenocorticotrophin hormone (ACTH), cortisol, and subjective stress were examined at baseline and five post-task time points in controls (n=31), subjects with PTSD as a result of an index trauma during childhood (i.e. before age 18; n=25), and subjects with PTSD as a result of an index trauma as an adult (n=33). Approximately, 50% of individuals in both trauma groups were alcohol dependent, and the impact of this comorbidity was also examined. Subjects with PTSD, regardless of age of index trauma, had a less robust ACTH response as compared to controls. Regardless of the presence or absence of comorbid alcohol dependence, subjects with childhood trauma had lower cortisol at baseline and at all post-task measurement points and did not demonstrate the decrease in cortisol over the course of the 2h monitoring period seen in subjects with adult index trauma and controls. The findings reveal differences in the neuroendocrine response to the CPT in individuals with PTSD compared to control subjects, and differences in PTSD subjects when examined by age of index trauma.

Stress-induced cortisol responses, sex differences, and false recollections in a DRM paradigm

The current studies investigated whether acute stress potentiates false recollections (so-called "false memories") in a Deese-Roediger-McDermott (DRM) paradigm, and whether sex differences modulate these effects. Participants were assigned to either a stress (trier social stress test) or a control group. Subsequently, they were subjected to DRM word lists and probed for recall and recognition. Results showed no differences between the stress and control group on measures of false recollections (Study 1; N=60). Even though correct recall was impaired by acute stress, there were no differences between high or low cortisol responders and controls on false recall or recognitions rates (Study 2; N=92). These results suggest that cortisol responses do not directly potentiate false recollections. Neither in Study 1 nor in Study 2 did we find any evidence that the effects of cortisol on false recollections are different in men and women, although there was an indication that independent of stress men produced more commission errors.

Impaired memory retrieval correlates with individual differences in cortisol response but not autonomic response

Stress can enhance or impair memory performance. Both cortisol release and sympathetic nervous system responses have been implicated in these differential effects. Here we investigated how memory retrieval might be affected by stress-induced cortisol release, independently of sympathetic nervous system stress responses. Thirty-two healthy participants (16 women) learned emotionally arousing and neutral words. One hour later, half of the participants underwent a stressor (cold pressor test) and the other half, a control warm water exposure, both followed by a delayed free recall task. The stressed participants were split into those who did (responders, N = 8) and those who did not (nonresponders, N = 6) show a cortisol response. Both responders and nonresponders showed comparable sympathetic nervous system activity (skin conductance level) during the cold pressor. The cortisol responders recalled significantly fewer words compared to nonresponders, and compared to control participants; this effect was most pronounced for moderately arousing words (compared to highly arousing and neutral words). These results suggest that individual differences in cortisol reactivity affect memory retrieval performance, and help to explain the differential effects of stress on memory.

Epigenetic modulation of the developing serotonergic neurotransmission in the semi-precocial rodent Octodon degus

Environmental influences during early life periods, particularly those provided by the mother or parents, are generally considered to have a strong impact on the development of brain and behaviour of the offspring. In the semi-precocial South American species Octodon degus, a rodent becoming increasingly popular in different laboratory research fields, the present study aimed to examine the consequences of the disturbance of the parent-offspring interaction induced by parental separation on the serotonergic neurotransmission. Based on a quantitative neurochemical approach using brain homogenates obtained from cortical regions and the hippocampus our results revealed that (i) the tissue levels of serotonin and 5-hydroxyindoleacetic acid showed in both sexes a moderate, around two-fold increase until adulthood, indicating relatively matured cortical and hippocampal serotonergic systems at birth. In addition, we found an age-, region- and sex-specific pattern of changes in the serotonergic system induced by (ii) an acute stress challenge early in life (1-h parental separation at the postnatal day 3, 8, 14 or 21) with the most pronounced effects at earlier ages (between postnatal days 3 and 14) in the female cortex and (iii) repeated stress exposure (1h daily) during the first 3 weeks of life affecting cortical regions of both sexes. Taken together, these data indicate that early life stress (i.e. parental separation) influences the developing serotonergic system in the semi-precocial O. degus, even if the brain is relatively well matured at the early stages of postnatal development.

Gender differences in cardiovascular and corticoadrenal response to stress and drug cues in cocaine dependent individuals

RATIONALE

Extensive research suggests that gender may affect neuroendocrine and cardiovascular arousal mechanisms underlying biological responses to stress.

OBJECTIVE

To examine the impact of gender on response to stress and to drug-cue exposure in treatment-seeking cocaine abusers.

METHODS

Fifty recently abstinent cocaine dependent individuals (25F/25M), who were matched on cocaine use history, were exposed to a brief guided-imagery procedure that involved imagining a recent personal stressful situation, a personal drug-related situation and neutral-relaxing situation, one imagery per session, presented in random order. Subjective craving and anxiety, cardiovascular measures and plasma adrenocorticotrophic hormone (ACTH), cortisol and prolactin were assessed.

RESULTS

Males showed significantly higher levels of ACTH, cortisol, and SBP, both at baseline and following all three imagery conditions. Females showed significantly higher basal heart rate and prolactin, although no gender differences were observed following imagery. No gender differences were seen in subjective anxiety or cocaine craving.

CONCLUSIONS

Results indicate significant gender differences in baseline sensitivity and subsequent variations in hypothalamus-pituitary-adrenal (HPA) and cardiovascular response to imagery challenge. Such gender-specific responses could have implications for the development of pharmacological treatments that address stress and drug-cue-related relapse in cocaine-abusing individuals.

Stress differentially modulates fear conditioning in healthy men and women

BACKGROUND

Stress and stress hormones modulate emotional learning in rats and might have similar effects in humans. Theoretic accounts of posttraumatic stress disorder (PTSD), for example, implicate the stress-induced modulation of fear conditioning in the development of intrusive emotional reactions. The present study examined the impact of acute stress and cortisol (CORT) on classically conditioned fear in men and women.

METHODS

Ninety-four healthy undergraduates were exposed to a mild stressor (or control condition) while subjective anxiety and glucocorticoid stress responses (salivary CORT) were measured. One hour later, all participants participated in a differential fear conditioning procedure while conditioned skin conductance responses (SCR) were recorded.

RESULTS

Exposure to the stressor increased subjective anxiety and elevated CORT levels. In men, stress exposure facilitated fear conditioning; whereas in women, stress appeared to inhibit fear conditioning. The impact of stress on differential conditioning in men was associated with increased CORT levels.

CONCLUSIONS

Consistent with animal models, these results demonstrate that stress exposure can modulate classical conditioning in humans, possibly via hormonal mechanisms. The enhancing effects of stress on the formation of conditioned fear might provide a useful model for the formation of pathological emotional reactions, such as those found in PTSD.

The effects of sex and hormonal status on the physiological response to acute psychosocial stress

Whether one is male or female is one of the most important determinants of human health. While males are more susceptible to cardiovascular and infectious disease, they are outnumbered by women for many autoimmune disorders, fibromyalgia and chronic pain. Recently, individual differences in the physiological response to stress have emerged as a potentially important risk factor for these disorders. This raises the possibility that sex differences in prevalence of disease could at least in part be explained by sex differences in the nature of the physiological response to stress. In a psychophysiological laboratory, the autonomic nervous system response can be provoked by many different stressors including physical, mental and psychosocial tasks, while the hypothalamic-pituitary-adrenal axis (HPAA) response seems to be more specific to a psychosocial challenge incorporating ego involvement. The responses of both systems to different psychosocial challenges have been subject to extensive research, although in respect of sex differences the HPAA response has probably been more systematically studied. In this review, we focus on sex differences in HPAA and autonomic nervous system responses to acute psychosocial stress. Although some differences are dependent on the stressor used, the responses of both systems show marked and consistent differences according to sex, with the phase of the menstrual cycle, menopausal status and pregnancy having marked effects. Between puberty and menopause, adult women usually show lower HPAA and autonomic responses than men of same age. However, the HPAA response is higher in the luteal phase, when for example post stress free cortisol levels approach those of men. After menopause, there is an increase in sympathoadrenal responsiveness, which is attenuated during oral hormone replacement therapy, with most evidence suggesting that HPAA activity shows the same trends. Interestingly, pregnancy is associated with an attenuated response of the sympathoadrenal and HPAA systems at least as assessed by biochemical stimulation. It is likely that these sex differences in autonomic function are a result of estrogen exposure which attenuates sympathoadrenal responsiveness. The HPAA is however somewhat more complex and evidence now suggests the influence of other modifiers such as arginine vasopressin (AVP) and the regulation of circulating cortisol bioavailability by corticosteroid-binding globulin (CBG). The pronounced and multi-faceted sex differences in stress responsiveness suggest that they are a product of a strong evolutionary pressure. We hypothesise that this has to a great deal been driven by the need to protect the fetus from the adverse effects of maternal stress responses, in particular excess glucocorticoid exposure. Studying this hypothesis may have a fundamental impact on our understanding about how adult health is set during early life and how adult disease could be prevented in men and women.

Dasyurid marsupials as models for the physiology of ageing in humans

Marsupials of the order Dasyuromorphia have features that make them useful as models for ageing processes in humans. First, they are long-lived for their size, with most small species living for at least 1 year, often several years, contrasting with the mouse, a conventional model for ageing studies, where most populations turn over within 4–6 months. Longevity in some dasyurids allows biological comparisons with other long-lived mammals. Second, the predictable reproduction and life histories of the genera Antechinus and Sminthopsis allow analysis of the role of sex hormones in physiological changes as ageing progresses. For Antechinus, this includes the interaction between testosterone and cortisol in initiating pathologies in males but not females. Many ageing processes are expressed differently between male and female humans, and have a stress component. The neuropathological changes that occur in Antechinus can be used as a model for the dementias of ageing, including Alzheimer’s disease. The age-related neuropathologies in Antechinus indicate that hormonal influences may be important. Finally, in Sminthopsis, the interaction between sex hormones, reproduction and the fattening season offer insights into the interaction between longevity and reduced energy intake, including obesity. Thus these mammals offer useful models for many of the possible influences for healthy ageing in humans.

Cortisol and memory retrieval in women: influence of menstrual cycle and oral contraceptives

RATIONALE

Studies in rodents observed that the effects of stress on memory are modulated by gonadal hormones. In animals and humans, stress and cortisol treatment impairs memory retrieval.

OBJECTIVES

To investigate if the acute impairing effect of cortisol on memory retrieval in women is influenced by endogenous or exogenous gonadal steroids.

METHODS

Three groups of women were studied: women during mensis (n=13), women in the luteal phase (n=14), and women using oral contraceptives (OCs; n=20). In a double-blind crossover fashion, they received cortisol (30 mg) or placebo 1 h prior to memory retrieval testing.

RESULTS

Overall cortisol led to a significant impairment of memory retrieval. Further exploratory analysis using t tests showed that both groups of naturally cycling women were significantly impaired (p<0.05), while no effect was apparent in the OC users (p=0.29).

CONCLUSIONS

The current results could suggest that OC use is associated with a reduced sensitivity of the brain to acute cortisol elevations. In contrast, menstrual-cycle-associated changes in estradiol and progesterone concentrations appear to have no strong influence on this acute cortisol effect. The underlying neurobiological mechanisms of these behavioral findings remain to be elucidated.