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Li D, Chen J, Weng C, Huang X. Impact of the severity of brain injury on secondary adrenal insufficiency in traumatic brain injury patients and the influence of HPA axis dysfunction on prognosis. Int J Neurosci 2023:1-10. [PMID: 37933491 DOI: 10.1080/00207454.2023.2280450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE To investigate secondary adrenal insufficiency post varying traumatic brain injuries' and its impact on prognosis. METHODS 120 traumatic brain injury patients were categorized into mild, moderate and severe groups based on Glasgow Coma Scale. Adrenal function was evaluated through testing. RESULTS Secondary adrenal insufficiency rates were 0% (mild), 22.85% (moderate) and 44.82% (severe). Hypothalamus-pituitary-adrenal axis dysfunction rates were 14.81% (mild), 42.85% (moderate) and 63.79% (severe). Differences among groups were significant (p < .05). Patients with intact hypothalamus-pituitary-adrenal axis had shorter hospital stays and higher Glasgow Coma Scale scores. Receiver operating characteristic analysis of 24-h urinary free cortisol showed an area of 0.846, with a 17.62 μg/24h cutoff, 98.32% sensitivity and 52.37% specificity. In the low-dose adrenocorticotropic hormone test, with an 18 μg/dL cutoff, the receiver operating characteristic area was 0.546, with 46.28% sensitivity and 89.39% specificity. CONCLUSION As traumatic brain injury severity increases, secondary adrenal insufficiency incidence rises. The low-dose adrenocorticotropic hormone test is promising for hypothalamus-pituitary-adrenal axis evaluation. Patients with hypothalamus-pituitary-adrenal dysfunction experience prolonged hospitalization and worse prognosis.
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Affiliation(s)
- Dongping Li
- Critical Care Medicine Department (ICU), Affiliated Hospital of Putian University, Putian, China
| | - Jianhui Chen
- Critical Care Medicine Department (ICU), Affiliated Hospital of Putian University, Putian, China
| | - Chunfa Weng
- Critical Care Medicine Department (ICU), Affiliated Hospital of Putian University, Putian, China
| | - Xiaohai Huang
- Critical Care Medicine Department (ICU), Affiliated Hospital of Putian University, Putian, China
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2
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Van't Westeinde A, Zimmermann M, Messina V, Karlsson L, Padilla N, Lajic S. Brain activity during visuospatial working memory in congenital adrenal hyperplasia. Cortex 2023; 159:1-15. [PMID: 36603403 DOI: 10.1016/j.cortex.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/30/2022] [Accepted: 10/06/2022] [Indexed: 12/23/2022]
Abstract
CONTEXT Patients with congenital adrenal hyperplasia (CAH) require life-long replacement of cortisol. Problems with cognitive function, especially working memory, have previously been identified, but the long-term effects of this disease on brain function are unknown. OBJECTIVE We investigate brain activity during working memory in CAH compared to controls. DESIGN, SETTING, AND PARTICIPANTS Twenty-nine individuals with CAH (17 females) and 40 healthy controls (24 females), 16-33 years, from a single research institute, underwent functional magnetic resonance imaging while doing a verbal and visuospatial working memory task. RESULTS Individuals with CAH responded faster on the verbal task. Although we found no differences in BOLD response over the whole group, there were significant interactions with sex: CAH males had increased activity in the bilateral lateral superior occipital cortex, left supramarginal and angular gyri, left precuneus, left posterior cingulate cortex and bilateral cerebellum during decoding of the visuospatial task, while females showed decreased activity in these regions. CONCLUSIONS Long-term cortisol imbalances do not seem to have a major impact on the functional brain responses during working memory in CAH. However, activity of the left dorsal visual stream in particular might be affected depending on sex. As the task employed may have been relatively easy, larger studies using more complex tasks are needed to further investigate this.
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Affiliation(s)
- Annelies Van't Westeinde
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Marius Zimmermann
- Section for Cognitive Systems, DTU Compute, Technical University of Denmark; DK-2800 Kgs, Lyngby, Denmark
| | - Valeria Messina
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Leif Karlsson
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Nelly Padilla
- Department of Women's and Children's Health, Karolinska Institutet, Department of Neonatology, Karolinska Vägen 8 (S3:03), SE- 171 76 Stockholm, Sweden
| | - Svetlana Lajic
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
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Kraemer WJ, Caldwell LK, Post EM, Beeler MK, Emerson A, Volek JS, Maresh CM, Fogt JS, Fogt N, Häkkinen K, Newton RU, Lopez P, Sanchez BN, Onate JA. Arousal/Stress Effects of "Overwatch" eSports Game Competition in Collegiate Gamers. J Strength Cond Res 2022; 36:2671-2675. [PMID: 35876429 DOI: 10.1519/jsc.0000000000004319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Kraemer, WJ, Caldwell, LK, Post, EM, Beeler, MK, Emerson, A, Volek, JS, Maresh, CM, Fogt, JS, Fogt, N, Häkkinen, K, Newton, RU, Lopez, P, Sanchez, BN, and Onate, JA. Arousal/stress effects of "Overwatch" eSports game competition in collegiate gamers. J Strength Cond Res XX(X): 000-000, 2022-To date, no physical response data are available for one of the most popular eSport games, Overwatch. The purpose of this investigation was to describe the stress signaling associated with competitive Overwatch play and to understand how acute hormonal responses may affect performance. Thirty-two male college-aged gamers (age: 21.3 ± 2.7 years; estimated time played per week: 18 ± 15 hours) completed the study. Subjects were randomly assigned to a 6-player team to compete in a tournament-style match. Salivary measures of cortisol and testosterone were collected immediately before (PRE) and after (POST) the first-round game, with the heart rate recorded continuously during the match. The mean characteristics were calculated for each variable and comparisons made by the skill level. Significance was defined as p ≤ 0.05. There were no differences in measures of salivary cortisol. A differential response pattern was observed by the skill level for testosterone. The low skill group displayed a significant increase in testosterone with game play (mean ± SD, testosterone PRE: 418.3 ± 89.5 pmol·L-1, POST: 527.6 ± 132.4 pmol·L-1, p < 0.001), whereas no change was observed in the high skill group. There were no differences in heart rate characteristics between skill groups. Overall, the average heart rate was 107.2 ± 17.8 bpm with an average max heart rate of 133.3 ± 19.1 bpm. This study provides unique physiological evidence that a sedentary Overwatch match modulates endocrine and cardiovascular responses, with the skill level emerging as a potential modulator.
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Affiliation(s)
- William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio.,Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio.,Exercise Medicine Research Institute.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Lydia K Caldwell
- Applied Physiology Laboratory, University of North Texas, Denton, Texas
| | - Emily M Post
- Exercise Science Department, Ohio Dominican, Columbus, Ohio
| | - Matthew K Beeler
- Department of Exercise Science, Hastings College, Hastings, Nebraska
| | - Angela Emerson
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
| | - Jeff S Volek
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Carl M Maresh
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Jennifer S Fogt
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio.,The College of Optometry, The Ohio State University, Columbus, Ohio
| | - Nick Fogt
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio.,The College of Optometry, The Ohio State University, Columbus, Ohio
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Robert U Newton
- Exercise Medicine Research Institute.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Pedro Lopez
- Exercise Medicine Research Institute.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Barbara N Sanchez
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - James A Onate
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio.,School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio; and.,Jameson Crane Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
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4
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Chaudhary S, Roy A, Summers C, Zhornitsky S, Ahles T, Li CSR, Chao HH. Hypothalamic connectivities predict individual differences in ADT-elicited changes in working memory and quality of life in prostate cancer patients. Sci Rep 2022; 12:9567. [PMID: 35688928 PMCID: PMC9187668 DOI: 10.1038/s41598-022-13361-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/24/2022] [Indexed: 11/09/2022] Open
Abstract
Androgen deprivation therapy (ADT) has been associated with adverse effects on cognition. However, we currently lack understanding of the neurobiology and prognostic markers of these effects. Given that ADT acts via the hypothalamus-pituitary-gonadal axis, we assessed whether baseline hypothalamic resting state functional connectivity (rsFC) could predict changes in working memory and quality of life in prostate cancer patients following androgen deprivation. In a prospective observational study, 28 men with non-metastatic prostate cancer receiving ADT and 38 patients not receiving ADT (controls), matched in age, years of education and Montreal Cognitive Assessment score, participated in brain imaging at baseline, and N-back task and quality-of-life (QoL) assessments at baseline and at 6 months follow-up. Imaging data were processed with published routines and evaluated at a corrected threshold. ADT and control groups did not differ in N-back performance or QoL across time points. In ADT, the changes in 0-back correct response rate (follow-up-baseline) were correlated with baseline hypothalamus-precentral gyrus rsFC; the changes in 1-back correct response rate and reaction time were each correlated with hypothalamus-middle frontal gyrus and superior parietal lobule rsFC. The changes in physical well-being subscore of QoL were correlated with baseline hypothalamus-anterior cingulate and cuneus rsFC. The hypothalamus rsFCs predicted N-back and QoL change with an area under the receiver operating characteristic curve of 0.93 and 0.73, respectively. Baseline hypothalamus-frontoparietal and salience network rsFC's predict inter-subject variations in the changes in working-memory and QoL following 6 months of ADT. Whether and how hypothalamic rsFCs may predict the cognitive and QoL effects with longer-term ADT remain to be investigated.
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Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, CMHC S110, 34 Park Street, New Haven, CT, 06519, USA.
| | - Alicia Roy
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Christine Summers
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, CMHC S110, 34 Park Street, New Haven, CT, 06519, USA
| | - Tim Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University, New Haven, CT, 06520, USA
- Department of Neuroscience, Yale University, New Haven, CT, 06520, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, Yale University, New Haven, CT, 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06520, USA
| | - Herta H Chao
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
- Department of Medicine and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, 06519, USA.
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Unlocking the Memory Component of Alzheimer’s Disease:Biological Processes and Pathways across Brain Regions. Biomolecules 2022; 12:biom12020263. [PMID: 35204764 PMCID: PMC8961579 DOI: 10.3390/biom12020263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
Alzheimer’s Disease (AD) is a neurodegenerative disorder characterized by a progressive loss of memory and a general cognitive decline leading to dementia. AD is characterized by changes in the behavior of the genome and can be traced across multiple brain regions and cell types. It is mainly associated with β-amyloid deposits and tau protein misfolding, leading to neurofibrillary tangles. In recent years, however, research has shown that there is a high complexity of mechanisms involved in AD neurophysiology and functional decline enabling its diverse presentation and allowing more questions to arise. In this study, we present a computational approach to facilitate brain region-specific analysis of genes and biological processes involved in the memory process in AD. Utilizing current genetic knowledge we provide a gene set of 265 memory-associated genes in AD, combinations of which can be found co-expressed in 11 different brain regions along with their functional role. The identified genes participate in a spectrum of biological processes ranging from structural and neuronal communication to epigenetic alterations and immune system responses. These findings provide new insights into the molecular background of AD and can be used to bridge the genotype–phenotype gap and allow for new therapeutic hypotheses.
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6
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Exercise mimetics: harnessing the therapeutic effects of physical activity. Nat Rev Drug Discov 2021; 20:862-879. [PMID: 34103713 DOI: 10.1038/s41573-021-00217-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 02/05/2023]
Abstract
Exercise mimetics are a proposed class of therapeutics that specifically mimic or enhance the therapeutic effects of exercise. Increased physical activity has demonstrated positive effects in preventing and ameliorating a wide range of diseases, including brain disorders such as Alzheimer disease and dementia, cancer, diabetes and cardiovascular disease. This article discusses the molecular mechanisms and signalling pathways associated with the beneficial effects of physical activity, focusing on effects on brain function and cognitive enhancement. Emerging therapeutic targets and strategies for the development of exercise mimetics, particularly in the field of central nervous system disorders, as well as the associated opportunities and challenges, are discussed.
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7
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Kexel AK, Kluwe-Schiavon B, Visentini M, Soravia LM, Kirschbaum C, Quednow BB. Stability and test-retest reliability of different hormonal stress markers upon exposure to psychosocial stress at a 4-month interval. Psychoneuroendocrinology 2021; 132:105342. [PMID: 34225185 DOI: 10.1016/j.psyneuen.2021.105342] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/21/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022]
Abstract
The Trier Social Stress Test (TSST) has been shown to reliably induce physiological stress responses in the hypothalamus-pituitary-adrenal (HPA) and in the sympathetic-adrenal-medullary (SAM) axis in cross-sectional studies. However, it was also reported that repeated exposure to the TSST might be associated with habituation, mainly of the HPA axis responsivity. Thus, in all longitudinal stress studies involving repeated TSST administration, potential habituation of the HPA axis response complicates the interpretation of results. The goal of the present study was therefore to assess stability and test-retest reliability of a number of different endocrinological stress markers as well as subjective stress responses after two exposures to the TSST four months apart. We assessed salivary and plasma cortisol profiles, plasma ACTH and noradrenaline profiles, as well as subjective stress ratings in healthy volunteers before, during, and after the TSST at six time-points both at test-day 1 (TSST_1, n = 42) and test-day 2 (TSST_2, n = 34) 4-months later. Half of the participants received the TSST in the early, the other half in the late afternoon. Discontinuous growth models were applied to model three phases of the stress response (preTSST, reactivity, recovery) for each marker. Subsequently, the stability of these phases was analyzed. Stability and test-retest reliability of standard physiological stress markers such as Area-under-the-Curve (AUCG, AUCI), Absolute Peak Change, and Relative Peak Change (RPC) were analyzed as well. We did not observe strong test-retest effects in any of the endocrinological measures. In contrast, test-retest effects in subjective stress were characterized by a faster drop directly after the second TSST, whereas the initial increase before the test period was the same for both test-days. Regarding test-retest-reliability, AUCG was the most reliable measure across all endocrinological and subjective stress markers (range: r = .606 to .858), while AUCI and RPC (range: r = - .146 to .548) were least reliable. A 4-month interval is a sufficient time interval between two repeated TSST exposures to largely reinstate the physiological stress response, which was also true for the initial psychological stress response. Thus, the TSST is well applicable in longitudinal studies.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Bruno Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Monika Visentini
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Leila M Soravia
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Clemens Kirschbaum
- Department of Biopsychology, Technical University Dresden, Zellescher Weg 19, 01069 Dresden, Germany
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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8
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Executive functioning as a predictor of physiological and subjective acute stress responses in non-clinical adult populations: A systematic literature review and meta-analysis. Neurosci Biobehav Rev 2021; 131:1096-1115. [PMID: 34562543 DOI: 10.1016/j.neubiorev.2021.09.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/12/2021] [Accepted: 09/19/2021] [Indexed: 01/20/2023]
Abstract
The goal of this systematic review and meta-analysis was to evaluate whether executive functioning predicts subsequent acute stress responses. A systematic search (conducted between May 22nd and 30th, 2019; updated on April 4th, 2020) on Cochrane, OpenGray, Proquest Dissertations and Thesis Global, PsycInfo, Pubmed, Scopus, and Web of Science revealed 27 correlational and five interventional studies. For quality appraisal, we used the BIOCROSS Tool, the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the Revised Cochrane Risk-of-bias Tool for Randomized Trials. Attentional control was most consistently associated with acute stress. A robust variation estimation meta-analysis, conducted when sufficient data was available, revealed a small, significant, and negative correlation between higher working memory and subsequent lower cortisol reactivity (r = .09, p = .025, 95 % CI [0.15, 0.02]). These results highlight the role of executive functioning for acute stress responses, the scarcity of relevant data, and the need for both interventional designs and the consideration of mediators and moderators to understand underlying mechanisms.
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Liu Q, Wu J, Zhang L, Sun X, Guan Q, Yao Z. The Relationship Between Perceived Control and Hypothalamic-Pituitary-Adrenal Axis Reactivity to the Trier Social Stress Test in Healthy Young Adults. Front Psychol 2021; 12:683914. [PMID: 34484038 PMCID: PMC8415907 DOI: 10.3389/fpsyg.2021.683914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Psychological factors can modulate the hypothalamic-pituitary-adrenal (HPA) axis activity toward stressors. Animal studies demonstrated that uncontrollability was one critical factor associated with HPA axis stress response, but the results in human studies were inconsistent. The current study adopted a standardized laboratory stress induction procedure, the Trier Social Stress Test (the TSST), as the stressor to regulate the objective controllability level, and young adult participants were asked to rate their subjectively perceived control level toward the stressor and measured their cortisol stress responses (N=54; 19 females and 35 males) to address this concern. Results showed that participants' perceived control on the TSST was related to the cortisol stress response. In other words, under the stress of a certain objective controllability level, the lower the subjectively perceived control level, the greater the HPA axis response. This finding suggested that, in addition to objective controllability, subjectively perceived control is a psychological factor that regulates activation of the HPA axis in young adults.
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Affiliation(s)
- Qian Liu
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China.,Shenzhen Futian Foreign Languages School, Shenzhen, China
| | - Jianhui Wu
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China.,Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Liang Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaofang Sun
- Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Qing Guan
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
| | - Zhuxi Yao
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
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