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Measurement of Pituitary Volume and Hormonal Changes in Patients With Post-traumatic Stress Disorder

Completed
Conditions
Posttraumatic Stress Disorder
Interventions
Procedure: MRI of the pituitary
Procedure: DEX/CRH test
Registration Number
NCT00815204
Lead Sponsor
Cedars-Sinai Medical Center
Brief Summary

Approximately, post-traumatic stress disorder (PTSD) occurs in 8% of the adult population over time. Exposure to traumatic events increases the risk of poor physical health and often leads to disability. The biology of PTSD is continually being explored in order to help find better treatments for this debilitating disorder. In our study, we propose to further our understanding of PTSD. Prior research has found that patients with PTSD have changes in the stress hormone pathway. In this pathway, there is release of certain hormones from the pituitary gland in the brain that feed into the blood stream and tell the adrenal gland to produce stress hormones.

The pituitary is a gland located at the base of the brain which controls the hormones in the body, including the stress hormones. Research in other psychiatric disorders has found changes in the pituitary volume along with changes in the hormones. This has not been investigated yet in PTSD. Therefore, we propose in our study to measure pituitary volume in people with PTSD and look at the changes in the stress hormone pathway. Moreover, we will investigate whether other hormones are affected by PTSD. In this way, we can further our understanding of the the biology of PTSD and help develop new therapies which can intervene through the hormonal system.

Detailed Description

Lifetime prevalence of post-traumatic stress disorder (PTSD) is estimated at 8%. Exposure to traumatic events increases the risk of poor physical health, and chronic PTSD often leads to disability. The pathophysiology of PTSD is continually being explored in order to help find better treatment modalities for this debilitating disorder. Proposed mechanisms for the altered stress axis in PTSD include changes at the level of the pituitary. Though the pituitary stress hormone axis has been explored, no work has been done to evaluate for changes in the pituitary volume in response to these changes in the stress axis in PTSD. We have designed a study which will assess for differences in pituitary volumes. We will compare volumes in patients with PTSD, non-PTSD subjects who have had a history of trauma, and healthy controls. We will test the HPA axis through the dexamethasone/CRH test, a standardized diagnostic test, and correlate the findings with changes in the pituitary volume. Moreover, we will assess for changes in other endocrine axes and proteins.

We propose to further our understanding of PTSD by establishing a direct link between structure and function. By establishing these links in structure and function, novel therapies which can intervene through the endocrine system may prove to be of benefit in treating PTSD

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
39
Inclusion Criteria
  • Age 18-80
  • history of PTSD
Exclusion Criteria
  • Uncontrolled medical or psychiatric conditions Liver or kidney disease Use of anti-depressants or ketoconazole Use of steroids within a year of the study Use of drugs of abuse Pregnancy or nursing Metal implants Low testosterone states A history of head bleeds or pituitary tumors

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
healthy controlsDEX/CRH test-
posttraumatic stress disorderMRI of the pituitary-
history of trauma exposure but no PTSDDEX/CRH test-
posttraumatic stress disorderDEX/CRH test-
history of trauma exposure but no PTSDMRI of the pituitary-
healthy controlsMRI of the pituitary-
Primary Outcome Measures
NameTimeMethod
Pituitary volumeOn second day of study
Secondary Outcome Measures
NameTimeMethod
Cortisol and ACTH levels on DEX/CRH testOn day 1 and day 2 of study test

Trial Locations

Locations (1)

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Cedars-Sinai Medical Center
🇺🇸Los Angeles, California, United States
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