Psychological Stress and Changes of Hypothalamic-Pituitary-Adrenal Axis in Patients with De Novo Parkinsons Disease
Omer C. Ibrahimagic, Amra Cickusic Jakubovic, Dzevdet Smajlovic, Zikrija Dostovic, Suljo Kunic, Amra Iljazovic.
Introduction: Psychological stress and changes in hypothalamic-pituitary-adrenal (HPA) axis in period after diagnosis of de novo Parkinson disease (PD) could be a big problem for patients. Materials and Methods: We measured psychological stress and changes in hypothalamic-pituitary-adrenal axis (HPA) in thirty patients (15:15) with de novo Parkinsons disease, average age 64.17 ± 13.19 (28-82) years (Department of Neurology, University Clinical Center Tuzla). We used Impact of events scale (with 15 questions) to evaluate psychological stress. Normal level of morning cortisol was 201-681 nmol/l, and morning adrenocorticotropic hormone (ACTH) up to 50 pg/ml. Results: Almost 55% patients suffered from mild or serious psychological stress according to IES testing (Horowitz et al.). Non-iatrogenic changes in HPA axis were noticed at 30% patients. The differences between female and male patients regarding to the age (p=0.561), value of cortisol (p=0.745), value of ACTH (p=0.886) and IES testing (p=0.318) were not noticed. The value of cortisol was the predictor of value of ACTH (r=0.427). Conclusion: Psychological stress and changes in hypothalamic-pituitary-adrenal axis are present in patients with de novo PD. There is significant relation between values of cortisol and ACTH. Psychological stress is frequent problem for de novo PD patients.
Key words: Psychological stress, HPA axis, de novo Parkinsons disease.