Document Detail


A pilot study of the phase angle between cortisol and melatonin in major depression - a potential biomarker?
MedLine Citation:
PMID:  20004915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Hypothalamic-pituitary-adrenal (HPA) axis and melatonin rhythm alterations have been independently reported in major depression (MDD) as well as in insomnia. In this pilot study, we link cortisol and melatonin rhythms and propose that the phase angle between cortisol acrophase (CA) and dim-light melatonin onset (20 pg/ml) (DLMO-20) may yield a useful state specific biomarker for MDD. METHODS: Six healthy (HC) and six depressed (MDD) psychotropic free subjects were admitted to the General Clinical Research Center. Blood was sampled for cortisol and melatonin from 1600h to 1000h, under dim lights (<20lux) and constant routine. Time for DLMO-20 and peak cortisol concentration was determined for each subject. Phase angle was computed as the difference in time between CA and DLMO-20. RESULTS: Phase angle was significantly increased in MDD's versus HC's (13.40+/-1.61h. versus 11.61+/-1.66h, p=0.026). Using ROC analysis, a phase angle greater than 13.57h distinguished MDD's from HC's (sensitivity=0.83, specificity=1.0). Mean nocturnal melatonin (1600-1000h) was significantly decreased in MDD's versus HC's (22.67+/-9.08 pg/ml versus 47.82+/-14.76 pg/ml, p=0.015). CONCLUSIONS: The phase angle between CA and DLMO-20 appears to distinguish HC's from MDD's and may be a useful biomarker to aid biologic assessment as well as treatment. Lower nocturnal melatonin in MDD's highlights its importance in MDD's pathophysiology. Additional study with larger sample size is needed to confirm the results of this pilot study. The mechanism for this phase angle difference and decreased melatonin, itself, requires further study.
Authors:
Theresa M Buckley; Alan F Schatzberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-12-11
Journal Detail:
Title:  Journal of psychiatric research     Volume:  44     ISSN:  1879-1379     ISO Abbreviation:  J Psychiatr Res     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376331     Medline TA:  J Psychiatr Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-74     Citation Subset:  IM    
Copyright Information:
Copyright 2009. Published by Elsevier Ltd.
Affiliation:
Dept. of Psychiatry and Behavioral Sciences, Stanford University Medical School, 401 Quarry Road, Stanford, CA 94305-5730, United States. tbuckley@stanfordalumni.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Circadian Rhythm*
Cross-Sectional Studies
Depressive Disorder, Major / blood*
Female
Humans
Hydrocortisone / blood*
Male
Melatonin / blood*
Middle Aged
Pilot Projects
ROC Curve
Time Factors
Young Adult
Grant Support
ID/Acronym/Agency:
2 M01 RR000070/RR/NCRR NIH HHS; 50604//PHS HHS; 5T32MH19938/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone; 73-31-4/Melatonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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