Background
There is substantial evidence that the hippocampus (HC) regulates the activity of
the hypothalamic-pituitary-adrenocortical (HPA) axis. Damage to the HC in animals
produces a transient alteration in diurnal and stress-related HPA activity. This study
was designed to examine the effects of HC damage on basal cortisol secretion in humans.
Methods
Salivary cortisol was measured in 22 patients with HC damage (12 with bilateral damage
and 10 with unilateral damage), 7 brain-damaged comparison participants, 10 healthy,
age-matched comparison participants, and 6 of the patients’ caregivers. Salivary cortisol
samples were taken immediately after awakening, 30 min after awakening, at 8:00 am, 11:00 am, 3:00 pm, 6:00 pm, and at bedtime on a single day. Brain-injured patients underwent a structural magnetic
resonance imaging scan to examine quantitative volumes of the HC.
Results
Both bilateral and unilateral HC damage abolished the cortisol response to awakening
documented in the comparison groups. Caregivers of bilateral HC patients showed a
reduced response to awakening. The remainder of the circadian pattern was not affected
in the HC patients; all groups showed a significant diurnal variation. There was no
association between HC volume and cortisol secretion.
Conclusions
Hippocampal damage in humans abolishes the cortisol response to awakening, whereas
the remainder of the diurnal cycle is unaffected in these patients. These data suggest
a unique role of the HC in the control of basal cortisol secretion.
Key words
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Article info
Publication history
Accepted:
August 7,
2004
Received in revised form:
August 3,
2004
Received:
May 26,
2004
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
