Leo Sher, M.D.

Our research work, “Cortisol response to cosyntropin administration in military veterans with or without posttraumatic stress disorder” was published 10 years ago in the February 2014 issue of Psychoneuroendocrinology (1).

To assess whether there is altered adrenocortical responsivity to hormonal stimulation in relation to war-zone deployment or posttraumatic stress disorder (PTSD), we performed the low-dose cosyntropin stimulation test in a sample of 45 male veterans: 13 war-zone exposed veterans with chronic PTSD (PTSD+), 22 war-zone exposed veterans without chronic PTSD (PTSD-), and 10 veterans not exposed to a war-zone and without chronic PTSD (non-exposed). Cosyntropin is an adrenocorticotropic hormone (ACTH) derivative that includes the first 24 amino acids of ACTH and maintains ACTH activity. Plasma cortisol and ACTH were measured at baseline and at intervals over a one-hour period following intravenous administration of 1μg of cosyntropin.

A significant main effect of group (PTSD+, PTSD-, non-exposed) on the cortisol response to cosyntropin was observed. Cosyntropin-stimulated plasma cortisol levels were significantly higher in the PTSD+ and PTSD- groups compared to the non-exposed group. A significant main effect of the group was also observed on peak cortisol levels.

Our findings demonstrate that there is an enhanced cortisol response to cosyntropin in war-zone exposed veterans with and without PTSD compared to veterans never deployed to a war zone, suggesting that war-zone exposure itself may have lasting effects on the hypothalamic-pituitary adrenal (HPA) system. Our data indicates that some aspects of HPA axis reactivity reflect trauma exposure even in the absence of PTSD.

Reference

1. Golier JA, Caramanica K, Makotkine I, Sher L, Yehuda R. Cortisol response to cosyntropin administration in military veterans with or without posttraumatic stress disorder. Psychoneuroendocrinology. 2014 Feb;40:151-8. doi: 10.1016/j.psyneuen.2013.10.020. Epub 2013 Nov 9.