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Randomized Controlled Trial
. 2019 Nov;44(12):2038-2044.
doi: 10.1038/s41386-019-0459-8. Epub 2019 Jul 6.

Effects of hydrocortisone on autobiographical memory retrieval in patients with posttraumatic stress disorder and borderline personality disorder: the role of childhood trauma

Sophie Metz  1 , Juliane Fleischer  2 , Matti Gärnter  2 , Sabrina Golde  2 , Moritz Duesenberg  2 , Stefan Roepke  2 , Oliver T Wolf  3 , Christian Otte  2 , Katja Wingenfeld  2
Affiliations
Randomized Controlled Trial

Effects of hydrocortisone on autobiographical memory retrieval in patients with posttraumatic stress disorder and borderline personality disorder: the role of childhood trauma

Sophie Metz et al. Neuropsychopharmacology. 2019 Nov.

Abstract

In a previous study, we found that patients with posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) showed better autobiographical memory (AM) retrieval after hydrocortisone administration than after placebo administration. Here we investigate the neural correlates of AM retrieval after hydrocortisone administration in patients with PTSD or BPD. We recruited 78 female participants for this placebo-controlled crossover study: 40 healthy controls, 20 patients with PTSD, and 18 patients with BPD (all without medication). All participants received an oral placebo or 10 mg hydrocortisone in a randomized order before performing an AM task. Neural activity was monitored during the task by functional magnetic resonance imaging. Neural activation did not differ between the three groups during AM retrieval, neither in the placebo condition nor after hydrocortisone intake. Multiple regression analysis revealed that Childhood Trauma Questionnaire scores correlated positively with hydrocortisone effects on activation in the anterior medial prefrontal cortex (amPFC), ventrolateral prefrontal cortex (vlPFC), posterior cingulate cortex (PCC), angular gyrus, and cerebellum. These results suggest that hydrocortisone-induced neural activation pattern during AM retrieval is related to childhood trauma. Previously described effects in the hippocampus, which were absent in the current study, might be related to PTSD caused by trauma in adulthood. The effects of hydrocortisone on brain activation and how these effects are influenced by childhood trauma, trauma in adulthood, and PTSD symptoms should be determined in future studies.

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Figures

Fig. 1
Fig. 1
Multiple regression of CTQ values on BOLD activity during the remember condition in the Autobiographical Memory Test (AMT) (contrast: hydrocortisone condition > placebo condition). Clusters in amPFC, angular gyrus, PCC, and ventrolateral prefrontal cortex. For depiction, the threshold was set to p < 0.01, uncorrected with an extent threshold of k > 200 voxels. Values represent Z-values
Fig. 2
Fig. 2
Correlation of CTQ and beta weights of the contrast hydrocortisone minus placebo condition in amPFC, angular gyrus, PCC, ventrolateral prefrontal cortex, and cerebellum. amPFC anterior medial prefrontal cortex, BPD patients with borderline personality disorder, CTQ Childhood Trauma Questionnaire, HC healthy controls, PCC posterior cingulate cortex, PTSD patients with posttraumatic stress disorder
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