Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Reviews in the Neurosciences

Editor-in-Chief: Huston, Joseph P.

Editorial Board: Topic, Bianca / Adeli, Hojjat / Buzsaki, Gyorgy / Crawley, Jacqueline / Crow, Tim / Gold, Paul / Holsboer, Florian / Korth, Carsten / Li, Jay-Shake / Lubec, Gert / McEwen, Bruce / Pan, Weihong / Pletnikov, Mikhail / Robbins, Trevor / Schnitzler, Alfons / Stevens, Charles / Steward, Oswald / Trojanowski, John


IMPACT FACTOR 2017: 2.590
5-year IMPACT FACTOR: 3.078

CiteScore 2017: 2.81

SCImago Journal Rank (SJR) 2017: 0.980
Source Normalized Impact per Paper (SNIP) 2017: 0.804

Online
ISSN
2191-0200
See all formats and pricing
More options …
Volume 23, Issue 5-6

Issues

Glucocorticoid-endocannabinoid interaction in cardiac surgical patients: relationship to early cognitive dysfunction and late depression

Daniela Hauer / Florian Weis / Patrizia Campolongo / Mirjam Schopp / Andres Beiras-Fernandez
  • Department of Cardiac Surgery, Ludwig Maximilians University, D-81377 Munich, Germany
  • Department of Cardiac Surgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Claudia Strewe / Markus Giehl / Roland Toth
  • Department of Anaesthesiology, Ludwig Maximilians University, D-81377 Munich, Germany
  • School of PhD Studies, Semmelweis University, Budapest, Hungary
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Erich Kilger / Gustav Schelling
Published Online: 2012-09-24 | DOI: https://doi.org/10.1515/revneuro-2012-0058

Abstract

Background: Endocannabinoids (ECs) are rapidly acting immune-modulatory lipid-signaling molecules that are important for adaptation to stressful and aversive situations. They are known to interact with glucocorticoids and other stress-responsive systems. Maladaptation to acute or chronic stress represents a major risk factor for the development of psychiatric disorders. In the present study, we administered stress doses of hydrocortisone in a prospective, randomized, placebo-controlled double-blind study in patients undergoing cardiac surgery (CS) to examine the relationship between the use of glucocorticoids, plasma EC levels, and the occurrence of early postoperative cognitive dysfunction (delirium) and of later development of depression.

Methods: We determined plasma levels of the ECs anandamide and 2-arachidonoylglycerol (2-AG) in CS patients of the hydrocortisone (n=56) and the placebo group (n=55) preoperatively, at postoperative day (POD) 1, at intensive care unit discharge, and at 6 months after CS (n=68). Postoperative delirium was diagnosed according to Diagnostic and Statistical Manual of the American Psychiatric Association IVth Edition (DSM-IV) criteria, and depression was determined by validated questionnaires and a standardized psychological interview (Structured Clinical Interview for DSM-IV).

Results: Stress doses of hydrocortisone did not affect plasma EC levels and the occurrence of delirium or depression. However, patients who developed delirium on POD 1 had significantly lower preoperative 2-AG levels of the neuroprotective EC 2-AG (median values, 3.8 vs. 11.3 ng/ml; p=0.03). Preoperative 2-AG concentrations were predictive of postoperative delirium (sensitivity=0.70; specificity=0.69; cutoff value=4.9 ng/ml; receiver operating characteristic curve area=0.70; 95% confidence interval=0.54–0.85). Patients with depression at 6 months after CS (n=16) had significantly lower anandamide and 2-AG levels during the perioperative period.

Conclusions: A low perioperative EC response may indicate an increased risk for early cognitive dysfunction and long-term depression in patients after CS. Glucocorticoids do not seem to influence this relationship.

Keywords: cardiac surgery; delirium; depression; endocannabinoids; glucocorticoids

About the article

Corresponding author: Daniela Hauer, Department of Anaesthesiology, Ludwig Maximilians University, D-81377 Munich, Germany


Received: 2012-04-28

Accepted: 2012-08-01

Published Online: 2012-09-24

Published in Print: 2012-11-01


Citation Information: , Volume 23, Issue 5-6, Pages 681–690, ISSN (Online) 2191-0200, ISSN (Print) 0334-1763, DOI: https://doi.org/10.1515/revneuro-2012-0058.

Export Citation

©2012 by Walter de Gruyter Berlin Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Clara R. Medici, Jaimie L. Gradus, Lars Pedersen, Henrik T. Sørensen, Søren D. Østergaard, and Christian F. Christiansen
Critical Care Medicine, 2017, Volume 45, Number 10, Page 1635
[2]
Sachin Patel, Mathew N. Hill, Joseph F. Cheer, Carsten T. Wotjak, and Andrew Holmes
Neuroscience & Biobehavioral Reviews, 2017, Volume 76, Page 56
[3]
Daniela Hauer, Gustav Schelling, Hannah Gola, Patrizia Campolongo, Julia Morath, Benno Roozendaal, Gilava Hamuni, Alexander Karabatsiakis, Piray Atsak, Michael Vogeser, Iris-Tatjana Kolassa, and Katharina Domschke
PLoS ONE, 2013, Volume 8, Number 5, Page e62741
[4]
Ann M. Parker, Thiti Sricharoenchai, Sandeep Raparla, Kyle W. Schneck, O. Joseph Bienvenu, and Dale M. Needham
Critical Care Medicine, 2015, Volume 43, Number 5, Page 1121
[5]
Aniko Krumbholz, Patricia Anielski, Nicole Reisch, Gustav Schelling, and Detlef Thieme
Therapeutic Drug Monitoring, 2013, Page 1
[6]
Anne-Mette C. Sauër, Arjen J. C. Slooter, Dieuwke S. Veldhuijzen, Maarten M. J. van Eijk, John W. Devlin, and Diederik van Dijk
Anesthesia & Analgesia, 2014, Volume 119, Number 5, Page 1046
[7]
Matthew N. Hill, Linda M. Bierer, Iouri Makotkine, Julia A. Golier, Sandro Galea, Bruce S. McEwen, Cecilia J. Hillard, and Rachel Yehuda
Psychoneuroendocrinology, 2013, Volume 38, Number 12, Page 2952
[8]
Robert H. Howland
Journal of Psychosocial Nursing and Mental Health Services, 2014, Volume 52, Number 5, Page 13

Comments (0)

Please log in or register to comment.
Log in