Cardiac arrest and cardiopulmonary resuscitation dysregulates the hypothalamic-pituitary-adrenal axis

Gretchen N. Neigh, Kate Karelina, Ning Zhang, Erica R. Glasper, Michael J. Owens, Paul M. Plotsky, Charles Nemeroff, A. Courtney Devries

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Cardiac arrest and cardiopulmonary resuscitation (CA/CPR) increase the risk for affective disorders in human survivors. Postischemic anxiety- and depressive-like behaviors have been documented in animal models of CA/CPR; however, the stability of post-CA/CPR anxiety-like behavior over time and the underlying physiologic mechanisms remain unknown. The hypothalamic-pituitary- adrenal (HPA) axis and the corticotropin releasing factor (CRF) system may mediate the pathophysiology of anxiety and depression; therefore, this study measured CA/CPR-induced changes in CRF receptor binding and HPA axis negative feedback. Mice were exposed to CA/CPR or SHAM surgery and assessed 7 or 21 days later. Consistent with earlier demonstrations of anxiety-like behavior 7 days after CA/CPR, increased anxiety-like behavior in the open field was also present 21 days after CA/CPR. On postoperative day 7, CA/CPR was associated with an increase in basal serum corticosterone concentration relative to SHAM, but this difference resolved by postoperative day 21. The Dexamethasone Suppression Test showed that the CA/CPR group had enhanced negative feedback compared with SHAM controls at postoperative day 21. Furthermore, there was a gradual increase in CRF 1 receptor binding in the paraventricular nucleus of the hypothalamus and bed nucleus of the stria terminalis, as well as a transient decrease of both CRF 1 and CRF 2A receptors in the dorsal hippocampus. Therefore, sustained changes in activity of the HPA axis and the CRF system after CA/CPR may contribute to the postischemic increase in affective disorders.

Original languageEnglish
Pages (from-to)1673-1682
Number of pages10
JournalJournal of Cerebral Blood Flow and Metabolism
Volume29
Issue number10
DOIs
StatePublished - Oct 1 2009
Externally publishedYes

Fingerprint

Cardiopulmonary Resuscitation
Heart Arrest
Anxiety
Corticotropin-Releasing Hormone
Mood Disorders
Corticotropin-Releasing Hormone Receptors
Septal Nuclei
Paraventricular Hypothalamic Nucleus
Corticosterone
Dexamethasone
Hypothalamus
Survivors
Hippocampus
Animal Models
Depression

Keywords

  • Cardiac arrest
  • Corticosterone
  • CRF
  • Dexamethasone
  • HPA
  • Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Neurology

Cite this

Neigh, G. N., Karelina, K., Zhang, N., Glasper, E. R., Owens, M. J., Plotsky, P. M., ... Devries, A. C. (2009). Cardiac arrest and cardiopulmonary resuscitation dysregulates the hypothalamic-pituitary-adrenal axis. Journal of Cerebral Blood Flow and Metabolism, 29(10), 1673-1682. https://doi.org/10.1038/jcbfm.2009.85

Cardiac arrest and cardiopulmonary resuscitation dysregulates the hypothalamic-pituitary-adrenal axis. / Neigh, Gretchen N.; Karelina, Kate; Zhang, Ning; Glasper, Erica R.; Owens, Michael J.; Plotsky, Paul M.; Nemeroff, Charles; Devries, A. Courtney.

In: Journal of Cerebral Blood Flow and Metabolism, Vol. 29, No. 10, 01.10.2009, p. 1673-1682.

Research output: Contribution to journalArticle

Neigh, Gretchen N. ; Karelina, Kate ; Zhang, Ning ; Glasper, Erica R. ; Owens, Michael J. ; Plotsky, Paul M. ; Nemeroff, Charles ; Devries, A. Courtney. / Cardiac arrest and cardiopulmonary resuscitation dysregulates the hypothalamic-pituitary-adrenal axis. In: Journal of Cerebral Blood Flow and Metabolism. 2009 ; Vol. 29, No. 10. pp. 1673-1682.
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