background It is known that in patients with bipolar disorder (bd) the hypothalamic- pituitary-adrenal (hpa) axis is dysregulated (Daban e.a. 2005). Until now, there was no simple method to investigate the hpa-axis functioning in vivo. The best way to establish glucocorticoid sensitivity is to perform a Dex/crh test, but this test is costly and time consuming.
A recently developed assay for analysing cortisol levels in hair is a promising method to provide a retrospective calendar of endogenous cortisol levels for at least 18 months (Thomson e.a.2010). Steudte et al found already an association (Steudte e.a. 2010), with lower cortisol levels in patients with generalized anxiety disorder Epub ahead of print). To our knowledge this is the first study in patients with bd investigating the role of hair cortisol levels in reflecting mood episodes.
aim What is the relation between cortisol levels in hairs of patients with bd and the mood changes as registered with the Life Chart during a six month period?
methods A prospective study was performed in 86 patients who monthly registered their mood using the life chart method (LCM). We collect around 10 mg of hairs, carefully cut with fine scissors as close to the scalp as possible. These hairs are analyzed for cortisol levels in strands of 3 cm. Methanol was used to extract cortisol from the hair samples. A salivary elisa cortisol kit was used to measure cortisol levels. In a subgroup of bd patients, hair was divided in 1 cm segments to evaluate cortisol levels in different disease states.
results Data will be presented regarding cortisol levels in bd patients in relation with mood episodes during a six month period.
conclusion The preliminary results are encouraging. It may lead to an easy and feasible biomarker (endophenotype) in clinical care.