Activity of the hypothalamic-pituitary-adrenal axis in multiple sclerosis: correlations with gadolinium-enhancing lesions and ventricular volume

Ann Neurol. 2002 Jun;51(6):763-7. doi: 10.1002/ana.10187.


The known interaction between the immune system and the hypothalamic-pituitary-adrenal axis led us to explore the interrelation between magnetic resonance imaging findings and the hypothalamic-pituitary-adrenal axis activity in 53 multiple sclerosis patients. The cortisol release induced by the dexamethasone-corticotropin-releasing hormone test was negatively associated with the presence and number of gadolinium-enhancing lesions and positively associated with ventricular size. This finding suggests a protective effect of the hypothalamic- pituitary-adrenal drive on acute lesional inflammation in multiple sclerosis, probably by limiting immune overshoot. In contrast, the nature of the correlation between hypothalamic-pituitary-adrenal hyperdrive and brain atrophy remains to be determined.

MeSH terms

  • Adult
  • Area Under Curve
  • Atrophy
  • Brain / pathology*
  • Corticotropin-Releasing Hormone
  • Dexamethasone
  • Female
  • Gadolinium / metabolism
  • Humans
  • Hypothalamo-Hypophyseal System / immunology
  • Hypothalamo-Hypophyseal System / physiology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis / immunology
  • Multiple Sclerosis / pathology*
  • Multiple Sclerosis / physiopathology*
  • Pituitary-Adrenal System / immunology
  • Pituitary-Adrenal System / physiology*
  • Statistics as Topic


  • Dexamethasone
  • Corticotropin-Releasing Hormone
  • Gadolinium