Therapeutic implications of hypothalamic-pituitaryadrenal-axis modulation in Alzheimer’s disease: A narrative review of pharmacological and lifestyle interventions

Watermeyer, Tamlyn, Gregory, Sarah, Robb, Catherine and Udeh-Momoh, Chi (2021) Therapeutic implications of hypothalamic-pituitaryadrenal-axis modulation in Alzheimer’s disease: A narrative review of pharmacological and lifestyle interventions. Frontiers in Neuroendocrinology, 60. p. 100877. ISSN 0091-3022

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Official URL: https://doi.org/10.1016/j.yfrne.2020.100877

Abstract

With disease-modifying treatments for Alzheimer’s disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.

Item Type: Article
Uncontrolled Keywords: Cortisol, Hypothalamic-pituitaryadrenal-axis, Alzheimer’s disease, Cognition, Intervention, Glucocorticoid receptor antagonists, Carbenoxolone, Lifestyle
Subjects: B900 Others in Subjects allied to Medicine
C800 Psychology
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Rachel Branson
Date Deposited: 07 Oct 2020 08:57
Last Modified: 02 Dec 2020 11:15
URI: http://nrl.northumbria.ac.uk/id/eprint/44434

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