There is some interesting talk in the British media among child and family psychologists...that putting children in daycare before the age of three may permanently affect cortisol levels in the brain leading to many problems later in life... no one gives specifics. Anyway, I realized within a few moments that what is important is that the idea of cortisol as neurotoxic is making the popular press further substantiating Rick's theory on its possible role in YOPD. If we look further at the analysis of the research, it is perhaps too flawed to see a real link. However, it does raise interesting subtexts on how much our modern lifestyle may wreak havoc on our symptoms and contribute to putting us here in the first place.

The best part is the link to the Neuroskeptic's blog and a lucid discussion on the role of cortisol in wealth of information therein. Yes, it is written by a neuroscientist on a mission to debunk myth and bad neuro-science...highly entertaining and informative. Just wanted to share and see if we cannot generate further interest in cortisol or other related topics.

Laura

Laura

This is where things get complicated. Cortisol is a very important substance and we die without it. It serves multiple functions and has differing effects depending on where, when, etc.

One of its roles is to quell inflammation in the brain. If we simply attempt to block cortisol then we might regret it as our symptoms worsen.

On the other hand, continuous (chronic) exposure to cortisol is an abnormal state. As exposure time increases, the effect changes from protective to destructive. So, we can't just ignore it either.

It seems that our strategy needs to be to address the inflammation and see if the cortisol will take care of itself. Activated microglia are the most prominent feature of neuroinflammation and anything that addresses them is where we look. Some to choose from-

Eur J Neurosci. 2002 Dec;16(11):2103-12.
Silymarin protects dopaminergic neurons against lipopolysaccharide-induced neurotoxicity by inhibiting microglia activation.

Food Chem Toxicol. 2009 Jun;47(6):1190-7. Epub 2009 Feb 20.
Hexane fraction of Zingiberis Rhizoma Crudus extract (ginger) inhibits the production of nitric oxide and proinflammatory cytokines in LPS-stimulated BV2 microglial cells via the NF-kappaB pathway.

Pharmazie. 2007 Dec;62(12):937-42.
Neuroprotective effect of curcumin is mainly mediated by blockade of microglial cell activation.

J Neurosci Res. 2004 Dec 1;78(5):723-31.
(-)-Epigallocatechin gallate (Green tea) inhibits lipopolysaccharide-induced microglial activation and protects against inflammation-mediated dopaminergic neuronal injury.

Eur J Pharmacol. 2010 Jun 25;636(1-3):1-7. Epub 2010 Mar 31.
Anti-inflammatory activities of resveratrol in the brain: role of resveratrol in microglial activation.

Transplantation. 2010 Apr 15;89(7):816-23.
Minocycline promotes long-term survival of neuronal transplant in the brain by inhibiting late microglial activation and T-cell recruitment.

Do antidepressants, especially those in the SSRI or SNRI, interact with our current levels of cortisol? Anyone know or hear of this?'
a
There are claims that one 30 mg dose can double cortisol levels then I read that levodopa can substantially lower it. Anyway, I am noticing PD symptoms are exacerbated since starting 30 mg. of Cymbalta XR, so I am trying to figure out how all of this interplays.

Thanks!

Laura

Laura: I know of someone recently who gained over 50 pounds after beginning a regimen of Cymbalta XR.

Carroll

Thanks, for Carroll. We don't know what sort of damage these drugs do on a cellular level, but with a weight gain of 50 lbs something must be going on. Look at this profile of SSRI and resultant cortisol symptoms. No wonder this class of drugs is associated with Parkinsonism...no neurologist should be prescribing any SSRI for PWP period. They do with abandon without any real evidence it works; yet ask them for anything not widely deemed safe and they scoff at you. I just wish their was a way to collect all this anecdotal info and get it written up somewhere with an official stamp on it somehow. Maybe submit to the Physician's Committee of Responsible Medicine?

PSSD Collaborative Research


This group of people have suffered permanent loss of libido and sexual function post SSRI. This brings up another subject of how prevalant these drugs are- the minute you mention depression. If you read the literature it is for severe depression. The kind where you forget to or don't care to bathe for a week; anything less than that than who knows how your neurotransmittters may be impacted?

Laura

Laura, I do think you are on to something here.

There are a number of recent U.S. studies of low-income children that suggest chronic stress resulting from family instability, poor housing, and violence, can affect long-term health. Children who are exposed to long-term stressors are more likely to develop obesity, hypertension, cardiac problems, diabetes, and asthma as adults than children not so exposed. One such study comes out of Stanford University. And there are other studies that suggest chronic childhood stress can caiuse neurological problems such as anxiety, tics, attention disorders, depression, and bipolar disorder.

Why this happens is not known but some scientists have speculated that chronic childhood stress causes facultative hyperthyroidism which is known to occur in people with PTSD. As to the genetics of stress, the gene MAOB has been under study for its role in stress and bipolar disorder. When the gene is under-active, it seems to have some correlation with bipolar disorder and increased reactivity to stress. MAOB also helps regulate dopamine, and variants of this gene influence the risk of Parkinson's disease.

So it may well be that chronic early stressors, like poverty, community violence, and unstable family situations, contribute as powerfully to the development of YOPD in some PWP as environmental factors do in others. If that's the case, we really do need to be mindful of the value of taking the village to raise not only the happy and health child but also the happy and healthy adult.

Hi tremorgrrrl,

Really? Chronic childhood stress causes tics?
Please do post those studies here if you can.

thanks,
Lara

It isn't just childhood stress we are talking about. We each carry an endocrine load inherited from our pasts going back generations and coded in what is called "epigenetics". This coding is carried by genes which turn themselves on or off based on the sort of environment they are born into.

As a result, we literally carry the "sins of our fathers". When our drunken great grandfather slapped his pregnant spouse, her blood chemistry changed immediately. Some of that breached the placenta and altered the developing child. In a sense, the bruise appeared on our cheek.

There is a cultural analogue as well. If the "village" stood silent we are different people than we would have been had they rallied to her defense.

I assure you that this is not academic. Your endocrine system and its mighty "fight or flight" circuits are formed by things like this.

Lara:

Thanks for asking. This is undoubtably more than you wanted (and not all of the research is exactly on point) but it is the basis for the linkage between childhood stress and facial and other tics. And to clarify: The research does not state that childhood stress causes tics. It does, however, state that childhood stress can be a cause of tics and certainly can exacerbate tics. And that is consistent with my statements above.

Some of the research:

Bostic JQ, Prince JB. Child and adolescent psychiatric disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry . 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 69.

Jankovic J, Lang AE. Movement disorders: Diagnosis and assessment. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice . 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 23.

Johnston MV. Movement disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 597.

Franklin SA, Walther MR, Woods DW. Behavioral interventions for tic disorders. Psychiatr Clin N Am. 2010;33:641-655.

Also:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revision. Washington, DC: American Psychiatric Association,2000.

Kurlan, Roger, ed. Handbook of Tourette's Syndrome and Related Tic and Behavioral Disorders. New York: Marcel Dekker, Inc., 1993.

Leckman, James. F., and Donald J. Cohen. Tourette's Syndrome Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. New York: John Wiley and Sons, Inc., 1999.

Robertson, Mary M., and Simon Baron-Cohen. Tourette Syndrome: The Facts. New York: Oxford University Press, 1998.

Chouinard, Sylvain, and Blair Ford. "Adult onset tic disorders." Journal of Neurology, Neurosurgery, & Psychiatry (June, 2000): 68.

Evidente, Virgilio G. H., M.D. "Is it a tic or Tourette's?: Clues for differentiating simple from more complex tic disorders." Postgraduate Medicine (October, 2000): 108.

Kurlan, R., M.D., and others. "Prevalence of tics in school-children and association with placement in special education." Neurology (October, 2001): 57.

Marcus, David, M.D., and Roger Kurlan, M.D. "Tic and its disorders." Movement Disorders (August, 2001): 19.

O'Connor, K. P., and others. "Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders." Behaviour Research and Therapy (June, 2001): 39.

And psychological features distinguishing obsessive-compulsive and chronic tic disorders" Clinical Psychology Review (June, 2001): 21.

Which brings us full circle. Both our modern lives and our ancient heritage working together? antagonistically? to affect our health. I utterly agree with this hypothesis yet I find no comfort in it. Maybe I should spend the evening watching reruns of "The Real Housewives of..." after all.