Psychogenic Components Research Articles

Psychogenic and neurogenic components in patients with psychogenic or neuropathic pruritus: PRURINEURO: Anon-interventional single-centre prospective assay.

The causes of pruritus are multiple and commonly classified into six different categories: dermatological, systemic, neuropathic, psychogenic, mixed and idiopathic. In clinical practice, psychogenic and neurogenic mechanisms tend to be separated in the etiological diagnosis of neuropathic or psychogenic disorders; nevertheless, studies investigating the respective psychogenic and neurogenic components are lacking. The main objective of this work was to highlight the differences and potential common characteristics between psychogenic pruritus and neuropathic pruritus. This study was a noninterventional single-centre prospective assay. Patients with neuropathic (NP) or psychogenic (PP) pruritus were proposed to participate. The psychogenic and neurogenic components of pruritus in these patients were evaluated using six validated questionnaires or criteria, namely, the diagnosis criteria of psychogenic pruritus, the NP5 questionnaire, the Brest Pruritus Qualitative Assessment Questionnaire, Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale, and DN4i. Twenty-five patients with NP and 15 with PP were included. A difference between the two groups was observed for NP5, with mean scores of 2.8±0.9 and 1.4±1 for the NP and PP groups, respectively (p<0.0001). For depression, the average score was 3.5±3.9 for the NP group and 7.5±5.1 for the PP group (p<0.02). While neuropathic and psychogenic disorders are different diagnoses, neuropathic and psychogenic components may exist simultaneously in patients with NP or PP.

MP36-15 PERCEPTION AND REALITY OF POSTOPERATIVE PENILE LENGTH IN MEN UNDERGOING GRAFTING PROCEDURE FOR PEYRONIE’S DISEASE

You have accessJournal of UrologyCME1 Apr 2023MP36-15 PERCEPTION AND REALITY OF POSTOPERATIVE PENILE LENGTH IN MEN UNDERGOING GRAFTING PROCEDURE FOR PEYRONIE’S DISEASE William Langbo, Morgan Sturgis, Jose Quesada Olarte, and Laurence Levine William LangboWilliam Langbo More articles by this author , Morgan SturgisMorgan Sturgis More articles by this author , Jose Quesada OlarteJose Quesada Olarte More articles by this author , and Laurence LevineLaurence Levine More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003270.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s disease presents as penile deformity, oftentimes with curvature and shortening, secondary to scarring of the tunica albuginea. Surgical reconstruction using partial plaque excision and grafting (PEG) is recommended for men with excellent erectile function and severe curvature refractory to conservative management. PEG can correct penile curvature while preserving length, however subjective patient satisfaction rates are highly variable. Our study sought to explore perceived penile shortening in the pre- and post-operative period in one of the largest sample sizes to date. METHODS: A retrospective chart review and phone survey was conducted to analyze patients ≥18 years old who had >3 months of in-office follow up after PEG surgery at a single, tertiary-care institution from February 2007 - November 2022. Erect length was approximated by in-office measurement of flaccid stretched penile length (SPL). Data was collected to assess subjective and objective penile length, patient satisfaction, and other variables. RESULTS: A total of 137 patients met inclusion criteria. 76% of all patients reported perceived preoperative shortening, while fewer (46%) reported perceived postoperative shortening. Perceived postoperative shortening was significantly associated with perceived preoperative shortening (p=0.05). (Table 1) There was no significant association between perceived postoperative shortening and measured change in SPL (p=0.16). In fact, on average, patients who underwent PEG gained 0.51 cm in SPL. Of patients who reported perceived postoperative shortening, only 25% objectively lost SPL; this group had an average increase of 0.33 cm in SPL. Subjective post-operative shortening was associated with both reduced patient satisfaction (p=0.006) and shorter time to follow up (p=0.001). CONCLUSIONS: Overall, patients were less likely to report perceived shortening after PEG. Perceived preoperative shortening was predictive of perceived postoperative shortening, in spite of measurements not indicating length loss, suggesting that pre-existing factors, such as erectile function or psychogenic components, might play a role. This is further supported by no difference in measured change in SPL between groups, with an overall average gain in SPL after PEG. The association between reported postoperative shortening and shorter follow up times may be due to an immediate adjustment period to the appearance of the penis after PEG, which resolves over time. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e485 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Langbo More articles by this author Morgan Sturgis More articles by this author Jose Quesada Olarte More articles by this author Laurence Levine More articles by this author Expand All Advertisement PDF downloadLoading ...

Effect of increased prolactin and psychosocial stress on erectile function

IntroductionSexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels.ObjectivesThe most common sexual dysfunction is erectile dysfunction. It usually affects men over the age of 40. The causes of erectile dysfunction can be organic, psychogenic or a combination of both. The most common organic causes of erectile dysfunction may be high blood pressure, diabetes mellitus, obesity or hormonal disorders. Psychogenic reasons are usually related to psychosocial stress. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia, and psychosocial stress.MethodsClinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focused on patient history, comprehensive sexological examination, biochemical analyzes of serum prolactin, total testosterone, thyroid stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40)ResultsThe results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = 0.50) and results of the trauma checklist score (R = 0.55) as well as significant Spearman correlations between TSC-40 and prolactin (R = 0.52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.ConclusionsOur result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.DisclosureNo significant relationships.

Rehabilitation of patients with chronic low back pain

Low back pain occupies one of the leading places among pain syndromes and is an urgent medical, social, and economic problem of our time. A review of modern domestic and foreign literature data on the features of diagnosis, treatment and rehabilitation of chronic dorsalgia in patients with comorbid pathology was carried out. The article reflects the main etiological factors, describes the types of back pain: non-specific (musculoskeletal), radiculopathy, pain associated with potentially dangerous diseases, in addition, issues of the pathogenesis of pain syndromes are highlighted with an indication of nociceptive, neuropathic, psychogenic components. The most common comorbidity in patients with chronic pain in the lower back is characterized. Diagnostic algorithms for the problem under study, measures of drug and non-drug therapy, the possibility of practicing yoga for chronic lower back pain from the standpoint of evidence-based medicine are considered. It was stated that the treatment of chronic pain in the lower back should be individual, with an impact on different links in the pathogenesis of the pathological process. At the same time, the practice of yoga allows you to comprehensively influence the body at various levels: physical, psychological, mental. However, further research is required in this area.

Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review

The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.

Effect of increased prolactin and psychosocial stress on erectile function.

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R=.50) and results of the trauma checklist score (R=.55) and significant Spearman correlations between TSC-40 and prolactin (R=.52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.

Contemporary and Novel Imaging Studies for the Evaluation of Erectile Dysfunction

Traditionally, it was thought that the pathogenesis of erectile dysfunction (ED) can be divided into psychological and organic factors. However, recent literature supports the development and progression of ED due to multidimensional alterations of a complex interplay of central and peripheral systems, from neural cognitive and efferent networks to loco-regional neuro-hormonal factors which are responsible for impaired penile vascular hemodynamics and ensuing lack of, or suboptimal, blood flow into the penis and/or veno-occlusive dysfunction. It is recognised that ED is strongly correlated with cardiovascular health and published clinical guidelines advocate screening for cardiovascular and metabolic risk factors in men presenting with ED. Over the past few decades, various imaging modalities have been developed and utilised to provide objective evaluation for ED to better characterise the state of penile health and exclude psychogenic components. The following article evaluates current and emerging imaging diagnostic tools for ED.

… Not only a sexuological problem

Partner sexual dysfunctions, for example impotence or erectile dysfunction (ED) are also problems in gynecological praxis. ED can be troubling, even devastating to a man, but it can be equally for his partner as well; this is one of many sexuological problems in gynecological praxis. It really undermines a relationship,can say gynecological patients during anamnesis. Erectile dysfunction (ED) can really affect womens self-esteem. The causes of ED have been analysed, taking into account the division into psychogenic and somatic factors. Among somatic causes, special attention has been devoted to endocrinopathy, including its relatively rare cause, namely Addison’s disease, also known as hypoadrenalism. It was emphasised that the causes of ED are usually complex, often with both somatic and psychogenic components.

A neuropathic component of lumboischialgia: mechanisms of development and treatment approaches

Low back pain (LBP) is accompanied by the development of pain syndrome that spreads into the leg in 25-57% of patients. This is an important factor predicting the risk of transition of pain from acute to chronic and is an indirect indicator of disease severity. It is often impossible to specify the primary mechanism facilitated pain irradiation in lumboischialgia because many structures can cause analogous symptoms. Mechanisms of development of LBP are represented by nociceptive, neuropathic and psychogenic components. Currently, the term 'neuropathic back pain' remains rather ambiguous. Existing data suggest that the term 'neuropathic LBP is not confined to classic radiculopathy and is realized through several pathophysiological mechanisms. Lumboischialgia is a clinical appearance of these mechanisms. The authors present main mechanisms of the development of lumboischialgia, discuss clinical markers of neuropathic component of LBP, approaches to its diagnosis and treatment.

A comprehensive review of erectile dysfunction in men with diabetes.

Erectile dysfunction (ED) is more common in men with diabetes (DM). Dependent on the selected population, age, DM type and duration, the prevalence of diabetic ED (DED) varies from 32 to 90%. In 12-30% of men ED is the first sign of diabetes, diagnosed later. Today men with diabetes live longer than ever, and develop more late diabetic complications. Having in mind also the global ageing of the world population all this data suggests an increasing number of men with DED in the future. The main factors playing in the complex pathogenesis of DED are diabetic neuropathy (oxidative stress, polyol pathway, advanced glycation end-products, nerve growth factor deficiency, dysfunction of protein kinase C, tissue remodeling, etc.), macrovascular arterial disease (endothelial dysfunction, abnormal collagen deposition and smooth muscle degeneration, dyslipidemia, arterial hypertension, veno-occlusive dysfunction, etc.), hypogonadism, structural remodeling of the corporeal tissue, psychogenic components and adverse drug reactions. The diagnostic process is based on the results of questionnaires, neurological, vascular (Doppler) and other more rarely used investigations.Because of the complex pathogenesis of DED diabetic men represent a "difficult" treatment group. The difficulties are from the "beginning", because patients do not talk about their problem spontaneously, and doctors do not ask about it. The treatment of DED should be team work, preferably including also specialists in sexual medicine. Psychological support and counseling of the couple is necessary in most cases. The general measures include implementation of a healthier lifestyle, improved glycemic-, lipids-, and arterial pressure control, and careful re-evaluation of the concomitant medications. The specific treatment includes as first line therapy the inhibitors of phosphodiesterase type 5 (PDE-5) with lesser effectiveness compared to non-DM men. There are rare studies with selected diabetic populations and even less with head-to-head comparisons between the PDE-5 inhibitors. Men with DM have a higher prevalence of hypogonadism. Testosterone replacement therapy should be started in symptomatic men with proven hypogonadism and no contraindications. Vacuum constriction devices and intracavernous or intraurethral applications of vasoactive drugs are the second line therapy. Vascular surgery rarely comes into consideration. The penile implant is the last and effective option in men with severe DED.

Understanding and targeting the Rho kinase pathway in erectile dysfunction.

Erectile dysfunction (ED) is a common disorder that affects a quarter of US men, and has many causes, including endothelial impairment, low testosterone levels, prior surgical manipulation, and/or psychogenic components. Penile erection is a complex process requiring neurally mediated relaxation of arteriolar smooth muscle and engorgement of cavernosal tissues, mediated by nitric oxide (NO). Current medical therapies for ED largely seek to maximize endogenous NO signalling. Certain aetiologies, including diabetes, are difficult to treat with current modalities, emphasizing the need for new molecular targets. Research has demonstrated the importance of RhoA-Rho-associated protein kinase (ROCK) signalling in maintaining a flaccid penile state, and inhibition of RhoA-ROCK signalling potentiates smooth-muscle relaxation in an NO-independent manner. The mechanisms and effects of RhoA-ROCK signalling and inhibition suggest that the RhoA-ROCK pathway could prove to be a new therapeutic target for the treatment of ED.

AB0314 Neurogenic Mechanisms of Chronic Joint Pain in Patients with Rheumatoid Arthritis and Knee Osteoarthritis

BackgroundChronic pain is the most typical clinical presentation of rheumatoid arthritis (RA) and osteoarthritis (OA). Suggest that the pain in RA and OA has mixed nature and includes nociceptive, neuropathic...

Pain syndrome in rheumatoid arthritis

Subjects and methods. One hundred and eighty-three patients with valid rheumatoid arthritis (RA) were examined to study the specific fea tures of chronic pain syndrome. The DN4 neuropathic pain diagnostic questionnaire was used to divide all the patients into 2 groups: 1) 78 patients with the neuropathic component of pain (NCP) and 2) 105 patients without the latter. Results. A clinical neurological examination could reveal peripheral nervous system lesion in 96% of Group 1 patients and in 4% of Group 2 ones. The patients with NCP were ascertained to be older, they were longer ill with RA, had higher clinical, X-ray stages and functional class, as well as higher pain intensity. However, no differences were found between the two groups in the values of disease activity (DAS 28) and erythrocyte sedimentation rate. There was a high rate (71%) of depressive disorders, the prevalence and degree of which in RA patients were determined by the characteristics of disease severity and did not depend on the presence of NCP. Discussion. The performed study demonstrated that, along with an obligate nociceptive mechanism, the patients with RA had neurogenic and psychogenic components of pain in 43 and 71% of cases, respectively. Consequently, chronic pain syndrome in RA is commonly mixed and both the activity of the inflammatory process and the magnitude of neurogenic and psychogenic components should be borne in mind for optimal pain control.

Analysis of reasons for failed surgery treatment in patients with back pain

Fifty-three patients followed up for back pain and operated on are analyzed. The failed back surgery syndrome was observed in 47% of cases. Surgical results did not depend on the duration of the last exacerbation, the frequency of admissions, the presence of radicular syndrome, the size of intervertebral hernias, and the type of intervention (discectomy or microdiscectomy). Magnetic resonance imaging showed postoperative recurrent hernia in 50% of patients with good surgical results and in 89% of those with its poor results, which suggested that the surgical outcome could be only partially determined by a recurrence. Surgical treatment failures were correlated with the presence of neuropathic pain, anxiety, and depression. The detection of the neuropathic and psychogenic components of pain syndrome and the use of combination therapy with antidepressants and anticonvulsants for back pain will reduce the number of surgical interventions and improve their results.

Biopsychosocial correlations in patients with chronic oro‐facial pain. Part II. Experiences of pain and dramatic events before the 16th year of life

Before the sixteenth year of life, biopsychosocial influences such as self-experienced and observed accidents/illnesses, adverse medical/dental treatments, dangerous events and self-experienced or observed force seem to affect the manifestation of chronic pain in the oro-facial area in the forms of temporomandibular disorder (TMD) and psychogenic denture-intolerance (PDI)/somatoform oro-facial pain (SOP). We evaluated the occurrence of these types of events before the age of 16 years in 50 TMD patients, 55 PDI/SOP patients and 55 randomly selected pain-free control group (CG) using the medical questionnaire 'Physical well-being and traumatic experiences (PTE). A separate dental questionnaire determined the effects of previous experiences of pain or force on the emotional self-assessment of the patients (pain localization and body feeling). The TMD group was significantly more likely to have experienced an accident and an illness before the age of 16 years than were the other two groups (PDI/SOP and CG) (P < 0.039). Temporomandibular disorder and PDI/SOP patients suffered frequent backaches significantly more than CG patients (P < 0.028). The PDI/SOP patients were least likely to report having felt threatened before or after the age of 16 years (P < 0.003) compared with the PDI/SOP and CG group. Sociodemographic parameters, experiencing an accident, previous medical incidents, experiences of force and emotional self-assessment influence the biopsychosocial dynamics that directly influence oro-facial symptoms with psychogenic components. Similar to medical history, age seems to play a decisive role in the manifestation of oro-facial psychic symptoms.

A Rational Combination Pharmacotherapy in Men with Erectile Dysfunction who Initially Failed to Oral Sildenafil Citrate Alone: A Pilot Study

Erectile dysfunction (ED) is a complex condition wherein men with minimal organic ED may develop a variable degree of psychogenic component sufficient to reduce the efficacy of medical management. A combination of trazodone with sildenafil has been used to overcome both organic as well as psychogenic components, thus improving the results of medical management. To evaluate the efficacy of combination of trazodone with sildenafil citrate in treatment of ED in men with initial failure to sildenafil citrate alone. The symptoms of ED were evaluated using the Erectile Dysfunction Intensity Scale (EDIS) before and after the treatment. Eighteen men with ED who initially failed to respond to sildenafil citrate alone were enrolled in the study between February 2004 and December 2004. All these men were given a priming dose of trazodone for a 2-week period before giving them sildenafil citrate. Of the 18 men, 12 responded favorably to the above treatment and continued to enjoy good sexual activity while on trazodone and sildenafil. The score on EDIS improved considerably in 12 (66.7%) men, marginally in two (11.1%) men, and did not improve at all in four (22.2%) men. Priming the patients with trazodone appears to be a reasonably good alternative in patients who have initial failure to oral sildenafil citrate and have been found to have no organic cause of ED. However, large double-blind studies are required to potentiate this hypothesis.

Retarded ejaculation

Retarded ejaculation (RE) has a relatively low prevalence (<3%), yet this condition results in considerable distress, anxiety, and lack of sexual confidence for those suffering from it. Furthermore, men with partners often experience impairment of both the sexual and nonsexual aspects of their relationships, with such negative effects compounded when procreation is a consideration. The definition of RE is ambiguous, due to the variability and paucity of data regarding normal coital ejaculatory latency. RE is influenced by both biogenic and psychogenic components, which may vary over time both between and within individuals. While specific pathophysiology can often be identified, further elucidation of the biogenic components of this dysfunction will require greater understanding of the physiological mechanisms underlying ejaculation. Yet, the most useful strategies for understanding RE will integrate rather than isolate the various biogenic and psychogenic aspects of this dysfunction. Evidence based evaluation and treatment protocols for this disorder are lower than for other sexual dysfunctions, but reports suggest better treatment efficacy when the etiology is predominantly psychogenic. As with erectile dysfunction (ED) and premature ejaculation (PE), if safe and efficacious oral pharmaceuticals are eventually developed for this condition, the treatment algorithm is likely to undergo significant alteration. Even then, however, the most effective treatments are likely to result from a combination treatment that integrates sex coaching with pharmacotherapy.

Phosphodiesterase 5 Inhibitors in the Treatment of Erectile Dysfunction

Erectile dysfunction (ED) has multifactor pathogenesis, with neurological, vascular, endocrinological and psychogenic components described. However, about 50-85% of ED population report the presence of one or more comorbidities i.e. hypertension, diabetes, cardiovascular disease, dyslipidemia which all impair endothelial function and, erection is a basically vascular event that necessitates an intact endothelium to occur. Hence, ED may be mostly considered as the clinical manifestation of a disease affecting penile circulation as a part of a generalized vascular disorder due to atherosclerosis. Orally active drugs, i.e. phosphodiesterase type-5 inhibitors (PDE5-i), are a group of on-demand drugs licensed for ED treatment and appear to offer advantages over past therapies in terms of ease of administration and cost, and they are now widely advocated as first-line therapy. The recent discovery that chronic not on-demand administration of these drugs may improve erectile and endothelial response in men previously unresponding to on-demand regimes, opens a new scenario in the treatment of men with ED and comorbidities. Finally, the recent approval of PDE5-i sildenafil for the treatment of pulmonary arterial hypertension represents the new challenge for these class of drugs. Aim of this article will be to provide an update on the pathophysiology of ED and how to use of different available PDE5-i in approaching sexual dysfunctional men, pointing out on their characteristic of efficacy and safety and different indications in special sub-populations.

ORIGINAL RESEARCH—PSYCHOLOGY: A New Evaluation Concept and Its Measurement: “Male Sexual Anticipating Cognitions”

ABSTRACT Context The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. Objective This conclusion led us to develop a French self-administered instrument, based on patients’ subjective sexual experiences, to evaluate “male sexual anticipating cognitions,” using Apter's reversal theory as a framework. Design, Setting, and Patients We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Results Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.

Testosterone Cannot Activate an Adult-Like Stress Response in Prepubertal Male Rats

The pubertal maturation of the hypothalamic-pituitary-adrenal (HPA) axis has received relatively little experimental attention. The present set of experiments sought to extend our understanding of the pubertal stress response by measuring corticotropin (ACTH), corticosterone, and testosterone levels in prepubertal and adult male rats exposed to a single 30-min session of restraint stress. We show that ACTH and corticosterone levels in prepubertal males take significantly longer to return to baseline after termination of the stressor compared to adults. These data indicate that prepubertal males demonstrate a more prolonged stress response compared to adults after a single acute stressor with both psychogenic and neurogenic components. As testosterone has been shown to reduce the stress response in adulthood, we next investigated whether the relatively low levels of circulating testosterone in prepubertal males mediated their protracted stress response. Data collected from additional experiments revealed that prepubertal males treated with adult-like physiological levels of testosterone still exhibited an extended stress response compared to similarly treated adults. These results indicate that the stress response demonstrated by adult males cannot be mimicked or activated in prepubertal males by mere supplementation of testosterone. Thus, we conclude that the HPA neuroendocrine axis is further shaped during pubertal development to allow for the emergence of a more tightly regulated stress response in adulthood.