ScholarWorks@UNO

Anterior Pituitary Volumes and Stress in Children with Chromosome 22q11.2 Deletion Syndrome (22q11.2DS)

BACKGROUND: Children with 22q11.2DS have high rates of anxiety and 30% will develop a psychotic disorder by adulthood. The physiological effects of long-term stress and dysregulation of the hypothalamic-pituitary-adrenal cortical (HPA) and/or sympathetic adrenal medullary (SAM) systems may contribute to the etiopathology of mental illness in this population. METHODS: Using high-resolution magnetic resonance imaging, we measured anterior pituitary volumes (APV) in children ages 7 to 16 with 22q11.2DS (n= 15) and typically developing controls (n = 20) in relation to psychological and hormonal measures of stress after a stress-induction task. RESULTS: APV did not differ between groups (p>0.05). Children with 22q11.2DS had higher levels of internalizing symptoms (anxiety, depression, somatization) and behavioral indices of stress (tension, restlessness, panic) versus controls and this correlated with smaller anterior pituitary volumes across groups (ps<0.05 corrected). Children with 22q11.2DS had higher levels of HPA-related cortisol and lower levels of dehydroepiandrosterone (DHEA) than controls but groups did not differ on SAM-mediated alpha amylase measures. Higher levels of DHEA was associated with smaller APV. CONCLUSION: Lower cortisol and higher DHEA as seen in the control group is indicative of a positive hormonal stress coping response. Children with 22q11.2DS show the opposite profile with higher cortisol and lower DHEA and elevated psychological indices of stress. This may indicate a dysregulation of the HPA but not the SAM stress response systems in children with 22q11.2DS.