UNRELIABILITY OF TRH TEST BUT NOT DEXAMETHASONE SUPPRESSION TEST AS AMARKER OF DEPRESSION IN CHRONIC VASCULOPATHIC PATIENTS

Thirteen vasculopathic nondepressed men, admitted to the hospital 2 we eks earlier because of stroke, 10 age- and weight-matched patients wit h major depression, and 10 age- and weight-matched normal controls wer e tested with TRH and on different occasion with the dexamethasone (DE X) suppression test (DST). Patients with stroke were tested again with TRH and DST after 1 year. All subjects were euthyroid. A blunted TSH response to TRH was observed in 77% of vasculopathic patients, 64% of depressed patients, and 27% of controls. Some depressed patients showe d serum GH or cortisol increments in response to TRH. Nonsuppression t o DEX was observed in 45% of depressed patients and 15% of vasculopath ics but not in normal controls. These data indicate that, in contrast to cortisol nonsuppression to DEX, blunted TSH response to TRH has poo r diagnostic value as a marker for depression after stroke and may mer ely represent the expression of neuroendocrine dysfunction associated with cerebral vasculopathy.