EVALUATION OF HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL HORMONES AND INFLAMMATORY CYTOKINES IN PATIENTS WITH PERSISTENT VEGETATIVE STATE

Hypothalamic-pituitary-adrenocortical hormones, i.e. prolactin (PRL), human growth hormone (hGH), thyroid stimulating hormone (TSH), and Cor tisol and plasma levels of cytokines, i.e. tumor necrosis factor-alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), and interleukin-6 (IL-6) , were assessed in 27 patients with persistent vegetative state (PVS) and in 16 outcome patients. In comparison with normal parameters, plas ma levels of TSH were not significantly altered, while elevated basal hGH concentrations in 48.1% of PVS subjects and depressed cortisol lev els in all PVS individuals and in patients who emerged from coma (outc ome patients), respectively, were observed. In addition, higher TNF-cl plasma levels in PVS subjects than in outcome patients and in healthy donors were found, while IL-1 beta plasma levels were elevated in bot h groups of patients in comparison with healthy controls. Of interest, in 55 % PVS male patients hyperprolactinemia was observed, whereas in outcome patients more than six months these values were within normal range. In four patients, who emerged from coma in the course of this study, prolactin plasma levels were followed-up and increased basal va lues progressively fell to normal range within six months.