The Role of Growth Hormone in Depression: A Human Model

Mubarak Algahtany; Shubham Sharma; Khalid Fahoum; Rowan Jing; Stanley Zhang; Kalman Kovacs; Fabio Rotondo; John Lee; Irene Vanek; Michael D Cusimano

doi:10.3389/fnins.2021.661819

The Role of Growth Hormone in Depression: A Human Model

Front Neurosci. 2021 Jun 24:15:661819. doi: 10.3389/fnins.2021.661819. eCollection 2021.

Authors

Mubarak Algahtany¹, Shubham Sharma^{2

3}, Khalid Fahoum^{2

4}, Rowan Jing^{2

5}, Stanley Zhang², Kalman Kovacs⁶, Fabio Rotondo⁶, John Lee⁷, Irene Vanek⁸, Michael D Cusimano^{2

8}

Affiliations

¹ Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
² Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.
³ Faculty of Medicine, Queen's University, Kingston, ON, Canada.
⁴ Weil Cornell Medicine, New York, NY, United States.
⁵ Indicator Research and Development Department, Canadian Institute for Health Information, Toronto, ON, Canada.
⁶ Department of Laboratory Medicine and Pathobiology, St. Michael Hospital, University of Toronto, Toronto, ON, Canada.
⁷ Division of Head and Neck Surgery, Department of Surgery, St. Michael Hospital, University of Toronto, Toronto, ON, Canada.
⁸ Division of Neurosurgery, Department of Surgery, St. Michael Hospital, University of Toronto, Toronto, ON, Canada.

Abstract

Background: Although the relationship between acromegaly and depression has been ascribed to the effects of chronic disease, the role of growth hormone (GH), and insulin like growth factor-1 (IGF-1) is not clear.

Objective: To determine whether related hormones levels in acromegalics are correlated with depressive symptoms and whether these symptoms are ameliorated following surgery.

Materials and methods: A prospective cohort study was conducted on patients diagnosed with acromegaly (n = 15) or non-functioning pituitary adenomas (NFPA; n = 20, as controls) and undergoing first-time surgery, who completed the Center for Epidemiological Studies Depression (CES-D) questionnaire both pre-surgery and post-surgery. The primary outcome was the patient's severity of depression symptomatology using the CES-D score; GH, IGF-1 levels, and tumor characteristics were also measured.

Results: Hormone levels (GH and IGF-1) and depression scores in acromegaly patients showed significant reductions following surgery (p < 0.05). The average change in CES-D score was 5.73 ± 2.58 (mean ± SE). A moderate correlation was found between GH levels and CES-D scores (r = 0.52, p < 0.01). The depressed affect subscale accounted for the most improvement in CES-D scores postoperatively and correlated most highly with GH levels. We did not find similar declines in the matched cohort of NFPA patients.

Conclusion and relevance: Surgical resection of the pituitary tumor in acromegaly patients leads to reduction in GH levels that is correlated with reduction in CES-D scores. The results suggest a role for GH in depression and provide a stronger foundation on which to build the hypothesis that GH impacts affect. The study also suggests that hormones should be factored into the matrix that entails the neuro-biological underpinnings of depressive disorders. Future work could explore the mechanisms involved, further brain and neuropeptide interactions, and, novel potential therapeutic targets in depressive and other mental health disorders.

Keywords: acromegaly; brain; depression; growth hormone; human; neuropeptides; transsphenoidal surgery.