Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2024; 14(10): 1437-1447
Published online Oct 19, 2024. doi: 10.5498/wjp.v14.i10.1437
Psychological stress impact neurotrophic factor levels in patients with androgenetic alopecia and correlated with disease progression
Yi Cheng, Li-Jing Lv, Yu Cui, Xiao-Mei Han, Yan Zhang, Cai-Xia Hu
Yi Cheng, Li-Jing Lv, Yu Cui, Xiao-Mei Han, Yan Zhang, Cai-Xia Hu, Department of Dermatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Hu CX designed the study and acquired and analyzed the experimental data; Cheng Y conducted the statistical analysis and wrote the manuscript; Zhang Y directed the research and designed the experiment; Lv LJ, Cui Y, and Han XM conducted the clinical data collection. All authors have read and approved the final manuscript.
Supported by Precision Medicine Joint Fund Cultivation project of Hebei Province, No. H2021206253.
Institutional review board statement: This study was approved by the Ethics Committee of the Fourth Hospital of Hebei Medical University (No. 2021KY036).
Informed consent statement: This study obtained informed consent forms signed by all patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cai-Xia Hu, MM, Department of Dermatology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang 050000, Hebei Province, China. 48201485@hebmu.edu.cn
Received: July 18, 2024
Revised: August 27, 2024
Accepted: September 6, 2024
Published online: October 19, 2024
Processing time: 91 Days and 0.6 Hours
Abstract
BACKGROUND

Androgenetic alopecia (AGA) is a common form of hair loss that can be influenced by psychological factors.

AIM

To investigate the impact of mental stress on neurotrophic factors in patients with AGA and correlate the findings with the progression of AGA.

METHODS

A total of 120 patients with AGA were analyzed in this study, which were divided into a non-stress group (n = 30) and a stress group (n = 90) on the basis of the presence or absence of psychological stress confirmed by Depression Anxiety Stress Scale-21 scale. The baseline demographic characteristics, serum cortisol levels, hair growth parameters, neurotrophic factors, and AGA progression scores between the non-stress and stress groups were compared. Correlation analyses were conducted to assess the relationships among stress, neurotrophic factors, hair loss progression, and AGA progression.

RESULTS

This study revealed significantly higher cortisol levels throughout the day in the stress group than in the non-stress group. The stress group exhibited lower levels of nerve growth factor, brain-derived neurotrophic factor, and glial cell line-derived neurotrophic factor and higher expression levels of neurotrophin (NT)-3 and NT-4 than the non-stress group. Hair parameters indicated lower hair diameter, decreased hair density, and more severe AGA grading in the stress group, whereas follicle count and terminal/vellus hair ratio showed no significant differences between the two groups. After 1 year of treatment with 5% minoxidil, efficacy was observed to be lower but AGA progression was notably more pronounced in the stress group than in the non-stress group. Disease progression was positively correlated with high stress and NT-4 levels.

CONCLUSION

This study provides compelling evidence of the influence of mental stress on neurotrophic factors and its correlation with the progression of AGA. The findings underscore the need for a comprehensive approach to the management of AGA that considers the physiological and psychosocial aspects. Further research is warranted to validate the findings and explore targeted therapeutic interventions for individuals with stress-related AGA.

Keywords: Mental stress; Neurotrophic factors; Androgenetic alopecia; Progression

Core Tip: This study investigates the impact of mental stress on neurotrophic factors in patients with androgenetic alopecia (AGA) and its correlation with AGA progression. Findings reveal that patients experiencing psychological stress have elevated serum cortisol levels and altered neurotrophic factor profiles, including reduced nerve growth factor, brain-derived neurotrophic factor, and glial cell line-derived neurotrophic factor. The stress group also exhibited more severe AGA progression despite treatment. These results highlight the need for integrated management approaches that address both physiological and psychological aspects of AGA to improve treatment outcomes.