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Pre-traumatic conditions can influence cortisol levels before and after a brain injury
Sodra Alvsborg Hosp, Sweden; Uddevalla Cent Hosp, Sweden; Univ Gothenburg, Sweden.
Sahlgrens Univ Hosp, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.ORCID iD: 0000-0003-0756-7723
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
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2020 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 141, no 4, p. 342-350Article in journal (Refereed) Published
Abstract [en]

Objective Satisfactory anabolic reactions, including the activation of the hypothalamic-pituitary-adrenal (HPA) axis, are essential following severe traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (SAH). Many factors may influence this activation. This study aimed to investigate whether individuals who reported chronic diseases, psychosocial afflictions, or stressful events before a severe brain injury display a different pattern regarding cortisol levels retrospectively and up to three months compared with those who did not report stressful experiences. Materials and Methods Fifty-five patients aged 16-68 years who were admitted to the neurointensive care unit (NICU) were included. Hair cortisol measurements offer a unique opportunity to monitor cortisol levels retrospectively and after the trauma. Hair strands were collected as soon as possible after admission to the NICU and every month until three months after the injury/insult. The participants/relatives were asked about stressful events, psychosocial afflictions and recent and chronic diseases. Results The group who reported chronic diseases and/or stressful events before the brain injury had more than twice as high median hair cortisol levels before the brain injury compared with those who did not report stress, but the difference was not statistically significant (P = .12). Those who reported stress before the brain injury had statistically significantly lower hair cortisol values after the brain injury and they remained until three months after the injury. Conclusions Stressful events and/or chronic disease before brain injury might affect mobilization of adequate stress reactions following the trauma. However, the large variability in cortisol levels in these patients does not allow firm conclusions and more studies are needed.

Place, publisher, year, edition, pages
WILEY , 2020. Vol. 141, no 4, p. 342-350
Keywords [en]
hair cortisol; pretraumatic conditions; severe brain injury; stress
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-163399DOI: 10.1111/ane.13212ISI: 000506255100001PubMedID: 31879940OAI: oai:DiVA.org:liu-163399DiVA, id: diva2:1391410
Note

Funding Agencies|Health and Medical Care Committee of Region Vastra Gotaland; Department of Research and Development-NU Hospital Organization, Region Vastra Gotaland; Department of Research Sodra Alvsborg Hospital; Sodra Alvsborg Research Council, Region Vastra Gotaland, Sweden

Available from: 2020-02-04 Created: 2020-02-04 Last updated: 2021-04-20

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Theodorsson, Elvar
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Division of Clinical ChemistryFaculty of Medicine and Health SciencesDepartment of Clinical Chemistry
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