ABSTRACT

Background: Cortisol is a crucial hormone for adaptation to challenging and stressful situations. Hair cortisol measurement is used to determine chronic stress; the growth rate of hair allows to determine averaged cortisol levels for a longer period. Objective: Pre- and post-injury measures of hair cortisol were compared in patients with mild traumatic brain injury (mTBI), and related to their coping styles.

Methods: For 46 patients with mTBI, 3 cm scalp hair samples were collected 4–6 weeks post-injury, resulting in two 1 cm segments, pre- and post-injury. Hair samples were also collected for 11 healthy controls. Hair cortisol was quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Complaints, anxiety, depression and coping style were measured two weeks post-injury and long term (six-twelve months), added with measures for post-traumatic stress and functional outcome.

Results: There were no differences between patients’ pre- and post-injury cortisol levels, nor between cortisol levels of patients and controls. However, pre- and post-injury cortisol levels of patients were negatively correlated with both passive and an avoidant coping style.

Conclusions: Our findings suggest that mTBI has no separate impact on chronic long-term cortisol levels, possibility indicating that variability in cortisol levels reflects individuals’ premorbid characteristics determining coping with stress in general.

摘要

背景：皮质醇是适应具有挑战性和压力的情况的关键激素。头发皮质醇测量用于确定慢性压力；头发的生长速度可以确定更长时间的平均皮质醇水平。目的：比较轻度创伤性脑损伤 (mTBI) 患者的头发皮质醇损伤前后的测量值，并与他们的应对方式相关。

方法：对于 46 名 mTBI 患者，在受伤后 4-6 周收集了 3 cm 的头皮毛发样本，产生了受伤前和受伤后两个 1 cm 段。还收集了 11 名健康对照的头发样本。使用液相色谱-串联质谱法 (LC-MS/MS) 对头发皮质醇进行定量。投诉、焦虑、抑郁和应对方式在受伤后两周和长期（6-12 个月）进行测量，并增加了对创伤后压力和功能结果的测量。

结果：患者受伤前和受伤后的皮质醇水平没有差异，患者和对照组的皮质醇水平也没有差异。然而，患者受伤前和受伤后的皮质醇水平与被动和回避应对方式均呈负相关。

结论：我们的研究结果表明，mTBI 对慢性长期皮质醇水平没有单独的影响，可能表明皮质醇水平的变异性反映了个体在总体上决定应对压力的病前特征。