Model System:

TBI

Reference Type:

Journal

Accession No.:

J73540

Journal:


Journal of Neurotrauma

Year, Volume, Issue, Page(s):

, 31, 8, 699-712

Publication Website:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967414/

Abstract:

Study evaluated cerebrospinal fluid (CSF) progesterone and cortisol levels over the first week after severe traumatic brain injury (TBI), examined the relationships between CSF and serum profiles, and assessed the utility of these hormones as predictors of long-term outcomes. One hundred thirty adults with severe TBI were evaluated. Serum samples and CSF samples were collected for 6 days post-injury, analyzed for cortisol and progesterone, and compared with 13 healthy controls. Hormone data were linked with clinical data, including Glasgow Outcome Scale scores at 6 and 12 months. Group based trajectory analysis was used to develop temporal hormone profiles delineating distinct subpopulations. Compared with controls, CSF cortisol levels were significantly and persistently elevated during the first week after TBI, and high CSF cortisol levels were associated with poor outcome. As a precursor to cortisol, progesterone mediated these effects. Serum and CSF levels for both cortisol and progesterone were strongly correlated after TBI relative to controls, possibly because of blood–brain barrier disruption. After the first few days post-injury, CSF progesterone levels declined to normal levels whereas cortisol levels remained elevated, possibly because of the different transport mechanisms that regulate cortisol and progesterone levels in the brain. These findings, when taken together, may help shed light on why corticosteroid trials have previously failed and why progesterone treatment after TBI may be beneficial.

Author(s):


Santarsieri, Martina, Niyonkuru, Christian, McCullough, Emily H., Dobbs, Julie A., Dixon, C. Edward, Berga, Sarah L., Wagner, Amy K.

Participating Centers: