Abnormal diurnal pattern of cortisol secretion in patients after aneurysmal subarachnoid hemorrhage

Shin, Il Young; Joo, Hye Myung; Chung, Yong Gu; Kim, Min S.; Park, Jung W.; Ahn, Ryun Sup

doi:10.3109/10253890.2010.522630

Cited by 6 publications

(3 citation statements)

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“…Subarachnoid haemorrhage severity was measured using the Hunt–Hess score, the Fisher score or the Glasgow Coma Scale score. Of the four studies involving only participants with an SAH, one ( n = 51) found a small correlation between higher morning cortisol levels and Glasgow Coma Scale [22], one ( n = 60) found a correlation between higher cortisol and the Fisher scale [51], one ( n = 25) found a negative correlation between cortisol concentrations and the Fisher CT grade [52], and one ( n = 30) found no correlation between urinary cortisol and the Hunt-Hess score [53].…”

Section: Associations Between Cortisol and Stroke Severitymentioning

confidence: 99%

Cortisol levels and the severity and outcomes of acute stroke: a systematic review

et al. 2014

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Studies in non-stroke patients have shown an association between dysregulation of the hypothalamic-pituitary-adrenal axis and morbidity and mortality. We conducted a systematic review to evaluate cortisol levels in acute stroke and their associations with outcome. We searched MEDLINE and EMBASE for articles up to April 2013 and PsychINFO for articles up to July 2013, using the keywords "cortisol" and "stroke" and associated terms or synonyms. We included studies published in peer-reviewed journals that recruited 10 or more participants and measured cortisol at least once in the first year following stroke. Data were extracted regarding cortisol levels, including changes over time and their relationship to stroke severity, and outcome. Of 11,240 abstracts, 101 full texts were obtained and 48 fulfilled our inclusion criteria. Cortisol levels were high in the first week after stroke in the majority of studies (26 studies, n = 1,340). HigherCorrespondence to: Amanda Jayne Barugh. a.j.barugh@sms.ed.ac.uk. Conflicts of interestOn behalf of all authors, the corresponding author states that there are no conflicts of interest. Ethical standard This manuscript does not contain new clinical studies or patient data. Europe PMC Funders GroupAuthor Manuscript J Neurol. Author manuscript; available in PMC 2016 June 30. Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts cortisol was associated with dependency (8/11 studies, n = 822), delirium (5/6 studies, n = 269) depression (3/5 studies n = 117) and mortality (8/10 studies, n = 856). Five studies adjusted for stroke severity; one found an association between higher cortisol and dependency, and three found an association between higher cortisol and mortality. Cortisol levels are high for at least 7 days after stroke. Elevated cortisol after stroke is associated with dependency, morbidity, and mortality; however, there is insufficient evidence to conclude that these relationships are independent of stroke severity.

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Section: Associations Between Cortisol and Stroke Severitymentioning

confidence: 99%

Cortisol levels and the severity and outcomes of acute stroke: a systematic review

et al. 2014

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“…A insuficiência adrenal secundária leva à atrofia da adrenal e também à redução da expressão dos receptores de ACTH na glândula adrenal. [44][45][46] O teste com 250 μgr de cosintrofina pode ser usado para estabelecer insuficiência adrenal secundária na qual o pico de cortisol não pode ultrapassar o nível de 500 nmol/L. A dose do teste de cosintrofina é controversa.…”

Section: Diagnóstico Clínico E Laboratorial De Hipopituitarismounclassified

Alterações endocrinológicas após hemorragia subaracnóidea

Ferreira

Moreira²,

Worm

2015

Arq Bras Neurocir

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). Palavras-Chave ResumoA avaliação da função hipofisária na fase aguda ou tardia dos pacientes que sofrem hemorragia subaracnóidea (HSA) é infrequente; entretanto, a HSA apresenta um risco significante de disfunção pituitária, principalmente devido à vulnerabilidade da sua suplência vascular. Há poucos estudos tratando do tema, mas os existentes sugerem que distúrbios hormonais pós-hemorragia subaracnóidea são mais prevalentes do que inicialmente se suspeitava. Não somente a hipófise anterior parece estar envolvida nessas alterações; a hiponatremia no estágio agudo pode ser uma manifestação de disfunção da hipófise posterior. As alterações hormonais após HSA ainda recebem pouca atenção das equipes assistenciais, podendo ser uma das complicações potencialmente graves sendo tratável quando há suspeição pelo diagnóstico clínico e laboratorial. Keywords ► brain aneurism AbstractThe evaluation of pituitary function in the acute and at late time in the patients with subarachnoid hemorrhage (SAH) is unusual. Meanwhile the SAH present with a high risc of pituitary disfunction primarily by the vulnerability of the vascular feeding vessels. Few studies about this subject suggest that hormonal disturbance are more prevalent that were suspected before. Both the anterior and posterior pituitary are involved. The hormonal changes after SAH are not well recognized by the physicians and can be treated even been a critical medical situation with clinical and laboratorial findings.

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“…Besides the anxiety of a next stroke, one explanation for the persistently impaired psychological functioning in aSAH survivors might be the possibility of a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA) after aSAH [11], with cortisol as main outcome marker. While a downregulation of the adrenocorticotropic hormone (ACTH), the precursor of cortisol, has been repeatedly shown, findings on the cortisol levels are less consistent.…”

Section: Introductionmentioning

confidence: 99%

In Individuals Following Aneurysmal Subarachnoid Haemorrhage, Hair Cortisol Concentrations Are Higher and More Strongly Associated with Psychological Functioning and Sleep Complaints than in Healthy Controls

Colledge

Brand²,

Zimmerer³

et al. 2017

Neuropsychobiology

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Background: Following an aneurysmal subarachnoid haemorrhage (aSAH), many patients report persistent deficits in psychological functioning, characterised by high levels of stress and symptoms of depression, low life satisfaction, along with poor sleep. Such deficits have been associated with altered saliva and serum cortisol levels due to a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA). However, hair cortisol concentrations (HCCs) have not been assessed in this population, although this method allows a long-term insight into cortisol values. Therefore, the objective of this study was to compare HCCs in aSAH patients and healthy controls and to examine how HCCs are associated with perceived stress, psychological functioning, and sleep complaints. Methods: In this cross-sectional study, data on depressive symptoms, hypochondriacal beliefs, life satisfaction, and sleep complaints were gathered in 15 aSAH patients and 17 healthy controls. HCCs of the previous 3 months were assessed. Results: aSAH patients had significantly higher HCCs than healthy controls. In aSAH patients, higher HCCs were significantly associated with increased depressive symptoms, hypochondriacal beliefs, lower life satisfaction, and increased sleep complaints. Such significant associations were not found in healthy controls. Conclusions: Our findings indicate that a dysregulation of HPA-AA is associated with some of the long-term impairments in psychological functioning and sleep in aSAH survivors. While the direction of association remained unclear, a dysregulated HPA-AA may be causally linked with the maintenance of poor psychological functioning and poor sleep. The overall findings should be considered in the planning of long-term treatment aimed at improving psychological functioning and sleep in aSAH patients.

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Abnormal diurnal pattern of cortisol secretion in patients after aneurysmal subarachnoid hemorrhage

Cited by 6 publications

References 58 publications

Cortisol levels and the severity and outcomes of acute stroke: a systematic review

Cortisol levels and the severity and outcomes of acute stroke: a systematic review

Alterações endocrinológicas após hemorragia subaracnóidea

In Individuals Following Aneurysmal Subarachnoid Haemorrhage, Hair Cortisol Concentrations Are Higher and More Strongly Associated with Psychological Functioning and Sleep Complaints than in Healthy Controls

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