TY - JOUR
T1 - High hair cortisol concentrations predict worse cognitive outcome after stroke
T2 - Results from the TABASCO prospective cohort study
AU - Ben Assayag, E.
AU - Tene, O.
AU - Korczyn, A. D.
AU - Shopin, L.
AU - Auriel, E.
AU - Molad, J.
AU - Hallevi, H.
AU - Kirschbaum, C.
AU - Bornstein, N. M.
AU - Shenhar-Tsarfaty, S.
AU - Kliper, E.
AU - Stalder, T.
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/8
Y1 - 2017/8
N2 - Background and purpose The role of stress-related endocrine dysregulation in the development of cognitive changes following a stroke needs further elucidation. We explored this issue in a longitudinal study on stroke survivors using hair cortisol concentrations (HCC), a measure of integrated long-term cortisol levels. Methods Participants were consecutive cognitively intact first-ever mild-moderate ischemic stroke/transient ischemic attack (TIA) survivors from the Tel Aviv Brain Acute Stroke Cohort (TABASCO) study. They underwent 3T magnetic resonance imaging (MRI) scanning and were cognitively assessed at admission, and at 6, 12 and 24 months post-stroke. Scalp hair samples were obtained during the initial hospitalization. Results Full data on baseline HCC, MRI scans and 2 years neuropsychological assessments were available for 65 patients. Higher HCC were significantly associated with a larger lesion volume and with worse cognitive results 6, 12 and 24 months post-stroke on most of the neurocognitive tests. 15.4% of the participants went on to develop clinically significant cognitive decline in the follow-up period, and higher HCC at baseline were found to be a significant risk factor for this decline, after adjustment for age, gender, body mass index and APOE e4 carrier status (HR = 6.553, p = 0.038). Conclusions Our findings suggest that individuals with higher HCC, which probably reflect higher long-term cortisol release, are prone to develop cognitive decline following an acute stroke or TIA.
AB - Background and purpose The role of stress-related endocrine dysregulation in the development of cognitive changes following a stroke needs further elucidation. We explored this issue in a longitudinal study on stroke survivors using hair cortisol concentrations (HCC), a measure of integrated long-term cortisol levels. Methods Participants were consecutive cognitively intact first-ever mild-moderate ischemic stroke/transient ischemic attack (TIA) survivors from the Tel Aviv Brain Acute Stroke Cohort (TABASCO) study. They underwent 3T magnetic resonance imaging (MRI) scanning and were cognitively assessed at admission, and at 6, 12 and 24 months post-stroke. Scalp hair samples were obtained during the initial hospitalization. Results Full data on baseline HCC, MRI scans and 2 years neuropsychological assessments were available for 65 patients. Higher HCC were significantly associated with a larger lesion volume and with worse cognitive results 6, 12 and 24 months post-stroke on most of the neurocognitive tests. 15.4% of the participants went on to develop clinically significant cognitive decline in the follow-up period, and higher HCC at baseline were found to be a significant risk factor for this decline, after adjustment for age, gender, body mass index and APOE e4 carrier status (HR = 6.553, p = 0.038). Conclusions Our findings suggest that individuals with higher HCC, which probably reflect higher long-term cortisol release, are prone to develop cognitive decline following an acute stroke or TIA.
KW - Dementia
KW - Hair cortisol concentrations
KW - Post-stroke cognitive decline
UR - http://www.scopus.com/inward/record.url?scp=85019890199&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2017.05.013
DO - 10.1016/j.psyneuen.2017.05.013
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C2 - 28549269
AN - SCOPUS:85019890199
SN - 0306-4530
VL - 82
SP - 133
EP - 139
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
ER -