{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:55:06Z","timestamp":1779911706336,"version":"3.53.1"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,8,14]],"date-time":"2012-08-14T00:00:00Z","timestamp":1344902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Child abuse and other early\u2010life environmental stressors are known to affect the hypothalamic\u2013pituitary\u2013adrenal axis. We sought to compare synacthen\u2010stimulated cortisol responses in children who suffered inflicted or accidental traumatic brain injury (<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with a history of early\u2010childhood <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> were recruited from the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tarship <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hildren's <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital database (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>uckland, <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ealand, 1992\u20132010). All underwent a low\u2010dose <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content><jats:sub>1\u201324<\/jats:sub> (synacthen 1\u00a0\u03bcg <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) test, and serum cortisol response was compared between inflicted (<jats:styled-content style=\"fixed-case\">TBI<jats:sub>I<\/jats:sub><\/jats:styled-content>) and accidental (<jats:styled-content style=\"fixed-case\">TBI<jats:sub>A<\/jats:sub><\/jats:styled-content>) groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We assessed 64 children with <jats:styled-content style=\"fixed-case\">TBI<jats:sub>I<\/jats:sub><\/jats:styled-content> and 134 with <jats:styled-content style=\"fixed-case\">TBI<jats:sub>A<\/jats:sub><\/jats:styled-content>. Boys were more likely than girls to suffer accidental (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;\u00a00\u00b7001), but not inflicted <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">TBI<jats:sub>I<\/jats:sub><\/jats:styled-content> children displayed a 14% reduction in peak stimulated cortisol in comparison with the <jats:styled-content style=\"fixed-case\">TBI<jats:sub>A<\/jats:sub><\/jats:styled-content> group (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;\u00a00\u00b7001), as well as reduced cortisol responses at\u00a0+\u00a030 (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;\u00a00\u00b701) and\u00a0+\u00a060\u00a0min (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;\u00a00\u00b7001). Importantly, these differences were not associated with severity of injury. The odds ratio of <jats:styled-content style=\"fixed-case\">TBI<jats:sub>I<\/jats:sub><\/jats:styled-content> children having a mother who suffered domestic violence during pregnancy was 6\u00b72 times that of the <jats:styled-content style=\"fixed-case\">TBI<jats:sub>A<\/jats:sub><\/jats:styled-content> group (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0&lt;\u00a00\u00b7001). However, reported domestic violence during pregnancy or placement of child in foster care did not appear to affect cortisol responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Synacthen\u2010stimulated cortisol response is attenuated following inflicted TBI in early childhood. This may reflect chronic exposure to environmental stress as opposed to pituitary injury or early\u2010life programming.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2265.2012.04376.x","type":"journal-article","created":{"date-parts":[[2012,2,28]],"date-time":"2012-02-28T18:12:11Z","timestamp":1330452731000},"page":"357-362","source":"Crossref","is-referenced-by-count":5,"title":["Cortisol response to synacthen stimulation is attenuated following abusive head trauma"],"prefix":"10.1111","volume":"77","author":[{"given":"Natasha L.","family":"Heather","sequence":"first","affiliation":[{"name":"Liggins Institute University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 G. 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