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Cortisol levels, which are elevated during acute hospitalization for most individuals after severe TBI, can influence cognition, but this association has not been studied previously in TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We hypothesized that serum and cerebral spinal fluid (CSF) cortisol trajectories over days 0\u20135 post-injury are associated with cognition 6-month post-injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined 94 participants with severe TBI, collected acute serum and\/or CSF samples over days 0\u20135 post-injury, and compared cortisol levels to those in 17 healthy controls. N = 88 participants had serum, and n = 84 had CSF samples available for cortisol measurement and had neuropsychological testing 6 months post-injury. Group based trajectory analysis (TRAJ) was used to generate temporal serum and CSF cortisol profiles which were examined for associations with neuropsychological performance. We used linear regression to examine relationships between cortisol TRAJ groups and both overall and domain-specific cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TRAJ analysis identified a\n                      <jats:italic toggle=\"yes\">high<\/jats:italic>\n                      group and a\n                      <jats:italic toggle=\"yes\">decliner<\/jats:italic>\n                      group for serum and a\n                      <jats:italic toggle=\"yes\">high<\/jats:italic>\n                      group and\n                      <jats:italic toggle=\"yes\">low<\/jats:italic>\n                      group for CSF cortisol. Multivariable analysis showed serum cortisol TRAJ group was associated with overall cognitive composites scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .024) and with executive function (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .039) and verbal fluency (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .029) domain scores. CSF cortisol TRAJ group was associated with overall cognitive composite scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .021) and domain scores for executive function (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .041), verbal fluency (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .031), and attention (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High acute cortisol trajectories are associated with poorer cognition 6 months post-TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683211048771","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T04:11:01Z","timestamp":1634962261000},"page":"1088-1099","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Acute Cortisol Profile Associations With Cognitive Impairment After Severe Traumatic Brain Injury"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-0383","authenticated-orcid":false,"given":"David J.","family":"Barton","sequence":"first","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj G.","family":"Kumar","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria A.","family":"Schuster","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon B.","family":"Juengst","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern"},{"name":"University of Texas Southwestern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9353-7541","authenticated-orcid":false,"given":"Byung-Mo","family":"Oh","sequence":"additional","affiliation":[{"name":"Seoul National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3245-6523","authenticated-orcid":false,"given":"Amy K.","family":"Wagner","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,23]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70164-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2014.09.003"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21876"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968315586465"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2012.2578"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2010.1586"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2007.106.4.538"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199103000-00001"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000056"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.3177"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2006.11.006"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-13639-8"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2011.01.028"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.6.4763"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5427-y"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-016-0663-y"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4705-12.2013"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2017.00044"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1681.2003.03867.x"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/endo.142.6.8213"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.4.10.1245"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000199"},{"key":"e_1_3_4_24_2","volume-title":"D-KEFS: Examiners Manual","author":"Delis D","year":"2001","unstructured":"Delis D, Kaplan E, Kramer JH. 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