ArticleJournal of neurotrauma2014
Cerebrospinal fluid cortisol and progesterone profiles and outcomes prognostication after severe traumatic brain injury.
Article in Journal of neurotrauma, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Effect of progesterone administration on the prognosis of patients with severe traumatic brain injury: a meta-analysis of randomized clinical trials.Drug design, development and therapy · 2019Pooled it
- Neurofilament Light Protein: A Marker for Injury Severity, Clinical Course, and Outcome Following Moderate to Severe Traumatic Brain Injury.Neurocritical care · 2026Article
- Brain-bone Crosstalk after Neurotrauma: Dual Effects of Traumatic Brain Injury on Skeletal Remodeling.Current osteoporosis reports · 2026Review
- Differential sex-dependent responses of circulating steroid hormones and cortical gene expression in a preclinical traumatic brain injury model.bioRxiv : the preprint server for biology · 2026Article
- Effects of Subanesthetic Intravenous Ketamine Infusion on Stress Hormones and Synaptic Density in Rats with Mild Closed-Head Injury.Biomedicines · 2025Article
- Neuroprotection strategies in traumatic brain injury: Studying the effectiveness of different clinical approaches.Surgical neurology international · 2024Review
- Blood leukocyte-based clusters in patients with traumatic brain injury.Frontiers in immunology · 2024Article
- The role of the stress system in recovery after traumatic brain injury: A tribute to Bruce S. McEwen.Neurobiology of stress · 2022Article
- Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care.TouchREVIEWS in endocrinology · 2022Article
- Association between perceived distress and salivary cortisol in veterans with mTBI.Comprehensive psychoneuroendocrinology · 2022Article
- The change of serum and CSF BDNF level as a prognosis predictor in traumatic brain injury cases: A systematic review.Surgical neurology international · 2022Article
- Acute Cortisol Profile Associations With Cognitive Impairment After Severe Traumatic Brain Injury.Neurorehabilitation and neural repair · 2021Article
- Treelet transform analysis to identify clusters of systemic inflammatory variance in a population with moderate-to-severe traumatic brain injury.Brain, behavior, and immunity · 2021Article
- Early chronic systemic inflammation and associations with cognitive performance after moderate to severe TBI.Brain, behavior, & immunity - health · 2021Article
- Novel Synthetic and Natural Therapies for Traumatic Brain Injury.Current neuropharmacology · 2021Review
- Progesterone Receptor Expression and Score Differences in Determining Grade and Subtype of Meningioma.Journal of neurosciences in rural practice · 2020Article
- Anti-Pituitary and Anti-Hypothalamus Autoantibody Associations with Inflammation and Persistent Hypogonadotropic Hypogonadism in Men with Traumatic Brain Injury.Journal of neurotrauma · 2020Observational
- Weak correlations between serum and cerebrospinal fluid levels of estradiol, progesterone and testosterone in males.BMC neuroscience · 2019Article
- Making sense of gut feelings in the traumatic brain injury pathogenesis.Neuroscience and biobehavioral reviews · 2019Review
- Neuroendocrine Whiplash: Slamming the Breaks on Anabolic-Androgenic Steroids Following Repetitive Mild Traumatic Brain Injury in Rats May Worsen Outcomes.Frontiers in neurology · 2019Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
Despite significant advances in the management of head trauma, there remains a lack of pharmacological treatment options for traumatic brain injury (TBI). While progesterone clinical trials have shown promise, corticosteroid trials have failed. The purpose of this study was to (1) characterize endogenous cerebrospinal fluid (CSF) progesterone and cortisol levels after TBI, (2) determine relationships between CSF and serum profiles, and (3) assess the utility of these hormones as predictors of long-term outcomes. We evaluated 130 adults with severe TBI. Serum samples (n=538) and CSF samples (n=746) were collected for 6 days post-injury, analyzed for cortisol and progesterone, and compared with healthy controls (n=13). Hormone data were linked with clinical data, including Glasgow Outcome Scale (GOS) scores at 6 and 12 months. Group based trajectory (TRAJ) 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. Also, differentially impaired hormone transport and metabolism mechanisms after TBI, potential de novo synthesis of steroids within the brain, and the complex interplay of cortisol and pro-inflammatory cytokines may explain these acute hormone profiles and, when taken together, may help shed light on why corticosteroid trials have previously failed and why progesterone treatment after TBI may be beneficial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.