Evidence map›Paper›PMID 40102551›Full record

ArticleScientific reports2025

Hair cortisol as a marker of stress in mild traumatic brain injury: a challenging measure.

Diana Ciubotariu, Koen Visser, Myrthe E de Koning, Jacoba M Spikman, Martijn van Faassen, Jasper Krijnen, Twan Storteboom, Ido P Kema, Joukje van der Naalt, Harm J van der Horn

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In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Diana CiubotariuDepartment of Neurology (In House Postal Code: AB51), University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands.
Koen VisserDepartment of Neurology (In House Postal Code: AB51), University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands.
Myrthe E de KoningDepartment of Neurology, Medical Spectrum Twente, Enschede, The Netherlands.
Jacoba M SpikmanDepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Martijn van FaassenDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jasper KrijnenDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Twan StorteboomDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Ido P KemaDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Joukje van der NaaltDepartment of Neurology (In House Postal Code: AB51), University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands.
Harm J van der HornDepartment of Neurology (In House Postal Code: AB51), University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands. h.j.van.der.horn@umcg.nl.

Funding

Mandema stipend from the University Medical Center Groningen MA 18-02
6 · The paper itself

Abstract

Cortisol is released through activation of the hypothalamic-pituitary-adrenal axis by physiological and psychological stressors, such as mild traumatic brain injury (mTBI). This hormone is accumulated in hair over longer periods of time, reflecting both acute and chronic forms of stress, allowing for retrospective analyses within certain timeframes. The main objectives of this study were to analyze pre- and post-injury hair cortisol concentrations, and to explore possible associations with personality and recovery after mTBI. Hair samples of 61 mTBI patients were collected at 4-6 weeks post-injury and divided into pre- (1 cm) and post-injury (1 cm) segments. For comparison, hair samples of 24 age, sex and education matched healthy controls (HC) were collected and divided into similar segments. Cortisol was quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). At two weeks post-injury, post-traumatic symptoms (PTS), emotional distress (anxiety/depression), and the personality trait neuroticism were measured. At six months post-injury, PTS and functional recovery (Glasgow Outcome Scale Extended) were determined. A significant increase in hair cortisol concentration from pre- to post-injury was found for both mTBI patients and HC, likely due to washout effects, with similar concentrations in both groups. Neither hair cortisol, nor the interaction with neuroticism, were associated with long-term PTS or functional recovery. Additionally, no differences in hair cortisol were observed between patients with a higher and lower risk of developing persistent PTS based on a modified Post-Concussion Symptoms Rule (PoCS Rule) including demographics, acute symptoms, pre-injury mental health and head CT. Altogether, our findings do not support the current use of hair cortisol as a potential marker of stress in mTBI.

Indexed as

Brain ConcussionHairHydrocortisoneStress, PsychologicalAdultBiomarkersCase-Control StudiesChromatography, LiquidFemaleHumansMaleMiddle AgedTandem Mass SpectrometryYoung AdultBiomarkersHydrocortisoneConcussionCortisolHormoneMild traumatic brain injuryOutcome

Identifiers

PMID40102551
PMCPMC11920047

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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.