Associations of the cortisol awakening response (CAR) with cortical activation asymmetry during the course of an exam stress period

The cortisol awakening response (CAR) is a cortisol rise which is distinct from the circadian rise in hypothalamus-pituitary-adrenal (HPA) axis activity before awakening. The CAR has been shown to be related to experiences of stress and negative affect, and activation of neocortical networks has been suggested as a mechanism. Right-sided cortical activation has been shown to be correlated with negative affect, and an association of electroencephalogram (EEG) asymmetry measures with cortisol secretion has been demonstrated. Therefore, we investigated for associations of the CAR with lateralised trait-like cortical activation and with changes in EEG asymmetry during a putative stressful period. We examined 37 undergraduate students before, during, and after an academic exam period. CARs were measured five times and EEG was measured both about 6 weeks before the beginning of the exams and 1 day before an exam. Trait-like interindividual differences in posterior cortical asymmetry were differentially associated with CARs at different measurement occasions. Participants with greater right centroparietal cortical trait activation showed an increased CAR in anticipation of the exams, whereas all other participants showed an increased CAR in response to the exams. Furthermore, EEG measures taken directly before the exam revealed that greater right frontal cortical activation was related to higher cortisol levels after awakening. The results suggest that lateralised cortical activation moderates CAR changes during the course of a stressful period. Lateralised cortical activation may be an important link between the CAR and health-related variables like experiences of stress and negative affect