High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury

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High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury

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dc.contributor.author Wilkinson, Charles W.
dc.contributor.author Pagulayan, Kathleen F.
dc.contributor.author Petrie, Eric C.
dc.contributor.author Mayer, Cynthia L.
dc.contributor.author Colasurdo, Elizabeth A.
dc.contributor.author Shofer, Jane B.
dc.contributor.author Hart, Kim L.
dc.contributor.author Hoff, David
dc.contributor.author Tarabochia, Matthew A.
dc.contributor.author Peskind, Elaine R.
dc.date.accessioned 2012-02-23T23:23:17Z
dc.date.available 2012-02-23T23:23:17Z
dc.date.issued 2012-02-07
dc.identifier.uri http://hdl.handle.net/1773/19631
dc.description.abstract Studies of traumatic brain injury from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones at least 1 year after injury, in 25–50% ofcases. Most studies found the occurrence of post traumatic hypopituitarism (PTHP) to be unrelated to injury severity. Growth hormone deficiency (GHD) and hypogonadism were reported most frequently. Hypopituitarism, and in particular adult GHD, is associated with symptoms that resemble those of PTSD, including fatigue, anxiety, depression, irritability, insomnia, sexual dysfunction, cognitive deficiencies, and decreased quality of life. However, the prevalence of PTHP after blast-related mild TBI (mTBI), an extremely common injury in modern military operations, has not been characterized. We measured concentrations of 12 pituitary and target-organ hormones in two groups of male US Veterans of combat in Iraq or Afghanistan. One group consisted of participants with blast-related mTBI whose last blast exposure was at least 1 year prior to the study. The other consisted of Veterans with similar military deployment histories but without blast exposure. Eleven of 26, or 42% of participants with blast concussions were found to have abnormal hormone levels in one or more pituitary axes, a prevalence similar to that found in other forms of TBI. Five members of the mTBI group were found with markedly low age-adjusted insulin-like growth factor-I (IGF-I) levels indicative of probable GHD, and three had testosterone and gonadotropin concentrations consistent with hypogonadism. If symptoms characteristic of both PTHP and PTSD can be linked to pituitary dysfunction, they may be amenable to treatment with hormone replacement. Routine screening for chronic hypopituitarism after blast concussion shows promise for appropriately directing diagnostic and therapeutic decisions that otherwise may remain unconsidered and for markedly facilitating recovery and rehabilitation. en_US
dc.language.iso en_US en_US
dc.publisher Frontiers in Neurology en_US
dc.subject traumatic brain injury, hypopituitarism, blast, concussion, growth hormone, pituitary en_US
dc.title High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury en_US
dc.type Thesis en_US


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