Neurobehavioral and Quality of Life Changes Associated with Growth Hormone Insufficiency after Complicated Mild, Moderate, or Severe Traumatic Brain Injury

• DOI: 10.1089/neu.2006.23.928
• Publication Date: 2006-06-14T17:03:02Z
• Authors: Daniel F. Kelly; David L. McArthur; Harvey Levin; Shana Swimmer; Joshua R. Dusick; Pejman Cohan; Christina Wang; Ronald Swerdloff
• Keywords: Depression

Adult-onset growth hormone deficiency (GHD) has been associated with reduced quality of life (QOL) and neurobehavioral (NB) deficits. This prospective study tested the hypothesis that traumatic brain injury (TBI) patients GHD or GH insufficiency (GHI) would exhibit greater NB/QOL impairment than without GHD/GHI. Complicated mild, moderate, severe adult TBI (GCS score 3-14) had pituitary function testing performed 6-9 months postinjury. GH-secretory capacity was assessed a GHRH-arginine stimulation test GHI were defined as peak GH<6 <or=12 ng/mL (5th 10th percentiles healthy control subjects, respectively). Of 44 (mean age, 32+/-18 years; median GCS, 7), one (2%) GHD, seven (16%) GHI, 36 (82%) GH-sufficient at post-injury. Mean 8.2+/-2.1 in GHD/GHI group versus 45.7+/-29 GHsufficient group. The two groups well-matched characteristics, except patient central hypogonadism treated testosterone prior to testing. At postinjury, higher rates least marker depression (p<0.01), QOL (by SF-36 Health Survey) domains limitations due physical health (p=0.02), energy fatigue (p=0.05), emotional well-being pain (p=0.01), general (p=0.05). Chronic develops approximately 18% complicated TBI, is diminished QOL. impact replacement therapy on NB these being randomized placebo-controlled trial.