Citation

Wright TJ, Urban RJ, Durham WJ, Dillon EL, Randolph K, Danesi CP, Gilkison C, Karmonik C, Zgaljardic DJ, Masel BE, Bishop J, Pyles R, Seidler R, Hierholzer A, Sheffield-Moore M. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

University of Texas Medical Branch at Galveston, 12338, Internal Medicine, Galveston, Texas, United States; msheffield-moore@tamu.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6690

PMID

31797721

Abstract

Pituitary dysfunction with reduced growth hormone (GH) secretion is common in patients following traumatic brain injury (TBI), and these patients often develop chronic symptoms including fatigue and altered cognition. We examined 18 subjects with a history of mild TBI, fatigue, and insufficient GH secretion. Subjects received GH replacement in a year-long, double-blind, placebo-controlled, crossover study, and were assessed for changes in physical performance, body composition, resting energy expenditure, fatigue, sleep, mood, and neuropsychological testing. Additionally, MRI was used to assess changes in brain structure and resting state functional connectivity. GH replacement resulted in decreased fatigue, sleep disturbance, and anxiety, as well as increased resting energy expenditure, improved body composition, and altered perception of sub-maximal effort when performing exercise testing. Associated brain changes included increased frontal cortical thickness and gray matter volume and resting state connectivity changes in regions associated with somatosensory networks. GH replacement altered brain morphology and connectivity and reduced fatigue and related symptoms in mild TBI patients. Additional studies are needed to understand the mechanisms causing TBI-related fatigue and symptom relief with GH replacement.

Language: en

Keywords

COGNITIVE FUNCTION; HORMONE REPLACEMENT; HYPOPITUITARISM; MRI; TRAUMATIC BRAIN INJURY