Effect of growth hormone replacement therapy on cognition after traumatic brain injury.
Traumatic brain injury (TBI) is a major public health issue, and yet medical science has little to offer for the persistent symptoms that prevent many of these individuals from fully re-entering society. Post-traumatic hypopituitarism, and specifically growth hormone deficiency (GHD), has been found in a large percentage of individuals with chronic moderate to severe TBI. Presently, there are no published treatment studies of hormone replacement in this population. In this study, 83 subjects with chronic TBI were screened for hypopituitarism. Forty-two subjects were found to have either GHD or GH insufficiency (GHI), of which 23 agreed to be randomized to either a year of GH replacement or placebo. All subjects completed the study with no untoward side effects from treatment. A battery of neuropsychological tests and functional measures were administered before and after treatment. Improvement was seen on the following tests: Dominant Hand Finger Tapping Test, Wechsler Adult Intelligence Scale III-Information Processing Speed Index, California Verbal Learning Test II, and the Wisconsin Card Sorting Test (executive functioning). The findings of this pilot study provide preliminary evidence suggesting that some of the cognitive impairments observed in persons who are GHD/GHI after TBI may be partially reversible with appropriate GH replacement therapy.
High
Walter M
WM
Department of Physical Medicine and Rehabilitation, University of Kentucky College of Medicine, Lexington, Kentucky 40504, USA. walter.high@uky.edu
Briones-Galang
Maria
M
Clark
Jessica A
JA
Gilkison
Charles
C
Mossberg
Kurt A
KA
Zgaljardic
Dennis J
DJ
Masel
Brent E
BE
Urban
Randall J
RJ
D000328:Adult; D001930:Brain Injuries / Q000097:blood* / Q000188:drug therapy* / Q000523:psychology; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000379:methods; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000097:blood* / Q000172:deficiency; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests
D019382:Human Growth Hormone