Anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury patients and the influence on functional outcome.
OBJECTIVE
The objective of this study is to determine the prevalence of anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury (TBI) patients. The investigation of a relationship between pituitary hormonal status and body mass index (BMI) in TBI patients by observing changes in BMI was conducted as well as an assessment of whether there is a difference in functional outcome related to anterior pituitary dysfunction in TBI patients.


METHODS
Forty-five TBI patients and 30 normal controls underwent a series of standard endocrine tests for anterior pituitary hormone function. It was studied whether changes in BMI correlated with anterior pituitary hormone levels. This study also compared changes in mini-mental state examination (K-MMSE) and functional independence measure (FIM) scores between patients in the hormone-sufficient and -deficient groups.


RESULTS
Anterior pituitary dysfunction was found in 31.1% of TBI patients. Changes in BMI statistically correlated with IGF-1 and basal cortisol levels. A meaningful difference was found between the hormone-sufficient and -deficient groups in light of the K-MMSE and FIM score gains.


CONCLUSIONS
These findings strongly suggest that patients who suffer head trauma should be routinely tested for anterior pituitary hormone deficiency.
Park
Ki Deok
KD
Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Centre, Incheon, Republic of Korea.
Kim
Deog Young
DY
Lee
Ju Kang
JK
Nam
Hee-Seung
HS
Park
Yoon-Ghil
YG
D000328:Adult; D015992:Body Mass Index; D001930:Brain Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D010903:Pituitary Gland, Anterior / Q000378:metabolism / Q000503:physiopathology*; D010908:Pituitary Hormones, Anterior / Q000172:deficiency / Q000378:metabolism*
D010908:Pituitary Hormones, Anterior