title: Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury.
abstract: OBJECTIVE
  Traumatic brain injury (TBI) is a major cause of long-term disability with variable recovery. Preclinical studies suggest that vitamin D status influences the recovery after TBI. However, there is no published clinical data on links between vitamin D status and TBI outcomes. The aim was to determine the (i) prevalence of vitamin D deficiency/insufficiency, and associations of vitamin D status with (ii) demographic factors and TBI severity, and with (iii) cognitive function, symptoms and quality of life, in adults after TBI.
  
  
  METHODS
  Retrospective audit of patients seen between July 2009 and March 2015. Serum vitamin D (25-hydroxy-cholecalciferol) was categorized as deficient (<40 nmol/l), insufficient (40-70 nmol/l) or replete (>70 nmol/l).
  
  
  METHODS
  A total of 353 adults seen in tertiary hospital clinic (75·4% lighter skinned, 74·8% male, age median 35·1 year, range 26·6-48·3 year), 0·3-56·5 months after TBI (74·5% moderate-severe).
  
  
  METHODS
  Serum vitamin D concentrations; Addenbrooke's Cognitive Examination (ACE-R), Beck Depression Inventory-II (BDI-II), SF-36 Quality of Life, Pittsburgh Sleep Quality Index.
  
  
  RESULTS
  In total, 46·5% of patients after TBI had vitamin D deficiency and 80·2% insufficiency/deficiency. Patients with vitamin D deficiency had lower ACE-R scores than those of vitamin D replete (mean effect size ± SEM 4·5 ± 2·1, P = 0·034), and higher BDI-II scores than those of vitamin D insufficient (4·5 ± 1·6, P = 0·003), correcting for age, gender, time since TBI and TBI severity. There was no association between vitamin D status and markers of TBI severity, sleep or quality of life.
  
  
  CONCLUSIONS
  Vitamin D deficiency is common in patients after TBI and associated with impaired cognitive function and more severe depressive symptoms.
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Omer A
authors.initials: OA
authors.lastname: Jamall
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.|Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Feeney
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Zaw-Linn
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Aysha
authors.initials: A
authors.lastname: Malik
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Mari E K
authors.initials: ME
authors.lastname: Niemi
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.|Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK.
authors.forename: Carmen
authors.initials: C
authors.lastname: Tenorio-Jimenez
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Ham
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Sagar R
authors.initials: SR
authors.lastname: Jilka
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Peter O
authors.initials: PO
authors.lastname: Jenkins
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Gregory
authors.initials: G
authors.lastname: Scott
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Lucia M
authors.initials: LM
authors.lastname: Li
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gorgoraptis
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Baxter
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Sharp
authors.affiliation: Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK. tony.goldstone@imperial.ac.uk.|Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK. tony.goldstone@imperial.ac.uk.|Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK. tony.goldstone@imperial.ac.uk.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Goldstone
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications*; D060825:Cognitive Dysfunction / Q000209:etiology; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012890:Sleep; D014808:Vitamin D Deficiency / Q000209:etiology*