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Impact of Repetitive and Traumatic Brain Injury on Pituitary Function

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Pituitary Disorders throughout the Life Cycle

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Abstract

Traumatic brain injury (TBI) is a global health problem which can associate temporary or permanent physical, cognitive, or psychosocial problems. Up to a third of patients develop pituitary gland dysfunction which can contribute to the post-TBI health problems and delay rehabilitation. Most studies were done in the civilian populations and identified growth hormone deficiency (GHD) as the most prevalent endocrine perturbation. Methodology was variable regarding patient population (i.e., severity of the TBI), time interval from the TBI, dynamic stimulation protocols, and thresholds used for diagnosis. Central hypogonadism, hypoadrenalism, hypothyroidism, and diabetes insipidus occur less frequently, while hypo- and hyperprolactinemia are rare. Overall, approximately a third of patients experience one or more chronic pituitary hormone abnormalities. GHD testing is recommended in patients experiencing suggestive manifestations 12 months after the TBI, due to potential recovery of GH secretion. GH replacement was associated with improved energy, moods, cognition, and quality of life in TBI in several retrospective and small prospective studies. Pituitary hormone replacement after TBI should follow the current standards of care for patients with hypopituitarism, including optimization of other hormones prior to GHD testing and replacement. Questions to be addressed in future large prospective research include (1) the diagnostic accuracy of GHD tests in the TBI population, (2) duration of therapy and long-term effects of GH replacement, and (3) prevalence and management of hypopituitarism resulting from sports- and combat-related repetitive injuries.

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, USA

    Adriana G. Ioachimescu

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  1. Adriana G. Ioachimescu
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Correspondence to Adriana G. Ioachimescu .

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Editors and Affiliations

  1. Mayo Clinic, Jacksonville, FL, USA

    Susan L. Samson

  2. Emory University School of Medicine, Atlanta, GA, USA

    Adriana G. Ioachimescu

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Ioachimescu, A.G. (2022). Impact of Repetitive and Traumatic Brain Injury on Pituitary Function. In: Samson, S.L., Ioachimescu, A.G. (eds) Pituitary Disorders throughout the Life Cycle. Springer, Cham. https://doi.org/10.1007/978-3-030-99918-6_24

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  • DOI: https://doi.org/10.1007/978-3-030-99918-6_24

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  • Online ISBN: 978-3-030-99918-6

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