Neuroendocrine function and associated mental health outcomes following mild traumatic brain injury in OEF-deployed service members
Neuroendocrine function and associated mental health outcomes following mild traumatic brain injury in OEF-deployed service members
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DOI：
10.1002/jnr.24604
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发表时间：
2020-06-01
影响因子：
4.2
通讯作者：
Tschiffely, Anna E.
中科院分区：
文献类型：
--
作者：
Ciarlone, Stephanie L.;Statz, Jonathan K.;Tschiffely, Anna E.
轻度创伤性脑损伤 (mTBI) 与精神健康障碍 (MHD) 和垂体功能改变有关。由于 mTBI、神经内分泌系统和 MHD 之间的复杂关系，我们认为神经内分泌功能障碍 (NED) 可能在负面的长期健康结果中发挥作用。本研究的目的是确定遭受爆炸震荡的服役人员 (SM) 是否更有可能患上 NED。我们假设受伤前或受伤后的 NED 与不良的心理和身体健康结果有关。武装部队健康监测部门的血清样本取自阿富汗脑震荡恢复护理中心 (CRCC) 治疗的脑震荡 (n = 59) 和非脑震荡 (n = 72) SM。血清在部署前 2 年内采集，并在 CRCC 访问后 3 年内采集一到两次。对样本进行黄体生成素 (LH)、睾酮、人类生长激素、皮质醇和催乳素分析，以评估损伤后的神经内分泌功能。结果表明，与对照组相比，发生 mTBI 的 SM 在受伤后 3 年表现出长期 LH 和睾酮缺乏。具体而言，47.6% 的头部受伤 SM 在受伤后 3 年时表现出五种激素中至少一种的功能减退。焦虑障碍是脑震荡伴垂体功能减退的 SM 中最常见的 MHD，而慢性垂体功能障碍的 SM 也有诊断出 MHD 的趋势。研究结果表明，与爆炸相关的 mTBI 可能与潜伏期后的长期健康结果有关。神经内分泌筛查可以增加治疗机会，为康复策略提供信息，并改善患者的整体生活质量。
Mild traumatic brain injury (mTBI) has been linked to mental health disorders (MHDs) and pituitary function alterations. Due to the complex relationship of mTBI, the neuroendocrine system, and MHDs, we propose that neuroendocrine dysfunction (NED) may play a role in negative long-term health outcomes. The goal of this study was to determine if blast-concussed service members (SMs) have a stronger likelihood of developing NED. We hypothesized that NED either pre- or post-injury is associated with poor mental and physical health outcomes. Serum samples from the Armed Forces Health Surveillance Branch were obtained from concussed (n = 59) and non-concussed (n = 72) SMs treated at the Concussion Restoration Care Center (CRCC) in Afghanistan. Serum was collected within 2 years prior to deployment and one or two times within 3 years following their CRCC visit. Samples were analyzed for luteinizing hormone (LH), testosterone, human growth hormone, cortisol, and prolactin to assess post-injury neuroendocrine function. Results indicate that SMs who incurred an mTBI exhibited long-term LH and testosterone deficiencies 3 years following injury compared to controls. Specifically, 47.6% of head-injured SMs displayed hypofunction in at least one of five hormones at 3 years post-injury. Anxiety disorders were the most common MHD observed in concussed SMs with hypopituitarism, while there was also a trend for SMs with chronic pituitary dysfunction to have MHD diagnoses. Findings indicate blast-related mTBI may be associated with long-term health outcomes following a period of incubation. Neuroendocrine screenings may increase treatment opportunities, inform rehabilitation strategies, and improve overall quality of life for patients.