CONSEQUENCES OF HYPOPITUITARISM FOLLOWING TRAUMATIC BRAIN INJURY (TBI)

创伤性脑损伤 (TBI) 后垂体机能减退的后果

• 批准号: 7605239
• 负责人: LAURENCE KATZNELSON
• 金额: $ 1.17万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-02-15 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7605239
• 关键词: 6 year old; Activities of Daily Living; Adrenal gland hypofunction; Affect; Androgens; Anorexia; Anterior Pituitary Gland; Behavioral; Body Composition; Body Weight decreased; Body fat; Bone Density; Cardiovascular system; Chronic; Chronic Phase; Clinical; Cognitive; Computer Retrieval of Information on Scientific Projects Database; Deterioration; Economics; Estrogens; Exercise Tolerance; Fatigue; Fatty acid glycerol esters; Female; Functional disorder; Funding; Glucocorticoids; Goals; Gonadal Steroid Hormones; Grant; Hormones; Hypogonadism; Hypopituitarism; Hypothyroidism; Impaired cognition; Injury; Institution; Lassitude; Lead; Literature; Malaise; Memory; Memory Loss; Mental Depression; Musculoskeletal System; Myopathy; Neurologic; Organic brain syndrome; Outcome; Patients; Performance; Pilot Projects; Pituitary Gland; Production; Prolactin; Protocols documentation; Psychotic Disorders; Quality of life; Recording of previous events; Recovery; Rehabilitation therapy; Relative (related person); Replacement Therapy; Research; Research Personnel; Resources; Signs and Symptoms; Skeletal Muscle; Somatotropin; Source; Syndrome; TBI Patients; Testing; Testosterone; Thyroid Gland; Traumatic Brain Injury; Unemployment; United States National Institutes of Health; Weight Gain; Woman; design; disability; disturbance in affect; falls; growth hormone deficiency; men; neuropsychiatry; respiratory

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hypotheses: This protocol will investigate the effect of traumatic brain injury (TBI)-associated hypopituitarism on body composition, quality of life (QOL), and activities of daily living (ADL). We hypothesize that: 1. TBI is associated with a high degree of hypopituitarism, including growth hormone deficiency. 2. Hypopituitarism in patients with TBI is associated with diminished skeletal muscle mass and increased body fat, decreased QOL, and decreased ability to perform ADL compared to patients with normal pituitary function. 3. In patients with history of TBI, the degree of hypopituitarism correlates with the degree of deterioration in skeletal muscle mass, body fat, QOL, and ADL. Goals: TBI has profound clinical and economic consequences. Common sequelae of injury include neurologic or neuromuscular damage, cognitive dysfunction, physical deconditioning, weight gain, or fat redistribution, as well as diminished quality of life and overall performance. These sequelae have been identified as major obstacles to successful rehabilitation. Many TBI patients fall short of complete recovery altogether and enter into a phase of chronic disability and unemployment. The syndrome of hypopituitarism is widely recognized, and the importance of replacement therapy well understood. Dysfunction of the anterior pituitary gland may lead to a compromise in growth hormone (GH), thyroid, glucocorticoid, sex hormone (testosterone in men/estrogen in women), and prolactin production. In general, patients with hypopituitarism present with fatigue and either weight gain or loss, and may have one or more hormone axes compromised. Central hypothyroidism widely impacts the respiratory, cardiovascular, neurologic, and musculoskeletal systems and therefore is associated with fatigue, poor exercise tolerance, impaired memory, and cause weakness and myopathy. Hypogonadism (testosterone deficiency) in men can lead to adverse affects on body composition, bone density, and neuropsychosocial function. Testosterone deficiency in men can have behavioral and cognitive consequences including mood disturbances, decreased verbal fluency, impaired memory, and poor QOL. There is a growing literature on the relative androgen deficiency in female patients with central hypogonadism, which may have adverse consequences on lean mass and function. Signs and symptoms of chronic adrenal insufficiency include malaise, lassitude, weakness, anorexia, and weight loss. In severe and chronic cases, patients may have neuropsychiatric manifestations such as memory loss, organic brain syndrome, depression, and overt psychosis. This pilot study will consist of a cross-sectional design with men and women between 18-55 years old 6 months following TBI. Control subjects will be identified posthoc by normal pituitary function. We will test body composition, QOL, and ADL in each subject to compare differences in hypopituitary vs. normal subjects and also correlate degree of hypopituitarism to degree of differences in outcomes.

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