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The Neuroendocrine Effects of Traumatic Brain Injury

Received July 13, 2006; revised January 16, 2007; accepted January 18, 2007. Dr. Rothman is affiliated with the Department of Medicine, University of Colorado, Denver, and Health Sciences Center, Aurora, Colorado. Drs. Arciniegas and Filley are affiliated with the Departments of Psychiatry and Neurology, University of Colorado, Denver, and Health Sciences Center, Aurora, Colorado. Dr. Wierman is affiliated with the Department of Medicine, University of Colorado, and the Research Service, Veterans Affairs Medical Center, Denver, Colorado. Dr. Arciniegas is also affiliated with the Brain Injury Rehabilitation Unit, HealthONE Spalding Rehabilitation Hospital, Aurora, Colorado. Dr. Filley is also affiliated with the Research Service, Veterans Affairs Medical Center, Denver, Colorado. Address correspondence to Dr. Wierman, 111H Endocrinology, VAMC, 1055 Clermont St., Denver, CO 80220; margaret.wierman{at}uchsc.edu (e-mail).

Neuroendocrine dysfunction after traumatic brain injury (TBI) is under-diagnosed, under-treated, and may adversely affect the rate of recovery. Single or multiple pituitary-target hormone disruption occurs in up to two-thirds of persons with TBI, most commonly affecting the gonadal and growth hormone axes. The time course of decline in and recovery of pituitary function in relation to cognitive dysfunction and rehabilitation progress are not well described. This article reviews the clinical spectrum of neuroendocrine deficits after TBI and their underlying mechanisms. Future studies of the effects of hormonal replacement on recovery are recommended.

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