Research Reports - Functional changes after human growth hormone replacement in patients with chronic traumatic brain injury and abnormal growth hormone secretion

J Neurotrauma. 2017 Feb 15;34(4):845-852. doi: 10.1089/neu.2016.4552. Epub 2016
Oct 13.

Mossberg KA(1), Durham WJ(1), Zgaljardic DJ(1,)(2), Gilkison CR(1), Danesi CP(1),
Sheffield-Moore M(1), Masel BE(1,)(2), Urban RJ(1).

We explored the effects of recombinant human growth hormone (rhGH) replacement on
physical and cognitive functioning in subjects with a moderate-to-severe
traumatic brain injury (TBI) with abnormal growth hormone (GH) secretion. Fifteen
individuals who sustained a TBI at least 12 months prior to study enrollment were
identified as having abnormal GH secretion by glucagon stimulation testing
(maximum GH response less than 8 ng/mL). Peak cardiorespiratory capacity, body
composition, and muscle force testing were assessed at baseline and one year
after rhGH replacement. Additionally, standardized neuropsychological tests that
assess memory, processing speed, and cognitive flexibility, as well as
self-report inventories related to depression and fatigue, were administered at
baseline and 1 year after rhGH replacement. Comparison tests were performed with
proper post hoc analyses. All analyses were carried out at α < 0.05. Peak O2
consumption, peak oxygen pulse (estimate of cardiac stroke volume), and peak
ventilation all significantly increased (p < 0.05). Maximal isometric and
isokinetic force production were not altered. Skeletal muscle fatigue did not
change but the perceptual rating of fatigue was reduced by ∼25% (p = 0.06).
Cognitive performance did not change significantly over time, whereas
self-reported symptoms related to depression and fatigue significantly improved.
The observed changes suggest that rhGH replacement has a positive impact on
cardiorespiratory fitness and a positive impact on perceptual fatigue in
survivors of TBI with altered GH secretion. 

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