Research Reports - Growth hormone replacement therapy in patients with traumatic brain injury

J Neurotrauma. 2013 Jun 1;30(11):998-1006

Moreau OK, Cortet-Rudelli C, Yollin E, Merlen E, Daveluy W, Rousseaux M

Abstract In patients with severe traumatic brain injury (TBI), a growth hormone
deficiency (GHD) is frequent and may contribute to the cognitive sequelae and
reduction in quality of life (QoL). Recent studies have suggested that GH
replacement therapy (GHRT) can improve processing speed and memory. The aim of
the study was to analyze the efficacy of GHRT on cognition, activities of daily
living (ADL), and QoL and the factors that predicted and contributed to these
effects. We included patients at least 1 year after their TBI and assessed
pituitary functions (with stimulation tests), cognition (attention, memory, and
executive function), participation in ADL and QoL. GHD was treated for at least 1
year in 23 patients, who were compared with 27 non-treated patients. Other
deficiencies were also treated. Measurements were performed at baseline and 1
year later. An analysis of variance of the factors group and session (p≤0.05)
showed that most cognitive parameters had improved at 1 year (evidencing a
session effect). A stronger effect of GHRT (i.e. a group x session interaction)
was found for Rey Osterrieth complex figure recall and 2/6 domains in the QoL
questionnaire ("personal" and "functional"). Trends (p≤0.07) were also found for
spatial orientation and immediate recall in the verbal memory test. Greatest
improvements were associated with lower performance before treatment. The
magnitude of the improvements in ADL and QoL was moderately correlated with the
improvement in cognition. In conclusion, replacement therapy can improve
cognition and QoL in patients with TBI who have GHD, especially in those with
severe disabilities.

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