Clinical Outcomes, Predictors, and Prevalence of Anterior Pituitary Disorders Following Traumatic Brain Injury

Lauzier, François; Turgeon, Alexis F.; Boutin, Amélie; Shemilt, Michèle; Côté, Isabelle; Lachance, O.; Archambault, Patrick; Lamontagne, François; Moore, Lynne; Bernard, Francis; Gagnon, Claudia; Cook, Deborah J.

doi:10.1097/ccm.0000000000000046

Cited by 58 publications

(41 citation statements)

References 62 publications

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“…Investigators have found that younger women have better outcomes than do older women post-TBI; this may be attributable to the neuro-protective effects of hormones found in pre-menopausal women (Kirkness et al, 2004; Wagner et al, 2004; Ley et al, 2013). Despite conflicting results, researchers and clinicians alike are becoming aware of hormonal disturbances that often follow TBI (Ghigo et al, 2005; Schneider et al, 2011; Lauzier et al, 2014). Therefore, it is imperative for depression treatment care plans following TBI to be tailored to each gender specifically to address the physiological and hormonal differences between men and women who are affected by brain injury.…”

Section: Discussionmentioning

confidence: 99%

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

et al. 2017

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In the general population, females experience depression at significantly higher rates than males. Individuals with traumatic brain injury (TBI) are at substantially greater risk for depression compared to the overall population. Treatment of, and recovery from, TBI can be hindered by depression; comorbid TBI and depression can lead to adverse outcomes and negatively affect multiple aspects of individuals’ lives. Gender differences in depression following TBI are not well understood, and relevant empirical findings have been mixed. Utilizing the Patient Health Questionnaire-9 (PHQ-9) 1 year after TBI, we examined whether women would experience more severe depressive symptoms, and would endorse higher levels of depression within each category of depression severity, than would men. Interestingly, and contrary to our hypothesis, men and women reported mild depression at equal rates; PHQ-9 total scores were slightly lower in women than in men. Men and women did not differ significantly in any PHQ-9 depression severity category. Item analyses, yielded significant gender differences on the following items: greater concentration difficulties (cognitive problems) in men and more sleep disturbances (psychosomatic issues) in women per uncorrected two-sample Z-test for proportions analyses; however, these results were not significant after the family-wise Bonferroni correction. Our results indicate that, in contrast to the general population, mild depression in persons with moderate to severe TBI may not be gender-specific. These findings underscore the need for early identification, active screening, and depression treatment equally for men and women to improve emotional well-being, promote recovery, and enhance quality of life following TBI.

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Section: Discussionmentioning

confidence: 99%

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

et al. 2017

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“…In a more recently published systematic review of 66 studies (5,386 adult patients), the prevalence of persistent anterior pituitary hormone deficiencies was approximately 30% (11). Hypopituitarism was associated with higher mortality in the intensive care unit (ICU) in this analysis.…”

Section: Epidemiologymentioning

confidence: 81%

“…Hypopituitarism was associated with higher mortality in the intensive care unit (ICU) in this analysis. Older patients and those who have suffered skull-base fractures or more severe TBI appear to be at higher risk of hypopituitarism (11).…”

Section: Epidemiologymentioning

confidence: 99%

American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: A Neuroendocrine Approach to Patients With Traumatic Brain Injury

2015

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“…In contradistinction, the mean duration of coma in the group studied by Moreau et al was 17.7 days. 10 11 Although they did not address specific hormone deficits, they found that approximately 30% of subjects with a TBI had chronic PTH. Older age, skull fractures and the severity of the TBI were predictors of PTH.…”

Section: Incidencementioning

confidence: 98%

Chronic Endocrinopathies in Traumatic Brain Injury Disease

Masel

Urban

2015

Journal of Neurotrauma

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The aim of this review was to explain the role played by pituitary hormonal deficiencies in the traumatic brain injury (TBI) disease process. Chronic dysfunction of the pituitary axis is observed in approximately 35% of individuals who sustain a moderate-to-severe TBI. The most common deficiency is that of growth hormone, followed by gonadotropin, cortisol, and thyroid. The medical, psychological, and psychiatric consequences of untreated hypopituitarism are extensive and can be devastating. Many of the consequences of a chronic symptomatic TBI have, in the past, been solely attributed to the brain injury per se. Analysis of the signs and symptoms of pituitary axis dysfunction suggests that many of these consequences can be attributed to post-traumatic hypopituitarism (PTH). PTH may well play a significant role in the progressive signs and symptoms that follow a chronic TBI.

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Clinical Outcomes, Predictors, and Prevalence of Anterior Pituitary Disorders Following Traumatic Brain Injury

Cited by 58 publications

References 62 publications

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: A Neuroendocrine Approach to Patients With Traumatic Brain Injury

Chronic Endocrinopathies in Traumatic Brain Injury Disease

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