Neurotrauma Department, Naval Medical Research Center, Silver Spring, MD, USA.
The Henry M. Jackson Foundation Inc., Bethesda, MD, USA.
J Neurosci Res. 2020 Jun;98(6):1174-1187. doi: 10.1002/jnr.24604. Epub 2020 Mar 11.
Mild traumatic brain injury (mTBI) has been linked to mental health disorders (MHDs) and pituitary function alterations. Due to the complex relationship of mTBI, the neuroendocrine system, and MHDs, we propose that neuroendocrine dysfunction (NED) may play a role in negative long-term health outcomes. The goal of this study was to determine if blast-concussed service members (SMs) have a stronger likelihood of developing NED. We hypothesized that NED either pre- or post-injury is associated with poor mental and physical health outcomes. Serum samples from the Armed Forces Health Surveillance Branch were obtained from concussed (n = 59) and non-concussed (n = 72) SMs treated at the Concussion Restoration Care Center (CRCC) in Afghanistan. Serum was collected within 2 years prior to deployment and one or two times within 3 years following their CRCC visit. Samples were analyzed for luteinizing hormone (LH), testosterone, human growth hormone, cortisol, and prolactin to assess post-injury neuroendocrine function. Results indicate that SMs who incurred an mTBI exhibited long-term LH and testosterone deficiencies 3 years following injury compared to controls. Specifically, 47.6% of head-injured SMs displayed hypofunction in at least one of five hormones at 3 years post-injury. Anxiety disorders were the most common MHD observed in concussed SMs with hypopituitarism, while there was also a trend for SMs with chronic pituitary dysfunction to have MHD diagnoses. Findings indicate blast-related mTBI may be associated with long-term health outcomes following a period of incubation. Neuroendocrine screenings may increase treatment opportunities, inform rehabilitation strategies, and improve overall quality of life for patients.
轻度创伤性脑损伤 (mTBI) 与心理健康障碍 (MHD) 和垂体功能改变有关。由于 mTBI、神经内分泌系统和 MHD 之间的复杂关系，我们提出神经内分泌功能障碍 (NED) 可能在负面的长期健康结果中发挥作用。本研究的目的是确定爆炸性脑震荡的军人 (SM) 是否更有可能出现 NED。我们假设，无论是在受伤前还是受伤后，NED 都与心理健康和身体健康不良结果有关。从在阿富汗的脑震荡康复护理中心 (CRCC) 治疗的脑震荡 (n = 59) 和非脑震荡 (n = 72) SM 中获得武装部队健康监测处的血清样本。在部署前 2 年内和 CRCC 就诊后 3 年内采集血清样本。分析黄体生成素 (LH)、睾酮、人生长激素、皮质醇和催乳素，以评估受伤后的神经内分泌功能。结果表明，与对照组相比，发生 mTBI 的 SM 在受伤后 3 年内表现出长期 LH 和睾酮缺乏。具体来说，47.6%的头部受伤 SM 在受伤后 3 年内至少有 5 种激素中的一种表现出功能低下。焦虑障碍是脑震荡 SM 中最常见的 MHD，同时也存在慢性垂体功能障碍 SM 有 MHD 诊断的趋势。研究结果表明，与爆炸有关的 mTBI 可能与潜伏期后的长期健康结果有关。神经内分泌筛查可能会增加治疗机会，为康复策略提供信息，并提高患者的整体生活质量。
