Weppner Justin, Rosenthal Kimberly, Bath Jennifer, Locklear Tonja, Martinez Melissa
Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
Department of Internal Medicine, Carilion Clinic, Roanoke, Virginia, USA.
Neurotrauma Rep. 2025 Apr 21;6(1):345-354. doi: 10.1089/neur.2025.0009. eCollection 2025.
Traumatic brain injury (TBI)-related growth hormone deficiency is often undertreated, despite documented physical, metabolic, and neuropsychiatric effects. Insulin-like growth factor (IGF-1), with neuroreceptors located in brain regions responsible for learning, memory, and mood, regulates cerebral blood flow, neurogenesis, and neuroplasticity. The aim of this study was to determine associations between IGF-1 levels and post-TBI symptom severity, anxiety, and depression. This retrospective observational study at an Academic Brain Injury Center included participants evaluated 3-12 months post-TBI with available IGF-1 values and complete Rivermead Post-Concussion Symptoms Questionnaire (RPQ-13), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) responses. Patients under 18 or over 65 and those with incomplete data were excluded. Participants were grouped by TBI severity: mild (Glasgow Coma Scale [GCS] 13-15) and moderate-to-severe (GCS < 13). IGF-1 -scores were standardized for age and gender. Significant negative correlations were found between IGF-1 levels and RPQ-13, GAD-7, and PHQ-9 scores across all TBI severity groups, with lower IGF-1 -scores correlating with higher symptoms of TBI, depression, and anxiety. The Generalized Linear Models showed that the IGF-1 score is a significant predictor for GAD-7, PHQ-9, and RPQ-13. Specifically, a one-point increase in the IGF-1 score is associated with a 29.85% decrease in anxiety symptoms on the GAD-7, a 16.30% reduction in depression severity on the PHQ-9, and a 39.23% decrease in post-TBI symptom severity on the RPQ-13. Findings suggest that decreased IGF-1 is associated with increased post-injury symptom severity, depression, and anxiety. Future studies should explore IGF-1 as a biomarker for TBI symptom severity.
创伤性脑损伤（TBI）相关的生长激素缺乏症常常未得到充分治疗，尽管已有关于其对身体、代谢及神经精神方面影响的记录。胰岛素样生长因子（IGF-1）在负责学习、记忆和情绪的脑区具有神经受体，可调节脑血流量、神经发生和神经可塑性。本研究的目的是确定IGF-1水平与TBI后症状严重程度、焦虑和抑郁之间的关联。这项在一所学术性脑损伤中心开展的回顾性观察研究纳入了TBI后3至12个月接受评估且有可用IGF-1值以及完整的Rivermead脑震荡后症状问卷（RPQ-13）、广泛性焦虑障碍量表-7（GAD-7）和患者健康问卷-9（PHQ-9）测评结果的参与者。排除了18岁以下或65岁以上以及数据不完整的患者。参与者按TBI严重程度分组：轻度（格拉斯哥昏迷量表[GCS]13 - 15）和中重度（GCS < 13）。IGF-1分数按年龄和性别进行了标准化。在所有TBI严重程度组中，均发现IGF-1水平与RPQ-13、GAD-7和PHQ-9分数之间存在显著负相关，IGF-1分数越低，与TBI、抑郁和焦虑的症状越严重相关。广义线性模型显示，IGF-1分数是GAD-7、PHQ-9和RPQ-13的显著预测因子。具体而言，IGF-1分数每增加1分，GAD-7上的焦虑症状减少29.85%，PHQ-9上的抑郁严重程度降低16.30%，RPQ-13上的TBI后症状严重程度降低39.23%。研究结果表明，IGF-1降低与损伤后症状严重程度增加、抑郁和焦虑相关。未来的研究应探索将IGF-1作为TBI症状严重程度的生物标志物。
