Prevalence of chronic hypopituitarism after blast concussion

Abstract

Studies of traumatic brain injury (TBI) from all causes have reported a prevalence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones measured at least one year after injury, of 25–50%. Hypopituitarism is associated with fatigue, anxiety, depression, insomnia, cognitive dysfunction, and deleterious changes in body composition and cardiovascular function. However, the prevalence of hypopituitarism after blast concussion/mild TBI (mTBI) has not previously been investigated. We measured twelve pituitary and target organ hormones in blood samples from Veterans of deployment to Iraq or Afghanistan with mTBI and from Veterans of deployment without blast exposure. Criteria for identifying abnormal hormone levels were derived from measurement of basal hormone concentrations in male non‐Veteran control subjects. Preliminary results indicate that 42% of individuals with blast mTBI exhibited abnormal hormone levels suggestive of pituitary dysfunction, with the most prevalent deficiencies being consistent with hypogonadism and growth hormone deficiency. These findings of a high frequency of hypopituitarism after blast concussion similar to that found in other forms of TBI provide support for the value of routine hormonal screening in facilitating the recovery and rehabilitation of blast‐exposed Veterans. Supported by DoD PT0753 and the Dept. of Veterans Affairs.