Chronic Hypopituitarism Associated with Increased Postconcussive Symptoms Is Prevalent after Blast-Induced Mild Traumatic Brain Injury
Open accessAbstract
The most frequent injury sustained by US service members deployed to Iraq or Afghanistan is mild traumatic brain injuries (mTBI), or concussion, by far most often caused by blast waves from improvised explosive devices or other explosive ordnance. TBI from all causes gives rise to chronic neuroendocrine disorders with an estimated prevalence of 25-50%. The current study expands upon our earlier finding that chronic pituitary gland dysfunction occurs with a similarly high frequency after blast-related concussions. We measured circulating hormone levels and accessed demographic and testing data from two groups of male veterans with hazardous duty experience in Iraq or Afghanistan. Veterans in the mTBI group had experienced one or more blast-related concussion. Members of the deployment control (DC) group encountered similar deployment conditions but had no history of blast-related mTBI. 12 of 39 (31%) of the mTBI participants and 3 of 20 (15%) veterans in the DC group screened positive for one or more neuroendocrine disorders. Positive screens for growth hormone deficiency occurred most often. Analysis of responses on self-report questionnaires revealed main effects of both mTBI and hypopituitarism on postconcussive and posttraumatic stress disorder (PTSD) symptoms. Symptoms associated with pituitary dysfunction overlap considerably with those of PTSD. They include cognitive deficiencies, mood and anxiety disorders, sleep problems, diminished quality of life, deleterious changes in metabolism and body composition, and increased cardiovascular mortality. When such symptoms are due to hypopituitarism, they may be alleviated by hormone replacement. These findings suggest consideration of routine post-deployment neuroendocrine screening of service members and veterans who have experienced blast-related mTBI and are reporting postconcussive symptoms.
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Limited evidence suggests a similar increase in hormone dysfunction following blast injury and non-blast TBI incurred during military service.
“Limited evidence suggests a similar increase in hormone dysfunction following blast injury as well as non-blast TBI incurred during military service.”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [44]
The Abstract and Discussion report hormone dysfunction after blast-related TBI in military veterans, including positive screens in 12 of 39 veterans with blast-related concussion. The Discussion mentions a military TBI cohort that included some non-blast injuries, but reports only a pooled pituitary-abnormality rate; it does not establish a similar increase specifically after non-blast TBI incurred during military service. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredStudies of military personnel with TBI suggested higher rates of pituitary dysfunction after TBI during military service, but none allowed full pituitary evaluations.
“All results suggested higher rates of pituitary dysfunction after TBI during military service, but none of the study designs allowed for full pituitary evaluations.”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [44]
The Discussion (page unavailable) reports higher rates of pituitary abnormalities in military personnel with TBI than in comparison groups, and says this study could provide screening assessments but not diagnostic evaluations because provocative testing was impossible. It does not establish that none of the other military studies allowed full pituitary evaluations. (LLM, conf=0.84)
Experimental — accuracy not yet measuredDownregulation of genes involved in GH has been described in postmortem studies of patients who died from COVID-19.
“Downregulation of genes involved in GH has been described in postmortem studies of patients who died from COVID-19 [44]”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [44]
The Results section reports serum IGF-I levels in participants with mild traumatic brain injury, and the Discussion addresses growth hormone deficiency. Searches for COVID-19 postmortem studies and GH-related gene downregulation found no passage addressing the attributed claim; the copy reports no contrary finding either. Page numbers were not available. (LLM, conf=0.78)
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- Authors
- Undurti, A., Colasurdo, E. A., Sikkema, C. L., Schultz, J. S., Peskind, E. R., Pagulayan, K. F., & Wilkinson, C. W.
- Affiliations
- University of Washington (US)
- United States Department of Veterans Affairs (US)
- Corresponding author
- Wilkinson, Charles W.
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2018-02-19
- Volume
- 9
- Pages
- 72-72
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC5825904
- OpenAlex
- W2790322976
- Cited by
- 44
- References
- 109
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 2 · 2021: 5 · 2020: 10 · 2019: 11 · 2018: 3
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- U.S. Department of Defense (W81XWH-11-1-0278)
- U.S. Department of Veterans Affairs (5 I01 RX 000509, IK2CX000516, B77421)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- mild traumatic brain injury, post-concussion symptoms, post-traumatic stress disorder, neuroendocrine disorders, growth hormone deficiency, veterans, improvised explosive devices, hormone replacement therapy, Iraq and Afghanistan deployment
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