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Miller RM, Dunn JA, O'Beirne GA, Whitney SL, Snell DL. Relationships between vestibular issues, noise sensitivity, anxiety and prolonged recovery from mild traumatic brain injury among adults: a scoping review. Brain Inj 2024; 38:607-619. [PMID: 38597651 DOI: 10.1080/02699052.2024.2337905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND We investigated the extent of literature and findings on relationships between vestibular issues, noise sensitivity (NS), and anxiety. We were interested in how relationships among these factors impacted adults' recovery three months or more after mild traumatic brain injury (mTBI). METHODS We conducted a scoping review to evaluate the extent of evidence linking relationships between vestibular issues, NS and anxiety with recovery after mTBI. Data relating to study characteristics and key findings were extracted and used to inform a critical narrative synthesis of findings. RESULTS After screening and full-text review, we included two studies. Both studies considered the combination of vestibular issues, NS and anxiety and mTBI recovery. Vestibular issues, NS and anxiety were all significantly associated with one another and their presence was the strongest indicator that symptoms would extend beyond three-months after mTBI. CONCLUSION Few studies have focused on the relationships that vestibular issues, NS and anxiety have with one another and recovery after mTBI. Given the apparent strong relationships between these factors and prolonged recovery, we highlight this as an area warranting further investigation.
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Affiliation(s)
- Rebekah M Miller
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Greg A O'Beirne
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, Univeristy of Auckland, Auckland, New Zealand
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Deborah L Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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Magyar-Sumegi ZD, Stankovics L, Lendvai-Emmert D, Czigler A, Hegedus E, Csendes M, Toth L, Ungvari Z, Buki A, Toth P. Acute neuroendocrine changes after traumatic brain injury. BRAIN & SPINE 2024; 4:102830. [PMID: 38764890 PMCID: PMC11101905 DOI: 10.1016/j.bas.2024.102830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024]
Abstract
Introduction Post-traumatic hypopituitarism (PTHP) is a significant, but often neglected consequence of traumatic brain injury (TBI). Research question We aimed to provide a comprehensive overview of epidemiology, pathophysiology, clinical features and diagnostic approaches of PTHP. Materials and methods MEDLINE, EMBASE, Cochrane Library and Web of Science were searched. 45 articles of human studies evaluating acute endocrine changes following mild, moderate and severe TBI were selected. Results Severity of TBI seems to be the most important risk factor of PTHP. Adrenal insufficiency (AI) was present in 10% of TBI patients (prevalence can be as high as 50% after severe TBI), and hypocortisolemia is a predictor of mortality and long-term hypopituitarism. Suppression of the thyroid axis in 2-33% of TBI patients may be an independent predictor of adverse neurological outcome, as well. 9-36% of patients with severe TBI exhibit decreased function of the somatotrophic axis with a divergent effect on the central nervous system. Arginine-Vasopressin (AVP) deficiency is present in 15-51% of patients, associated with increased mortality and unfavorable outcome. Due to shear and injury of the stalk hyperprolactinemia is relatively common (2-50%), but it bears little clinical significance. Sex hormone levels remain within normal values. Discussion and conclusion PTHP occurs frequently after TBI, affecting various axis and determining patients' outcome. However, evidence is scarce regarding exact epidemiology, diagnosis, and effective clinical application of hormone substitution. Future studies are needed to identify patients at-risk, determine the optimal timing for endocrine testing, and refine diagnostic and treatment approaches to improve outcome.
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Affiliation(s)
- Zsofia Dina Magyar-Sumegi
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
- Doctoral School of Clinical Neurosciences, Medical School, University of Pecs, Pecs, Hungary
| | - Levente Stankovics
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | | | - Andras Czigler
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Emoke Hegedus
- Doctoral School of Clinical Neurosciences, Medical School, University of Pecs, Pecs, Hungary
- Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Pecs, Hungary
| | - Mark Csendes
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- Doctoral School of Clinical Neurosciences, Medical School, University of Pecs, Pecs, Hungary
| | - Luca Toth
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Ungvari
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Andras Buki
- Department of Neurosurgery, Faculty of Medicine and Health, Orebro University, Orebro, Sweden
| | - Peter Toth
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
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Ruan F, Chen J, Yang J, Wang G. MILD TRAUMATIC BRAIN INJURY ATTENUATES PNEUMONIA-INDUCED LUNG INJURY BY MODULATIONS OF ALVEOLAR MACROPHAGE BACTERICIDAL ACTIVITY AND M1 POLARIZATION. Shock 2022; 58:400-407. [PMID: 36166827 PMCID: PMC9712263 DOI: 10.1097/shk.0000000000001989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
ABSTRACT Traumatic brain injury is one of the main causes of death and disability worldwide, and results in multisystem complications. However, the mechanism of mild traumatic brain injury (MTBI) on lung injury remains unclear. In this study, we used a murine model of MTBI and pneumonia ( Pseudomonas aeruginosa ;) to explore the relationship between these conditions and the underlying mechanism. Methods: Mice (n = 104) were divided into control, MTBI, pneumonia, and MTBI + pneumonia groups. MTBI was induced by the weight-drop method. Pneumonia was induced by intratracheal injection with P. aeruginosa Xen5 strain. Animals were killed 24 h after bacterial challenging. Histological, cellular, and molecular indices of brain and lung injury were assessed using various methods. Results: Mice in both the MTBI and pneumonia groups had more Fluoro-Jade C-positive neurons than did the controls ( P < 0.01), but mice in the MTBI + pneumonia group had fewer Fluoro-Jade C-positive cells than did the pneumonia group ( P < 0.01). The MTBI + pneumonia mice showed decreased bacterial load ( P < 0.05), reduced lung injury score and pulmonary permeability ( P < 0.01), less inflammatory cells, and lower levels of proinflammatory cytokines (TNF-α and IL-1β; P < 0.01) when compared with the pneumonia group. Molecular analysis indicated lower levels of phosphorylated nuclear factor-κB in the lung of MTBI + pneumonia mice compared with the pneumonia group ( P < 0.01). Furthermore, alveolar macrophages from MTBI mice exhibited enhanced bactericidal capacity compared with those from controls ( P < 0.01). Moreover, MTBI + pneumonia mice exhibited less CD86-positive M1 macrophages compared with the pneumonia group ( P < 0.01). Conclusions: MTBI attenuates pneumonia-induced acute lung injury through the modulation of alveolar macrophage bactericidal capacity and M1 polarization in bacterial pneumonia model.
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Affiliation(s)
- Feng Ruan
- Department of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China
- Department of Surgery, SUNY Upstate Medical University, Syracuse, New York, 13210, USA
| | - Jing Chen
- Department of Ophthalmology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, P.R. China
| | - Jianxin Yang
- Department of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China
| | - Guirong Wang
- Department of Surgery, SUNY Upstate Medical University, Syracuse, New York, 13210, USA
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Gianoli GJ. Post-concussive Dizziness: A Review and Clinical Approach to the Patient. Front Neurol 2022; 12:718318. [PMID: 35058868 PMCID: PMC8764304 DOI: 10.3389/fneur.2021.718318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/13/2021] [Indexed: 01/25/2023] Open
Abstract
Dizziness is a frequent complaint after head trauma. Among patients who suffer a concussion (mild traumatic brain injury or mTBI), dizziness is second only to headache in symptom frequency. The differential diagnosis of post-concussive dizziness (PCD) can be divided into non-vestibular, central vestibular and peripheral vestibular causes with growing recognition that patients frequently exhibit both central and peripheral findings on vestibular testing. Symptoms that traditionally have been ascribed to central vestibular dysfunction may be due to peripheral dysfunction. Further, our ability to test peripheral vestibular function has improved and has allowed us to identify peripheral disorders that in the past would have remained unnoticed. The importance of the identification of the peripheral component in PCD lies in our ability to remedy the peripheral vestibular component to a much greater extent than the central component. Unfortunately, many patients are not adequately evaluated for vestibular disorders until long after the onset of their symptoms. Among the diagnoses seen as causes for PCD are (1) Central vestibular disorders, (2) Benign Paroxysmal Positional Vertigo (BPPV), (3) Labyrinthine dehiscence/perilymph fistula syndrome, (4) labyrinthine concussion, (5) secondary endolymphatic hydrops, (6) Temporal bone fracture, and (7) Malingering (particularly when litigation is pending). These diagnoses are not mutually exclusive and PCD patients frequently exhibit a combination of these disorders. A review of the literature and a general approach to the patient with post-concussive dizziness will be detailed as well as a review of the above-mentioned diagnostic categories.
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Heslot C, Cogné M, Guillouët E, Perdrieau V, Lefevre-Dognin C, Glize B, Bonan I, Azouvi P. Management of unfavorable outcome after mild traumatic brain injury: Review of physical and cognitive rehabilitation and of psychological care in post-concussive syndrome. Neurochirurgie 2020; 67:283-289. [PMID: 33049290 DOI: 10.1016/j.neuchi.2020.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 08/26/2020] [Accepted: 09/13/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Mild Traumatic Brain Injury (mTBI) is a public health issue with approximately 42 million people worldwide affected yearly. Most patients have a favorable short-term recovery but 10-20% are likely to develop post-concussive syndrome (association of physical, cognitive, and psychological difficulties after injury). Post-concussive syndrome can be associated with Post-Traumatic Stress Disorder (PTSD). There is to date no recommendation on the interventions that could be done to reduce post-concussive syndrome. The present review aims at summarizing the effect of therapeutic education, physical and cognitive rehabilitation and of psychological care in mTBI patients with post-concussive syndrome. METHODS In the current international literature, we investigated the effects of therapeutic education, physical and cognitive rehabilitation and of psychological care in this population using the Medline database and we discussed the results of these studies. RESULTS The application of a therapeutic education intervention within 3 months after mTBI has been found appropriate and effective to prevent post-concussion syndrome in several studies but the timeline of this intervention differs among the existing studies. Concerning physical disabilities, several pharmacological, rehabilitative and non-pharmacological techniques have shown some efficacy in reducing headache and vertigo; rTMS seems also promising in this context. The management of fatigue is also crucial and requires a multidisciplinary approach. We did not find any intervention in mTBI patients with post-concussive syndrome suffering from dysosmia and/or dysgueusia. No pharmacological treatment is currently recommended to reduce the cognitive symptoms of post-concussive syndrome after mTBI. Rehabilitation and brain-stimulation techniques have already proven their efficacy to reduce the cognitive impairment in this population. Even if the use of Virtual Reality software seems well tolerated in this population, its efficacy and additional value needs to be demonstrated in larger studies. Concerning the psychological care after mTBI, Cognitive and Behavioral Therapy interventions are the most frequently reported in this population, followed by psychoeducational interventions. PTSD management seems crucial in overall recovery of patients with post-concussive syndrome. CONCLUSION Many studies have sought to demonstrate the effectiveness of various rehabilitation techniques, including different cognitive rehabilitation programs, technology-assisted rehabilitation, different types of brain stimulation and some pharmacological treatments. However, most of these studies are of a low level of scientific evidence and it would be necessary to carry out well-conducted prospective randomized trials in order to offer an appropriate and effective multidisciplinary management for patients with post-concussive syndrome after mTBI.
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Affiliation(s)
- C Heslot
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - M Cogné
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
| | - E Guillouët
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - V Perdrieau
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - C Lefevre-Dognin
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - B Glize
- Rehabilitation Medicine Unit, Bordeaux University Hospital, place Amélie-Raba-Léon, 33000 Bordeaux, France; EA4136, Bordeaux University, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - I Bonan
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Unit Empenn-U1228, INSERM, INRIA, University of Rennes 1, Rennes, France
| | - P Azouvi
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047 HANDIReSP, Versailles-Saint Quentin University, France
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Endocrine Dysfunction Following Stroke. J Neuroimmune Pharmacol 2020; 16:425-436. [PMID: 32621001 DOI: 10.1007/s11481-020-09935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
Endocrine dysfunction is known to occur after traumatic brain injury. The purpose of this study was to examine the incidence of various endocrine dysfunctions after a stroke. The Taiwan National Health Insurance Research Database (NHIRD) was searched from 2001 to 2011 for patients with a diagnosis of stroke. Stroke patients were matched by diagnosis date, age, and sex to patients without a stroke. Cox proportional hazards regression analyses were performed to compare the incidence of goiter, acquired hypothyroidism, thyroiditis, pituitary dysfunction, and disorders of the adrenal glands between stroke and non-stroke patients. There were 131,951 patients in the stroke group, and 131,951 in the matched non- stroke group (mean age 66.1 ± 14.9 years). Stroke patients had significantly higher risk of acquired hypothyroidism (crude hazard ratio [cHR] = 1.65, 95% confidence interval [CI]: 1.44, 1.90; adjusted hazard ratio [aHR] = 1.65, 95% CI: 1.42, 1.91), pituitary dysfunction (cHR = 2.32, 95% CI: 1.79, 2.99; aHR = 1.92, 95% CI: 1.46, 2.52), and disorders of the adrenal glands (cHR = 1.79, 95% CI: 1.52, 2.12; aHR =1.62, 95% CI: 1.36, 1.92) than non-stroke patients. Pituitary dysfunction and disorders of the adrenal glands were found in both hemorrhagic stroke and ischemic stroke patients, while hypothyroidism was seen in ischemic stroke patients only. No significant association was found for goiter and thyroiditis. In conclusions, stroke survivors have an approximately 2-fold increased risk of developing acquired hypothyroidism, pituitary dysfunction, or disorders of the adrenal glands. These risks should be taken into account in the management of patients who have ischemic or hemorrhagic strokes. Graphical Abstract.
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Ciarlone SL, Statz JK, Goodrich JA, Norris JN, Goforth CW, Ahlers ST, Tschiffely AE. Neuroendocrine function and associated mental health outcomes following mild traumatic brain injury in OEF‐deployed service members. J Neurosci Res 2020; 98:1174-1187. [DOI: 10.1002/jnr.24604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 01/31/2020] [Accepted: 02/10/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Stephanie L. Ciarlone
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
- The Henry M. Jackson Foundation Inc. Bethesda MD USA
| | - Jonathan K. Statz
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
- The Henry M. Jackson Foundation Inc. Bethesda MD USA
| | - Jessica A. Goodrich
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
- The Henry M. Jackson Foundation Inc. Bethesda MD USA
| | - Jacob N. Norris
- Cyber, Science, & Technology Department Space and Naval Warfare Systems Center Pacific San Diego CA USA
| | - Carl W. Goforth
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
- Department of Surgery Uniformed Services University of the Health Sciences Bethesda MD USA
| | - Stephen T. Ahlers
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
| | - Anna E. Tschiffely
- Neurotrauma Department Naval Medical Research Center Silver Spring MD USA
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Gray S, Bilski T, Dieudonne B, Saeed S. Hypopituitarism After Traumatic Brain Injury. Cureus 2019; 11:e4163. [PMID: 31065469 PMCID: PMC6497183 DOI: 10.7759/cureus.4163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/01/2019] [Indexed: 02/02/2023] Open
Abstract
Acquired hypopituitarism is associated with traumatic brain injury. This neuroendocrine dysfunction can cause both short-term and long-term morbidity resulting in a cognitive, physiological, and behavioral decline, which increases the burden of the disease and the cost of care. Data in the trauma literature is derisory on this subject. The aim of this review is to edify clinicians on this condition, outline the screening criteria and methods for hypopituitarism after traumatic brain injury, and bring awareness to the chronic effects.
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Affiliation(s)
- Sanjiv Gray
- Surgery, University of Central Florida, Orlando, USA
| | - Tracy Bilski
- Surgery, University of South Florida Morsani College of Medicine, Kissimmee, USA
| | | | - Saqib Saeed
- Surgery, Harlem Hospital Center, New York, USA
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Beyer H, Gempt J. Hypophysenstörungen nach Schädel-Hirn-Trauma bei Erwachsenen. Notf Rett Med 2019. [DOI: 10.1007/s10049-018-0491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rowe RK, Rumney BM, May HG, Permana P, Adelson PD, Harman SM, Lifshitz J, Thomas TC. Diffuse traumatic brain injury affects chronic corticosterone function in the rat. Endocr Connect 2016; 5:152-66. [PMID: 27317610 PMCID: PMC5002959 DOI: 10.1530/ec-16-0031] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/17/2016] [Indexed: 01/02/2023]
Abstract
As many as 20-55% of patients with a history of traumatic brain injury (TBI) experience chronic endocrine dysfunction, leading to impaired quality of life, impaired rehabilitation efforts and lowered life expectancy. Endocrine dysfunction after TBI is thought to result from acceleration-deceleration forces to the brain within the skull, creating enduring hypothalamic and pituitary neuropathology, and subsequent hypothalamic-pituitary endocrine (HPE) dysfunction. These experiments were designed to test the hypothesis that a single diffuse TBI results in chronic dysfunction of corticosterone (CORT), a glucocorticoid released in response to stress and testosterone. We used a rodent model of diffuse TBI induced by midline fluid percussion injury (mFPI). At 2months postinjury compared with uninjured control animals, circulating levels of CORT were evaluated at rest, under restraint stress and in response to dexamethasone, a synthetic glucocorticoid commonly used to test HPE axis regulation. Testosterone was evaluated at rest. Further, we assessed changes in injury-induced neuron morphology (Golgi stain), neuropathology (silver stain) and activated astrocytes (GFAP) in the paraventricular nucleus (PVN) of the hypothalamus. Resting plasma CORT levels were decreased at 2months postinjury and there was a blunted CORT increase in response to restraint induced stress. No changes in testosterone were measured. These changes in CORT were observed concomitantly with altered complexity of neuron processes in the PVN over time, devoid of neuropathology or astrocytosis. Results provide evidence that a single moderate diffuse TBI leads to changes in CORT function, which can contribute to the persistence of symptoms related to endocrine dysfunction. Future experiments aim to evaluate additional HP-related hormones and endocrine circuit pathology following diffuse TBI.
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Affiliation(s)
- Rachel K Rowe
- Phoenix Veterans Affairs Health Care SystemPhoenix, Arizona, USA BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Benjamin M Rumney
- BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA Department of Biology and BiochemistryUniversity of Bath, UK
| | - Hazel G May
- BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA Department of Biology and BiochemistryUniversity of Bath, UK
| | - Paska Permana
- Phoenix Veterans Affairs Health Care SystemPhoenix, Arizona, USA
| | - P David Adelson
- BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA School of Biological and Health Systems EngineeringArizona State University, Tempe, Arizona, USA
| | | | - Jonathan Lifshitz
- Phoenix Veterans Affairs Health Care SystemPhoenix, Arizona, USA BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Theresa C Thomas
- Phoenix Veterans Affairs Health Care SystemPhoenix, Arizona, USA BARROW Neurological Institute at Phoenix Children's HospitalPhoenix, Arizona, USA Department of Child HealthUniversity of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
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Cosano G, Giangreco M, Ussai S, Giorgini T, Biasutti E, Barbone F, Pisa FE. Polypharmacy and the use of medications in inpatients with acquired brain injury during post-acute rehabilitation: A cross-sectional study. Brain Inj 2016; 30:353-62. [DOI: 10.3109/02699052.2015.1118767] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McGill JB, Silverstein JM, Wren ME. PITUITARY DYSFUNCTION IN DEVELOPMENTAL DELAY: MEDICAL AND ETHICAL CONCERNS. Endocr Pract 2015; 21:848-50. [PMID: 26121462 DOI: 10.4158/ep14424.co] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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A systematic review of fatigue in patients with traumatic brain injury: The course, predictors and consequences. Neurosci Biobehav Rev 2014; 47:684-716. [DOI: 10.1016/j.neubiorev.2014.10.024] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/18/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022]
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Yu H, Watt H, Mohan S. The negative impact of traumatic brain injury (TBI) on bone in a mouse model. Brain Inj 2013; 28:244-51. [PMID: 24295038 DOI: 10.3109/02699052.2013.859735] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION While it is well established that the brain produces hypothalamic hormones and neuropeptides that influence skeletal metabolism, the impact of traumatic brain injury (TBI) on bone is unknown. Based on the recognition from clinical studies that there is an association between TBI and long-term hypothalamic pituitary dysfunction, it was hypothesized that TBI exerts a negative impact on skeletal growth and maintenance. METHODS To test the hypothesis, this study employed a repetitive weight drop model for TBI. Four impacts were applied for four consecutive days on 5-week old female C57BL/6 J mice. Bone measurements were taken 2 weeks after the first impact. RESULTS Bone mineral content (BMC), bone area (B area) and bone mineral density (BMD) in the total body were reduced by 14.5%, 9.8% and 5.2%, respectively, in the impacted vs. control mice. There was a 17.1% reduction in total volumetric BMD (vBMD) and a 4.0% reduction in material vBMD in cortical bone. In trabecular bone, there was a 44.0% reduction in BV/TV. Although there was no change in the cross-sectional bone size, the tibial growth plate and the tibia itself were shortened. CONCLUSION The repetitive animal TBI model produced an immediate, strong negative impact on bone mass acquisition in young mice.
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Affiliation(s)
- Hongrun Yu
- Musculoskeletal Disease Center, Jerry L. Pettis Memorial VA Medical Center , Loma Linda, CA , USA and
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Demirbilek H, Özbek MN, Baran RT, Baran A. Multiple pituitary hormone deficiency due to gunshot injury in a 6-year-old girl. J Clin Res Pediatr Endocrinol 2013; 5:209-11. [PMID: 24072093 PMCID: PMC3814539 DOI: 10.4274/jcrpe.1027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Gunshot injuries (GSI) of the cranial area have an extremely high mortality rate. Herein, we present a girl who has been living with a bullet in the posterior sellar region. A 6-year-old girl was admitted with complaints of headache, polyuria and polydypsia, which started after a GSI. At the time of admission the patient's anthropometric, physical and neurological examinations were normal. Urine output was 5.5 L/m2/24h. A water deprivation test suggested central diabetes insipidus, which responded to treatment. Evaluation of other pituitary hormones revealed central hypothyroidism and growth hormone deficiency. Pituitary hormone deficiency must be kept in mind in patients injured by a gunshot to the sellar/parasellar region.
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Affiliation(s)
- Hüseyin Demirbilek
- Diyarbakır Children's State Hospital, Pediatric Endocrinology, Diyarbakır, Turkey. E-mail:
| | - Mehmet Nuri Özbek
- Diyarbakır Children’s State Hospital, Pediatric Endo crinology, Diyarbakır, Turkey
| | - Rıza Taner Baran
- Diyarbakır Children’s State Hospital, Pediatric Endo crinology, Diyarbakır, Turkey
| | - Ahmet Baran
- Diyarbakır Children’s State Hospital, Radiology, Diyarbakır, Turkey
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Agrawal A, Reddy PA, Prasad NR. Endocrine manifestations of traumatic brain injury. INDIAN JOURNAL OF NEUROTRAUMA 2012. [DOI: 10.1016/j.ijnt.2012.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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