Screening for possible hypopituitarism following mild traumatic brain injury: The first all-female study. Who do we need to evaluate further?¹

Article type: Research Article

Authors: Claessen, Lára Ósk Eggertsdóttir^{a; b; *} | Kristjánsdóttir, Hafrún^d | Jónsdóttir, María K.^{e; f} | Lund, Sigrún Helga^g | Kristensen, Ingunn S.U.^f | Sigurjónsdóttir, Helga Ágústa^{a; c}

Affiliations: [a] Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland | [b] Department of Emergency Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland | [c] Department of Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland | [d] Physical Activity, Physical Education, Sport and Health (PAPESH) Research Centre, Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland | [e] Mental Health Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland | [f] Psychology Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland | [g] deCODE Genetics, Inc/Amgen Inc., Reykjavík, Iceland

Correspondence: [*] Address for correspondence: Lára Ósk Eggertsdóttir Claessen, M.D. Emergency Medicine Resident, Department of Emergency medicine, Landspitali University Hospital, Fossvogur 108, Reykjavík, Iceland. E-mails: [email protected] and [email protected].

Note: [1] This article received a correction notice (Erratum) post publication with DOI 10.3233/NRE-236001, available at http://doi.org/10.3233/NRE-236001.

Abstract: BACKGROUND:Studies on hypopituitarism (HP) following mild traumatic brain injury (mTBI) have focused on male populations although women may be more susceptible to the sequelae of mTBI. This is, to the best of our knowledge, the first all-female study screening for HP following mTBI. OBJECTIVE:Screening for possible HP in female athletes reporting a history of one or more mTBI. METHODS:Pituitary hormone screening blood tests (SBT) were performed in 133 of the 151 female athletes included. Repeated results outside the reference value (O-RV) were considered abnormal necessitating further endocrinological evaluation. RESULTS:Repeated SBT were O-RV in 88 women (66.2%). Decreased levels of serum insulin growth factor 1 (S-IGF1) were found in 55.6% of participants and elevated levels of serum prolactin (S-prolactin) in 22.6%. Serum cortisol levels were below the RV in 6.0% and thyroid hormonal levels in 11.3%. Lower age and increased number of mTBI symptoms correlated significantly with the risk of hormonal results O-RV. CONCLUSION:The majority of the study population had SBT O-RV, warranting further workup of possible HP. Decreased levels of S-IGF1 were most commonly observed followed by elevated S-prolactin possibly indicating hypothalamic-pituitary impairment. Lower age and increased number of symptoms of mTBI may indicate the need to screen for HP.

Keywords: Head trauma, sport-related concussion (SRC), female athletes, pituitary hormones, hormone deficiency

DOI: 10.3233/NRE-220194

Journal: NeuroRehabilitation, vol. 52, no. 2, pp. 259-271, 2023