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P-985 - Chronic Pituitary Dysfunction Associated With Cognitive and Neuropsychiatric Deficits After Blast-related Mild Traumatic Brain Injury

Published online by Cambridge University Press:  15 April 2020

C.W. Wilkinson ,
E.R. Peskind ,
K.F. Pagulayan ,
E.A. Colasurdo  and
J.B. Shofer
C.W. Wilkinson
Affiliation:
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington, USA Northwest Network Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
E.R. Peskind
Affiliation:
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington, USA Northwest Network Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
K.F. Pagulayan
Affiliation:
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington, USA Northwest Network Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
E.A. Colasurdo
Affiliation:
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington, USA Northwest Network Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
J.B. Shofer
Affiliation:
Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington, USA Northwest Network Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA

Abstract

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Introduction

Studies of traumatic brain injury (TBI) from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones, in 25–50% of cases. Hypopituitarism, particularly growth hormone deficiency (GHD), is associated with symptoms that can be mistaken for PTSD, including fatigue, anxiety, depression, irritability, insomnia, sexual dysfunction, poor concentration and memory, and decreased quality of life.

Objectives

The objective of this study is to determine the prevalence and consequences of posttraumatic hypopituitarism (PTHP) after blast-related mild TBI (mTBI), an extremely common injury in modern military operations.

Aims

Blood samples are analyzed from US military Veterans with blast mTBI and from Veterans with similar experience but without blast exposure to determine the frequency of PTHP and to characterize specific hormonal defects.

Methods

Concentrations of 12 hormones are measured with radioimmunoassays or enzyme-linked immunosorbent assays and behavioral and neuropsychological testing is conducted on all subjects.

Results

Eleven of 26, or 42%, of subjects with blast mTBI were found with abnormal hormone levels in one or more pituitary axes. Five individuals with mTBI were found with probable GHD, and three mTBI participants showed evidence of hypogonadism. Veterans without blast exposure had no hormonal abnormalities.

Conclusions

There is a high prevalence of PTHP after blast mTBI, the neuropsychiatric symptoms of which are treatable with hormonal replacement. Screening for PTHP after blast mTBI shows promise for appropriately directing diagnostic and therapeutic decisions that may otherwise remain unconsidered.

Type
Abstract
Information
European Psychiatry , Volume 27 , Issue S1: Abstracts of the 20th European Congress of Psychiatry , 2012 , pp. 1
Copyright
Copyright © European Psychiatric Association 2012
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