Growth Hormone Alters Brain Morphometry, Connectivity, and Behavior in Subjects with Fatigue after Mild Traumatic Brain Injury.

Pituitary dysfunction with reduced growth hormone (GH) secretion is common in patients following traumatic brain injury (TBI), and these patients often develop chronic symptoms including fatigue and altered cognition. We examined 18 subjects with a history of mild TBI, fatigue, and insufficient GH secretion. Subjects received GH replacement in a year-long, double-blind, placebo-controlled, crossover study, and were assessed for changes in physical performance, body composition, resting energy expenditure, fatigue, sleep, mood, and neuropsychological status.

Hypoaminoacidemia Characterizes Chronic Traumatic Brain Injury.

Individuals with a history of traumatic brain injury (TBI) are at increased risk for a number of disorders, including Alzheimer's disease, Parkinson's disease, and chronic traumatic encephalopathy. However, mediators of the long-term morbidity are uncertain. We conducted a multi-site, prospective trial in chronic TBI patients (∼18 years post-TBI) living in long-term 24-h care environments and local controls without a history of head injury.

Chronic Endocrinopathies in Traumatic Brain Injury Disease.

The aim of this review was to explain the role played by pituitary hormonal deficiencies in the traumatic brain injury (TBI) disease process. Chronic dysfunction of the pituitary axis is observed in approximately 35% of individuals who sustain a moderate-to-severe TBI. The most common deficiency is that of growth hormone, followed by gonadotropin, cortisol, and thyroid.

Hyperbaric oxygen therapy for traumatic brain injury: still an enigma.

With their article on the use of HBOT for post TBI dysautonomia, Lv and colleagues discuss a novel use for this form of treatment. Although HBOT has been a part of our TBI treatment armamentarium for many years, its use remains a very controversial issue. In this commentary, the science and research studies behind HBOT for TBI are reviewed, hopefully leaving the reader with an adequate knowledge base to answer a patient or family's inquiries as to the usefulness of HBOT for TBI.

Traumatic brain injury: a disease process, not an event.

Traumatic brain injury (TBI) is seen by the insurance industry and many health care providers as an "event." Once treated and provided with a brief period of rehabilitation, the perception exists that patients with a TBI require little further treatment and face no lasting effects on the central nervous system or other organ systems. In fact, TBI is a chronic disease process, one that fits the World Health Organization definition as having one or more of the following characteristics: it is permanent, caused by non-reversible pathological alterations, requires special training of the patient for rehabilitation, and/or may require a long period of observation, supervision, or care.

Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease.

Objective: The prevalence of apathy was assessed across select cognitive and psychiatric variables in 32 nondemented patients with Parkinson disease (PD) and 29 demographically matched healthy control participants.

Background: Apathy is common in PD, although differentiating apathy from motor, cognitive, and/or other neuropsychiatric symptoms can be challenging. Previous studies have reported a positive relationship between apathy and cognitive impairment, particularly executive dysfunction.

Traumatic brain injury induced hypopituitarism: the need and hope of rehabilitation.

Traumatic brain injury is a leading cause of death and disability in developed countries. Damage caused by focal and diffuse lesions produces symptoms involving most major medical systems as well as symptoms of neurological and psychological origin. The severity of a traumatic brain injury is difficult to assess, and therefore, an initial accurate prognosis is difficult as well.

Regional CBF in chronic stable TBI treated with hyperbaric oxygen.

To investigate whether Hyperbaric Oxygen Therapy (HBO2) could improve neurologic deficits and regional cerebral blood flow (rCBF) in chronic traumatic brain injuries (TBI), the authors employed a nonrandomized control pilot trial. Five subjects, at least three years post head injury, received HBO2. Five head injured controls (HIC) were matched for age, sex, and type of injury.

Rehabilitation and hypopituitarism after traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability in the United States (US). The severity of a TBI is difficult to assess, and therefore, accurate determination of the prognosis is difficult. The symptoms of a TBI involve most major medical systems, and share many similarities with the symptoms of hypopituitarism.

Use of community integration questionnaire (CIQ) to characterize changes in functioning for individuals with traumatic brain injury who participated in a post-acute rehabilitation programme.

Objective: Evaluate changes in community integration for survivors of traumatic brain injury (TBI) who participated in a post-acute rehabilitation programme.

Design: Cohort, prospective study investigating change from admission to post-discharge.

Participants: Individuals, the majority of whom were diagnosed with severe TBI, were placed into one of two groups as follows: (1).

Excessive daytime sleepiness in adults with brain injuries.

Objectives: To determine the prevalence, demographics, and causes of excessive daytime sleepiness in adults with brain injuries after the acute phase of their injury and to investigate the relations between self-report and objective measures of hypersomnolence.

Design: A case series of patients enrolled consecutively into a residential rehabilitation program.

Setting: University sleep laboratory, live-in rehabilitation center.

Virtual reality in the assessment of selected cognitive function after brain injury.

Objective: To assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment.

Study Design: A computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks.

Neuropsychological assessment and the Disability Rating Scale (DRS): a concurrent validity study.

Assessment of current level of functioning among clients with traumatic brain injury (TBI) often guides the establishment of realistic outcome goals for post-acute rehabilitation. Further, data generated from neuropsychological testing provide a clinician with a better understanding of a client's pattern of cognitive strengths and weaknesses. The Disability Rating Scale (DRS) is commonly used by TBI rehabilitation facilities to assess a client's general level of functioning in terms of impairment, disability, and handicap.

Predictive validity of the Neurobehavioural Cognitive Status Examination (NCSE) in a post-acute rehabilitation setting.

Within the context of a post-acute rehabilitation setting, association and agreement between results from the Neurobehavioural Cognitive Status Examination (NCSE) and from the neuropsychological (NP) evaluation are examined. All participants (n = 48) had sustained a severe traumatic brain injury and NCSE testing preceded NP testing by an average of 1 month. A significant relationship and fair classification agreement (i.