This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Fifteen to twenty percent of adults who suffer a traumatic brain injury (TBI) that requires hospitalization and rehabilitation have been found to have growth hormone (GH) deficiency by GH stimulation testing. Moreover, abnormalities have also been established for the cortisol and thyroid axis. The hypothesis of this proposal is that hormone replacement in TBI patients with documented abnormalities in the GH, thyroid, or cortisol axis will improve muslce function, body composition, aerobic capacity (GH) and performance in tests of neuropsychologic function (GH, thyroid, cortisol).
The specific aims of the proposal are to: 1) Determine the effect of recombinant human growth hormone (rhGH) on muscle function, body composition, aerobic capacity, and neuropsychologic function in subjects with TBI, 2) Determine the effect of thyroid hormone replacement on neuropsychologic function in subjects with TII, and 3) Determine the effect of cortisol replacement on neuropsychologic function in subjects with TII. This study proposes: (1) to screen patients with a history of traumatic brain injury to identify patients with pituitary dysfunction, (2) to treat all clear-clut abnormalities of adrenal or thyroid function, and (3) to study patients with GHD or subtle defects in adrenal or thyroid function, and (4) to study patients with GHD or subtle defects in adrenal or thyroid function through randomized controlled trials of replacemnt with the the respective hormone.
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