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Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

, 31, 4, 277-287

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Study examined relationships between persistent hypogonadotropic hypogonadism (PHH) and long-term outcomes after severe traumatic brain injury (TBI), and determined whether subacute testosterone levels can predict PHH. Post-TBI blood samples were collected during week 1, every 2 weeks until 26 weeks, and at 52 weeks. Serum hormone levels were measured, and individuals were designated as having PHH if 50 percent or more of samples met criteria for hypogonadotropic hypogonadism. At 6 and 12 months postinjury, the study assessed global outcome, disability, functional cognition, depression, and quality of life. The analysis included 78 men, median age was 28.5 years, for whom at least 2 subacute blood samples were collected. Thirty-four patients (44 percent) had PHH during the first year postinjury. Multivariable regression, controlling for age, demonstrated PHH status predicted worse global outcome scores, more disability, and reduced functional cognition at 6 and 12 months post-TBI. Two-step testosterone screening for PHH at 12 to 16 weeks postinjury yielded a sensitivity of 79 percent and specificity of 100 percent. The findings suggest that PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12 to 16 weeks.


Barton, David J., Kumar, Raj G., McCullough, Emily H., Galang, Gary, Arenth, Patricia M., Berga, Sarah L., Wagner, Amy K.