Testosterone, sex steroids, and aging in neurodegenerative disease after acquired brain injury: a commentary

Traumatic brain injury (TBI) is associated with higher incidence of neurodegenerative disease and the effects of aging appear more pronounced after TBI. This paper examines the potential interaction of aging, TBI, and change in male testosterone production.

An abbreviated review of literature documenting hypogonadism after TBI is provided. Potential mechanisms of endocrine dysgrasia associated with aging are reviewed as they relate and interact with endocrine change after TBI in males. These factors align to suggest the need for development of surveillance guidelines for male individuals living with TBI.

The neuroprotectant, neuroactivation, growth, and cell therapy characteristics of testosterone in the central nervous system are considerable. Age-related decrements in testosterone production may be accelerated after TBI.

Testosterone deficiency in male individuals after TBI can be present after TBI or can develop during aging. Age-related decreases in testosterone production after TBI may act to amplify endocrine dysfunction after TBI. Ongoing clinical surveillance for testosterone deficiency associated with both TBI and aging may be reasonable.