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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Low or Low-Normal Insulin-Like Growth Factor 1 After Traumatic Brain Injury: Interpretation and Implications.

Varun Mishra1, Melissa Martinez2,3, Justin Weppner1,2,3,4

  • 1Department of Internal Medicine, Virginia Tech-Carilion School of Medicine, Roanoke, Virginia, USA.

Journal of Neurotrauma
|March 23, 2026
PubMed
Summary

Growth hormone deficiency (GHD) after traumatic brain injury (TBI) can cause lasting symptoms. A new framework helps interpret Insulin-like Growth Factor 1 (IGF-1) levels to accurately diagnose GHD in TBI patients.

Keywords:
growth hormone deficiencyinsulin-like growth factor 1 (IGF-1)neuroendocrine dysfunctionneuroendocrine evaluationtraumatic brain injury

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Area of Science:

  • Neuroendocrinology
  • Traumatology

Background:

  • Traumatic brain injury (TBI) frequently leads to growth hormone deficiency (GHD), impacting patient recovery and quality of life.
  • Overlapping symptoms of GHD and TBI complicate diagnosis, necessitating reliable diagnostic tools.
  • Insulin-like growth factor 1 (IGF-1) is a common marker for GH status, but its interpretation requires careful consideration.

Purpose of the Study:

  • To develop a clinical framework for interpreting low or low-normal IGF-1 z-scores in patients with TBI.
  • To differentiate GHD from other conditions causing low IGF-1 in the TBI population.
  • To enhance diagnostic accuracy and patient management for neuroendocrine dysfunction post-TBI.

Main Methods:

  • Systematic literature review of PubMed and PubMed Central databases.
  • Focused on IGF-1, GHD, differential diagnoses, and GH testing guidelines.
  • Analysis of evidence to create a pragmatic interpretation framework for IGF-1 z-scores.

Main Results:

  • GHD is a primary cause of reduced IGF-1 in TBI patients.
  • Other potential causes of low IGF-1 include malnutrition, organ dysfunction, diabetes, hypothyroidism, and genetic conditions.
  • IGF-1 z-scores standardize levels for age and sex, improving diagnostic precision.

Conclusions:

  • A systematic approach to IGF-1 interpretation is crucial for distinguishing GHD from secondary causes in TBI patients.
  • The proposed framework integrates neuroendocrine evaluation with broader clinical assessments.
  • Refined screening protocols for neuroendocrine dysfunction in TBI patients are needed.