Evaluating Quality of Life Effects after Growth Hormone Replacement in Individuals with Moderate-to-Severe Traumatic Brain Injury and Growth Hormone Deficiency

Traumatic brain injury (TBI) is a leading cause of long-term disability, with chronic complications including growth hormone deficiency (GHD). Growth hormone replacement therapy (GHRT) has shown promise in improving these outcomes, but evidence specific to moderate-to-severe TBI (msTBI) populations using TBI-specific quality of life (QoL) measures remains limited. This prospective cohort study evaluated the impact of 1 year of GHRT on QoL in 69 adults with msTBI and GHD, using the QoL after Brain Injury (QOLIBRI) questionnaire. GHD was diagnosed via glucagon stimulation testing at least 1-year postinjury. GHRT was initiated and titrated to achieve therapeutic insulin-like growth factor 1 levels, with QOLIBRI scores collected at baseline, 6 months, and 12 months. Statistical analyses included Friedman tests and multivariate mixed-effects models. Results demonstrated significant improvements in all QOLIBRI domains after 1 year of GHRT. Mixed effects analysis showed a trend toward lower overall QoL after GHRT in severe TBI patients and most model variation existed among individuals by domain of QOLIBRI. These findings suggest that GHRT is associated with improved cognitive, emotional, and physical aspects of QoL in msTBI patients with GHD, as measured by a TBI-specific instrument. The study is limited by its single-center, observational design and lack of a control group. Further research with larger, controlled cohorts is warranted to clarify the long-term benefits of GHRT and optimize management strategies for this population. Enhanced screening and treatment of endocrine dysfunction may improve outcomes for individuals with msTBI.