GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study
Objective: Growth hormone (GH) was shown to stimulate proliferation, migration and survival of neural cells in animal models. GH deficiency (GHD) was reported following traumatic brain lesions; however, there are not available data in spinal cord injury (SCI) patients. The aim of the study was to ev...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-10-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0296.xml |
| _version_ | 1818154804248051712 |
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| author | Guillem Cuatrecasas Hatice Kumru M Josep Coves Joan Vidal |
| author_facet | Guillem Cuatrecasas Hatice Kumru M Josep Coves Joan Vidal |
| author_sort | Guillem Cuatrecasas |
| collection | DOAJ |
| description | Objective: Growth hormone (GH) was shown to stimulate proliferation, migration and survival of neural cells in animal models. GH deficiency (GHD) was reported following traumatic brain lesions; however, there are not available data in spinal cord injury (SCI) patients. The aim of the study was to evaluate (1) the frequency of GHD in chronic SCI population; (2) the efficacy/safety of GH replacement in patients with SCI and suboptimal GH secretion.
Design and methods: Nineteen consecutive patients with chronic thoracic complete SCI (AIS-A) were studied. Patients with low GH secretion were randomized in a double-blind, placebo-controlled study to receive either subcutaneous placebo injections or GH combined with physical therapy, for 6 months. Baseline cranial MRI, AIS motor and sensory scale, quality of life (spinal cord impact measurement) and modified Ashworth spasticity scale, quantitative sensory testing and neurophysiological exploration were assessed at baseline, 1, 3 and 6 months following treatment.
Results: Thirteen had GH deficiency. Seven received GH, five placebo and one dropped out. Both groups were similar according to clinical and demographical data at baseline, except for greater GH deficiency in the GH treatment group. At 6th month, patients treated with GH showed a significant improvement in SCIM-III score and in electrical perception threshold up to the 5th level below SCI, on both sides compared to baseline.
Conclusions: GHD seems to be frequent in traumatic SCI and GH replacement is safe without side effects. GH combined with physical therapy can improve quality of life of SCI patients and, strikingly, the sensory perception below lesion level. |
| first_indexed | 2024-12-11T14:32:20Z |
| format | Article |
| id | doaj.art-07ea05261aeb47d2845f8eaf2a3a031e |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-12-11T14:32:20Z |
| publishDate | 2018-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-07ea05261aeb47d2845f8eaf2a3a031e2022-12-22T01:02:20ZengBioscientificaEndocrine Connections2049-36142049-36142018-10-0171010311039https://doi.org/10.1530/EC-18-0296GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot studyGuillem Cuatrecasas0Hatice Kumru1M Josep Coves2Joan Vidal3Endocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, Spain; Universitat Oberta Catalunya (UOC), Barcelona, SpainInstitut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain; Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain; Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, SpainEndocrinology Department, Hospital Quiron-Teknon, CPEN S.L., Barcelona, SpainInstitut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain; Univ Autònoma de Barcelona, Cerdanyola del Vallès, Spain; Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, SpainObjective: Growth hormone (GH) was shown to stimulate proliferation, migration and survival of neural cells in animal models. GH deficiency (GHD) was reported following traumatic brain lesions; however, there are not available data in spinal cord injury (SCI) patients. The aim of the study was to evaluate (1) the frequency of GHD in chronic SCI population; (2) the efficacy/safety of GH replacement in patients with SCI and suboptimal GH secretion. Design and methods: Nineteen consecutive patients with chronic thoracic complete SCI (AIS-A) were studied. Patients with low GH secretion were randomized in a double-blind, placebo-controlled study to receive either subcutaneous placebo injections or GH combined with physical therapy, for 6 months. Baseline cranial MRI, AIS motor and sensory scale, quality of life (spinal cord impact measurement) and modified Ashworth spasticity scale, quantitative sensory testing and neurophysiological exploration were assessed at baseline, 1, 3 and 6 months following treatment. Results: Thirteen had GH deficiency. Seven received GH, five placebo and one dropped out. Both groups were similar according to clinical and demographical data at baseline, except for greater GH deficiency in the GH treatment group. At 6th month, patients treated with GH showed a significant improvement in SCIM-III score and in electrical perception threshold up to the 5th level below SCI, on both sides compared to baseline. Conclusions: GHD seems to be frequent in traumatic SCI and GH replacement is safe without side effects. GH combined with physical therapy can improve quality of life of SCI patients and, strikingly, the sensory perception below lesion level.https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0296.xmlgrowth hormoneGH deficiencyspinal cord injuryphysical therapysafety |
| spellingShingle | Guillem Cuatrecasas Hatice Kumru M Josep Coves Joan Vidal GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study Endocrine Connections growth hormone GH deficiency spinal cord injury physical therapy safety |
| title | GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study |
| title_full | GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study |
| title_fullStr | GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study |
| title_full_unstemmed | GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study |
| title_short | GH deficiency in patients with spinal cord injury: efficacy/safety of GH replacement, a pilot study |
| title_sort | gh deficiency in patients with spinal cord injury efficacy safety of gh replacement a pilot study |
| topic | growth hormone GH deficiency spinal cord injury physical therapy safety |
| url | https://ec.bioscientifica.com/view/journals/ec/7/10/EC-18-0296.xml |
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