Enhancement of recovery after ischemic stroke has been a challenging area, with no intervention being widely adopted to promote recovery in clinical practice. Other acute brain insults such as TBI and subarachnoid hemorrhage have demonstrated hypopituitarism in 25% or more of patients shortly after injury. The symptoms of hypopituitarism depend on which hormone is deficient, but for hGH, they include impaired attention and memory, reduced energy, cognitive dysfunction, a decrease in muscle mass and strength, reduced bone mass and density and cardiac dysfunction, all of which are common in stroke survivors. Over the study period, 13 patients were successfully tested within a week of stroke. Overall, 9(69%) of these patients meeting the criteria or borderline for human growth hormone deficiency.
The biological reason behind the observed decline in hGH after stroke, TBI, or subarachnoid hemorrhage is largely unknown. Importantly, pituitary dysfunction after TBI is associated with a worse neurological outcome and increased morbidity and mortality, which may also be relevant to stroke survivors or future study outcomes. Animal studies have indicated that GH treatment after stroke accelerates physical recovery and leads to better learning and memory. Importantly, GH supplementation has also been shown to reduce neuronal loss in animals, which is attributed to either neuroprotection or stimulation of neurogenesis. Previous human trials of hGH treatment in a deficient clinical population of TBI patients of a comparable age range has been shown to result in significantly improved cognitive outcomes.