Virginia Via Research Day Book 2026

Medical Student Research Clinical

05 EVALUATING QUALITY OF LIFE EFFECTS AFTER GROWTH HORMONE REPLACEMENT IN INDIVIDUALS WITH TRAUMATIC BRAIN INJURY AND GROWTH HORMONE DEFICIENCY

Brooke Scardina, OMS-III; Mason Nelson, OMS-III; Ramzi Badra, OMS-III; Varun Mishra, MS-IV; Taylor P. van Doren, PhD, Melissa Martinez, NP-C; Justin L. Weppner, DO Corresponding author: jlweppner@carilionclinic.org

VCOM-Virginia, Blacksburg, Virginia Virginia Tech-Carilion School of Medicine, Roanoke, Virginia High Point University, High Point, North Carolina Carilion Clinic Brain Injury Center, Roanoke, Virginia Context: Traumatic brain injury (TBI) remains a leading cause of mortality and long-term morbidity worldwide. TBI survivors may experience persistent neurobehavioral symptoms that impact their quality of life, such as memory and concentration deficits, anxiety, depression, and fatigue. Growth hormone deficiency (GHD) is common after moderate-to-severe TBI (msTBI) and may contribute to these impairments. This study evaluates the impact of growth hormone replacement therapy (GHRT) on quality of life (QOL) in msTBI patients with GHD. Objective: The objective of our research is to determine whether GHRT improves QOL in patients with msTBI and GHD. We hypothesize that GHRT will lead to significant improvements as measured by a validated, TBI-specific instrument: the Quality of Life after Brain Injury (QOLIBRI) questionnaire. Methods: A prospective cohort of 69 adults aged 18–65 with msTBI and confirmed GHD (via glucagon stimulation test at least one-year post-injury) was enrolled from a single center. Participants initiated

GHRT and were followed for 12 months. QOL was assessed at baseline, 6 months, and 12 months using the QOLIBRI questionnaire, which evaluates six domains: Thinking Abilities, Emotions, Independence/ Daily Function, Social Relationships, Feelings, and Physical Problems. Demographic and clinical variables, including age, sex, race, BMI, TBI severity, GOSE score, and neuroimaging findings, were recorded. Changes in QOLIBRI domain scores were analyzed using Kruskal-Wallis tests, and ordinary least squares regression explored predictors of QOL outcomes. Results: Significant improvements were observed in Thinking Abilities (mean increase from 24.9 to 28.1, p=0.029), Emotions (21.1 to 26.2, p<0.001), and reductions in negative Feelings (16.2 to 13.9, p=0.0055), including anxiety and depression (both p<0.001). Physical Problems scores improved (9.7 to 8.6, p=0.012). Independence/Daily Function and Social Relationships domains showed no significant overall change, though satisfaction with sex life improved (p=0.002). Overall QOL increased significantly (p=0.0037). Severe TBI and hypothalamic injury

predicted lower QOL, while diffuse axonal injury predicted higher QOL. Conclusion: GHRT is associated with significant improvements in cognitive, emotional, and physical QOL domains in msTBI patients with GHD. However, it is important to note that specific ameliorations vary between QOLIBRI domains. These findings support routine endocrine screening and consideration of GHRT in this population to improve QOL. Further research with larger cohorts and longer follow-up is warranted to confirm these benefits and assess long-term outcomes. IRB Statement: This study was approved by the Carilion Clinic IRB, protocol number 24-1919.

Table of Contents

176 Edward Via College of Osteopathic Medicine (VCOM)