A Systematic Review of Testosterone Therapy in Men With Spinal Cord Injury or Traumatic Brain Injury.

Autor:	McLoughlin RJ; Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA., Lu Z; Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA., Warneryd AC; College of Arts and Sciences, University of Pennsylvania, Philadelphia, USA., Swanson RL 2nd; Center for Neurotrauma, Neurodegeneration and Restoration, Corporal Michael J. Crescenz VA (Veteran Affairs) Medical Center, Philadelphia, USA.; Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jan 27; Vol. 15 (1), pp. e34264. Date of Electronic Publication: 2023 Jan 27 (Print Publication: 2023).
DOI:	10.7759/cureus.34264
Abstrakt:	Spinal cord injuries (SCI) and traumatic brain injuries (TBI) increase the risk of testosterone deficiency and result in adverse changes in body composition and poor functional outcomes. The current systematic review aims to provide insights into the use of testosterone therapy for treating men with SCI and TBI. The PubMed and EMBASE databases were systematically reviewed using appropriate terms, and resulting manuscripts were screened using defined Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The patient population included male patients with SCI or TBI. Further inclusion criteria were: a) human participants 18 years of age or older; b) manuscript published in English; c) study included an intervention with exogenous testosterone; and d) articles published in peer-reviewed journals with full text available. Two reviewers independently extracted data regarding injury type, intervention, and outcomes. Following screening for inclusion/exclusion criteria, a total of 12 primary research studies conducted over the last 30 years were included. Men with SCI were investigated in 11 articles. The combination of testosterone patches and resistance training with functional electrical stimulation (FES) for 16 weeks in men with SCI and an average baseline testosterone level above the cutoff for testosterone deficiency increased muscle mass, strength, bone quality, and basal metabolic rate while testosterone patches without exercise for 16 weeks produced no significant changes in these parameters. Testosterone patches for 12 months in men with SCI and testosterone deficiency also increased lean tissue mass (LTM) and resting energy expenditure (REE). In one study, men with TBI and testosterone deficiency receiving testosterone gel for eight weeks showed a non-statistically significant greater absolute change in functional independence measure (FIM) and grip strength compared to a placebo group. Testosterone therapy with exercise may help improve muscle mass, bone health, strength, energy expenditure, and cardiac health in men with SCI without major side effects. It is difficult to draw conclusions regarding the effects of testosterone therapy in men with TBI based on the limited available evidence. Further investigation is warranted to explore the relationship between testosterone therapy and recovery after SCI and TBI. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, McLoughlin et al.)
Databáze:	MEDLINE
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