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Growth Hormone DeficiencyNCT07795736

Charactertizing Growth Hormone Deficiency in Traumatic Brain Injury

An observational study of Growth Hormone Deficiency and Traumatic Brain Injury, run by University of Calgary at 2 sites in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this observational study is to characterize the impact of growth hormone deficiency (GHD) on quality of life, symptom burden, and sleep in adults with traumatic brain injury (TBI), and to evaluate whether these outcomes improve with growth hormone replacement therapy. Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
What is being tested?
Not applicable (observational study)
Type of treatment
Pill or oral medicine
How many people
200 participants
Where
2 sitesCanada
Study dates
1 Jun 2024to 1 Nov 2028
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Patients who have sustained a traumatic brain injury and have persisting symptoms lasting beyond 1 year post-injury.

Inclusion criteria: Adults aged 18-70 years must be referred and have a diagnosis of mTBI made by a brain injury specialist physician and meet the 2023 ACRM diagnostic criteria (Appendix A, Panel A) or the NIH diagnostic criteria for moderate/severe TBI (Appendix A, Panel B). All participants must be symptomatic for at least one-year post-injury (determined by the Glasgow Extended Scale score of less than 8 for moderate/severe TBI and a Rivermead Post-Concussion Questionnaire score of > 13 with 3 or more symptoms scored > 3 for mTBI), at the time of screening. All participants must also be fluent in English and be able to either complete questionnaires online or over the phone.

In terms of concomitant therapies and medication, all prescription and non-prescription medications (e.g., over-the-counter drugs and herbal supplements) and therapies will be recorded by participants during baseline assessments. Participants with GHD on treatment will be asked to disclose any changes in medications/and or therapies at each bi-weekly follow up questionnaires.

Exclusion criteria include untreated pituitary deficits to minimize confounding factors (unless treated/consulted with Dr. Debert and/or Dr. Lithgow), other intracranial abnormalities, chronic neurological conditions, untreated medical conditions, major medical conditions in the past 6 months such as stroke, and current or planned pregnancy.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Chantel T Debert, MD MSc FRCPC CSCN contact

(403) 944-4500

cdebert@ucalgary.ca

Christina Campbell, MSc contact

403-944-8649

christina.campbel1@ucalgary.ca

Canada2 sites, 2 recruiting
  • Foothills Medical Center, Main Floor Special Services

    Calgary, Alberta, T2N2T9

    Chantel Debert, MD, FRCPC, (403) 944-4500, chantel.debert@albertahealthservices.ca

    Not yet recruiting
  • University of Calgary

    Calgary, Alberta, T3G 5N2

    Chantel T Debert, MD MSc FRCPC, 403- 944-4500, cdebert@ucalgary.ca

    Recruiting

Other trials in Canada

About this study

Official title: Characterizing Growth Hormone Deficiency in Traumatic Brain Injury: Evaluation of the Growth Hormone in Adult Quality of Life Questionnaire

The goal of this observational study is to characterize the impact of growth hormone deficiency (GHD) on quality of life, symptom burden, and sleep in adults with traumatic brain injury (TBI), and to evaluate whether these outcomes improve with growth hormone replacement therapy.

The main questions it aims to answer are:

Read more
  • Does quality of life, as measured by the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA), differ between adults with TBI and GHD compared to those with TBI and no GHD?
  • Do fatigue, cognition, mood, post-concussion symptoms, body image, libido, perceived stress, and sleep architecture differ between these two groups?
  • Among participants with GHD who begin growth hormone replacement therapy, do symptom burden and quality of life improve over a 12-week treatment period?

Eligible participants will be asked to complete baseline questionnaires and undergo testing for growth hormone deficiency (glucagon stimulation testing). A subset of participants will also complete objective sleep assessments using actigraphy and at-home polysomnography. For those who are diagnosed with growth hormone deficiency and choose to pursue treatment, questionnaires will be repeated bi-weekly while receiving growth hormone replacement therap

Read the detailed description

Growth hormone deficiency (GHD) is the most common chronic hormone deficit following traumatic brain injury (TBI) with variable prevalence (average of 10-15%), likely a reflection of the timing and methods of testing, age, and injury severity. Previous guidelines recommend assessment of GHD with serum IGF-1. However, studies have found IGF-1 lacks specificity and sensitivity and does not correlate with dynamic testing in patients with mild TBI and GHD.

The primary objective of this observational study is to determine whether the Quality of Life in Adult Growth Hormone Deficiency Assessment (QoL-AGHDA) can aid in predicting GHD in patients with mild TBI.

Patients aged 18-75 years with a diagnosis of mild TBI (American congress of rehabilitation 2023 guidelines and Centre for disease control and prevention definition of traumatic brain injury) with persistent symptoms at 1-year post-injury attending the Calgary Brain Injury program and the chronic pain centre will be screened for suspected GHD by physicians.

Eligible participants will complete the QoL-AGHDA along with other symptom based measures and will be referred to endocrinology for provocative testing for GHD (glucagon stimulation testing).

The secondary objective is to determine if the QoL-AGHDA can provide an objective measure of growth hormone treatment efficacy in patients with TBI and GHD. To address this, participants found to have GHD (peak GH of <3mcg/L following glucagon stimulation test) will be provided with growth hormone replacement (Genotropin, Pfizer) for 3 months. Participants will be asked to repeat questionnaires (QoL-AGHDA and additional symptom measures) bi-weekly throughout the 3-months of treatment.

Exploratory sleep assessment:

  1. Participants will be invited to participate in one or both optional sleep components of the study. All participants will be offered 6 consecutive days and nights of wrist actigraphy (MotionWatch8, CamNtech) following completion of the glucagon stimulation test or initial endocrinology appointment. The wrist-worn accelerometer will objectively measure sleep patterns, duration, and rest-activity cycles, while participants will complete a brief daily electronic sleep diary to capture subjective sleep characteristics. Participants diagnosed with GHD will be invited to repeat the actigraphy protocol and sleep diary after 3 months of growth hormone replacement therapy.
  2. A subset of approximately 30 participants will also complete two consecutive nights of at-home polysomnography (PSG) using the Nox SAS Solution (Nox Medical, Reykjavik, Iceland). Participants will receive written and video instructions for self-application of the device. The second night of PSG will be used for analysis to characterize objective sleep architecture and identify sleep disturbances using physiological measures including brain activity, respiratory parameters, oxygen saturation, heart rate, body position, and movement. The PSG subgroup will include approximately 10 healthy controls, 10 participants with persistent symptoms following mild TBI without GHD, and 10 participants with persistent symptoms following mild TBI and GHD. Healthy controls will complete baseline demographic and medical history forms, medication use questionnaires, and the Epworth Sleepiness Scale prior to PSG.
Being tested
Not applicable (observational study)
Keywords
Concussion, Persistent post-concussion symptoms, Traumatic brain injury, Growth hormone deficiency, Hypopituitarism, Quality of Life, Growth hormone replacement therapy, Post-traumatic hypopituitarism
Medical subject headings
Dwarfism, Pituitary, Brain Injuries, Traumatic, Brain Concussion, Hypopituitarism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Not applicable (observational study)Other

    Not applicable (observational study)

Study groups in NCT07795736
Study groupRoleWhat they receive
Suspected Growth Hormone DeficiencyParticipants attending the Calgary Brain Injury Program or Chronic Pain Centre with persistent post-concussion symptoms for over 1 year suspected of having GHD. Participants will be asked to complete the QoL-AGHDA and additional post-concussion symptom questionnaires and referred to endocrinology for provocative testing (glucagon stimulation testing)
Receives: Other: Not applicable (observational study)
Growth Hormone Deficiency TreatmentParticipants with GHD (peak GH of < 5 mcg/L following glucagon stimulation test (GST) will be provided with growth hormone replacement (Genotropin, starting dose 0.2 ug/L and 0.3ug/L for women taking exogenous oral estrogen, Pfizer) for 3 months. Participants will repeat the QoL-AGHDA and exploratory outcome questionnaires bi-weekly throughout treatment (3-months).
Receives: Other: Not applicable (observational study)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quality of Life in Adult Growth Hormone Deficiency Assessment (Qol-AGHDA)

    A 25-question, self-administered, condition specific quality of life measure used to determine the extent to which growth hormone deficiency has affected the patient's quality of life. Participants are instructed to answer "yes" or "no" to statements relating to problems with memory and concentration, tiredness, tenseness, social isolation and self-confidence. Higher scores indicate greater symptom burden and lower quality of life.

    Measured: To be completed at baseline and repeated bi-weekly during Genotropin treatment and treatment completion (3 months)

  2. Glucagon Stimulation Testing

    Provocative glucagon stimulation testing completed by endocrinology. Peak growth hormone of less than 3mcg/L indicative of growth hormone deficiency

    Measured: Baseline

Secondary outcomes (16)
  1. Saint Louis University Mental Status Examination (SLUMS)

    Assesses for mild cognitive impairment. Total possible score ranges from 0 to 30, with higher scores indicative of better outcomes.

    Measured: To be assessed at baseline and at completion of treatment (3 months)

  2. Fatigue and Altered Cognition Scale (FACS)

    A 20-item self-reported questionnaire that measures central fatigue and altered cognition, , with 10 items comprising each subscale. Items are rated on an electronic visual analog scale (0-100), with higher scores indicating greater symptom severity.

    Measured: To be repeated bi-weekly during Genotropin treatment and treatment completion (3 months)

  3. Patient Health Questionnaire - 9 (PHQ-9)

    Assesses depressive symptoms. Total possible score ranges from 0-27, with higher scores indicative of worse outcomes.

    Measured: To be assessed at baseline, bi-weekly during Genotropin treatment and at completion of treatment (3 months)

  4. Generalized Anxiety Disorder -7 (GAD-7)

    Assesses feelings of anxiety. Total possible score ranges from 0-21, with higher scores indicative of worse outcomes.

    Measured: To be assessed at baseline, bi-weekly during Genotropin treatment and at completion of treatment (3 months)

  5. Rivermead Post-Concussion Symptom Questionnaire (RPQ)

    Assesses the severity of 16 commonly experienced PCS symptoms. Participants are instructed to rate the extent to which they have suffered from each of the listed symptoms in the past 24 hours, as compared to pre-injury levels, using a scale of 0 ("not experienced at all") to 4 ("a severe problem"). The RPQ has been demonstrated as a valid measure of PPCS with a minimal clinically important difference (MCID) of 4.5 points. It is advised to analyze this assessment as two separate scales (RPQ-13 and RRQ-3). The RPQ-3 has a total possible score of 0-12, with higher scores indicative of worse outcomes. The RPQ-13 has a total possible score of 0-52, with higher scores indicative of worse outcomes. Using these sub-scales, the instrument has good test-retest reliability and external construct validity. This questionnaire probes the separate cognitive, emotional and somatic components of PPCS.

    Measured: To be assessed at baseline, bi-weekly during Genotropin treatment and at completion of treatment (3 months)

  6. Glasgow outcome scale extended (GOSE)

    Assesses outcomes following brain injury. Scores range from 1 to 8 with higher scores meaning better outcomes.

    Measured: To be assessed at baseline, bi-weekly during Genotropin treatment and at completion of treatment (3 months)

  7. Sleep and Concussion Questionnaire

    A self-reported 6-item questionnaire to identify and quantify changes in sleep in response to concussion and monitor these changes over time.

    Measured: To be assessed at baseline, bi-weekly during Genotropin treatment and at completion of treatment (3 months)

  8. Sexual Desire Inventory (SDI

    A 14-item self-report tool that measures sexual desire, distinguishing between dyadic (with others) and solitary (by oneself) desire. This provides insight into sexual motivation, and any changes over time.

    Measured: To be assessed at baseline, 4-weeks post-treatment starts and at completion of treatment (3 months)

  9. Godin Leisure-Time Questionnaire:

    A brief self-report tool that measures frequency of mild, moderate, and strenuous physical activity during free time in a typical week, and how this has changed following injury.

    Measured: To be assessed at baseline and at completion of treatment (3 months)

  10. Body Image Scale (BIS):

    A 10-item self-report questionnaire that assesses affective, behavioral, and cognitive aspects of body image perception.

    Measured: To be assessed at baseline, 4-weeks post-treatment starts and at completion of treatment (3 months)

  11. Epworth Sleepiness Scale (ESS)

    An 8-item self-report questionnaire that assesses daytime sleepiness by rating the likelihood of dozing in common daily situations, producing a total score where higher values indicate greater levels of daytime sleepiness.

    Measured: To be assessed at baseline, 4-weeks post-treatment starts and at completion of treatment (3 months)

  12. Perceived Stress Scale (PSS)

    A 10-item self-report questionnaire that evaluates the degree to which individuals perceive their lives as unpredictable, uncontrollable, and overwhelming over the past month. Respondents rate how often they experienced specific thoughts and feelings on a 5-point Likert scale (0 = never to 4 = very often), with total scores ranging from 0 to 40, where higher scores indicate greater perceived stress.

    Measured: To be assessed at baseline, treatment start, 4-weeks post-treatment start and at completion of treatment (3 months)

  13. Waist Circumference:

    Waist circumference will be measured using a flexible measuring tape placed midway between the last rib and the top of the iliac crest, with the participant standing comfortably. The measurement will be recorded to the nearest 0.1 cm.

    Measured: To be assessed at baseline and at completion of treatment (3 months)

  14. Hand Grip Strength

    Hand grip strength will be assessed using a hand grip dynamometer. Participants will complete three trials with each hand, and the average of the three trials for each hand will be calculated and used for analysis.

    Measured: To be assessed at baseline and at completion of treatment (3 months)

  15. Wrist Based Actigraphy

    At the time of the GST or initial endocrinology appointment, all participants will be asked to wear a wrist-based actigraph on their non-dominant hand (MotionWatch8, CamNtech), an accelerometer that tracks movement and activity, for six consecutive days and nights after the GST has been completed. During each actigraphy recording period, participants will complete a brief daily digital sleep diary. This will allow for objective measurement of sleep patterns, duration, and rest-activity cycles, which will be compared with participants' subjective perceptions of sleep recorded in the sleep diary.

    Measured: If participants have GHD, they will be asked to repeat the same actigraphy protocol for 6 nights/days with daily sleep diary completion at the 3-month post treatment mark.

  16. At-home polysomnography (PSG)

    A subset of participants will be invited to complete a two-night at-home sleep study using a portable polysomnography device (Nox SAS Solution, Nox Medical, Reykjavik, Iceland). The Nox device records multiple sleep-related physiological signals during sleep, including breathing patterns, oxygen saturation, heart rate, body position, and movement. Participants will be provided with video and written instructions to guide them through the self-setup of the device and sensors prior to the recording period. The sleep study will be completed in the participant's home over two consecutive nights. Data collected from the Nox system will be used to characterize objective sleep patterns and identify potential sleep disturbances. Approximately 30 participants will be recruited for this exploratory component, including: 10 healthy controls with no history of concussion or traumatic brain injury, 10 participants with persisting symptoms following mTBI without GHD, 10 participants with GHD \& mTBI

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2026
  2. Study start1 Jun 2024
  3. Primary completion1 Mar 2028 (estimated)
  4. Study completion1 Nov 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07795736
Sponsor's protocol ID
REB24-0244
Status last verified
Jul 2026
First submitted
26 Aug 2026
Last updated
31 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Growth Hormone Deficiency and Traumatic Brain Injury, run by University of Calgary at 2 sites in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 31 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Chantel T Debert, MD MSc FRCPC CSCN ((403) 944-4500, cdebert@ucalgary.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality of Life in Adult Growth Hormone Deficiency Assessment (Qol-AGHDA) (time frame: To be completed at baseline and repeated bi-weekly during Genotropin treatment and treatment completion (3 months)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2026.

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