Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To gather preliminary information on anti-mullerian hormone in premenopausal women in the long term following Traumatic Brain Injury (TBI). Specifically, to investigate the relationship between anti-mullerian hormone levels, menstrual cycle metrics, menopausal symptoms, distress and cognition in premenopausal women one or more years following TBI.
Design : A prospective cohort design was used.
Setting : Outpatient acquired brain injury clinic requiring physician referral in Toronto, Ontario, Canada.
Participants (or Animals, Specimens, Cadavers) : Ten premenopausal women who sustained a TBI 1 or more years ago were consecutively recruited, provided consent and completed all study assessments.
Interventions : not applicable
Main Outcome Measure(s) : Menopause Rating Scale-Menopause symptoms (psychological, vasomotor, somatic)
Repeatable Battery for Assessment of Neurological Status (RBANS)- cognition
Symptom Checklist-90r- Global severity scale for distress
This preliminary research found that 50% of participants had less than ideal AMH levels (that is in the lowest 10th percentile or below normal for their age group). New onset of menstrual disturbances were reported by more than 50% of participants. All participants reported high frequency of menopausal symptoms despite not being of premenopausal age or status. With respect to cognition, 50% of women scored clinically low on the RBANS compared to norms for age. Finally, 40% of women scored clinically high for distress.
Conclusions : Results support the need for further research on the topic of how women age following TBI and long term affects on reproductive health and menopausal status. A full powered study is needed with women across all levels of severity.
Melissa Biscardi– Trainee, Unversity of Toronto, Toronto, Ontario
Angela Colantonio– Professor and Director, University of Toronto, Toronto, Ontario
Nora Cullen– Scientist, Toronto Rehabilitation Institute, Toronto, Ontario
Gillian Einstein– Professor and Director, University of Toronto, Toronto, Ontario
Reema Shafi– Post Doc, University of Toronto, Toronto, Ontario