To the Editor The study by Grashow et al¹ on the association of a history of concussion symptoms with self-reported low testosterone levels and erectile dysfunction (ED) seems to suggest that concussion leads to persistent pituitary damage. The body of research regarding traumatic brain injury (TBI) and pituitary dysfunction, including evidence cited by Grashow et al, supports an association between moderate to severe TBI and hypopituitarism, but to our knowledge, research specifically examining the association between concussion and hypopituitarism is lacking. Although pituitary dysfunction is not uncommon following moderate to severe TBI, hypogonadism is often transient,² and there is little empirical evidence to support the claim that mild TBI is associated with hypogonadism in the short or long term.

致编者Grashow等[ ^1]的研究表明，脑震荡症状的历史与自我报告的睾丸激素水平低和勃起功能障碍（ED）有关，提示脑震荡会导致垂体持续性损害。有关创伤性脑损伤（TBI）和垂体功能障碍的研究，包括Grashow等人引用的证据，都支持中度至重度TBI与垂体功能低下之间的联系，但是据我们所知，尚缺乏专门研究脑震荡与垂体功能低下之间联系的研究。尽管中度至重度TBI后垂体功能障碍并不罕见，但性腺功能低下常常是短暂的^2。 很少有经验证据支持轻度TBI与短期或长期性腺机能减退有关的说法。