I know how devastating a traumatic brain injury (TBI) can be. I am one of the 1.7 million people who sustain a TBI every year and have endured the lasting effects of my TBI with debilitating Migraine, chronic head and neck pain, cognitive problems and memory issues. Some TBI survivors aren't as lucky as I and will remain in a semi-state of consciousness for an extended period of time. Recovery from TBI is typically long and protracted, and numerous patients will continue to have problems for years. The Centers for Disease Control and Prevention (CDC) reports 14% of TBI survivors leave the hospital in a prolonged condition of negligible consciousness or in a vegetative state. To date, there is no customary treatment for TBI, but researchers have looked into using amantadine, a medication now used off-label to treat Parkinson's, to help patients with severe TBI speed up their recovery.
A TBI can occur from a fall, motor vehicle accident, assault, surgery or forceful blow to the head. Patients who suffer a severe TBI may remain in a state of minimal consciousness and have limited sleeping and waking cycles, limited eye opening and tracking activity and only respond sporadically to commands. Some die, as in the case of Natasha Richardson. Most TBI survivor's recovery occurs in the first three months after the injury, but a group of researchers led by Dr. Joseph Giacino, Director of Rehabilitation Neuropsychology at Spaulding Rehabilitation Hospital in Boston, looked into the benefits of amantadine - to help speed a patient's recovery - in a placebo controlled study.
Amantadine, first developed to treat respiratory infections and the flu, also seems help enhance the levels of dopamine (a neurotransmitter) in the brain responsible for arousal, mood and activity. By giving TBI patients amantadine, administered four to 16 weeks after the injury for a period of four weeks, researchers discovered it helped hasten recovery. Patients could better communicate, identify certain items and had a longer attention span. Moreover, patients who took amantadine shortly after sustaining the TBI rather than later - and were in a minimal conscious state instead of a vegetative state - seemed to recover faster.
However, two weeks after amantadine stopped being administered, the effects seemed to wear off. Researchers aren't sure if extending the drug for a longer treatment period would increase its effects and lead to an even better outcome. The researchers reported that the results were "suggesting the acceleration of recovery in patients who are receiving amantadine and the deceleration or loss of function after treatment is discontinued. The acute phase of recovery from severe traumatic brain injury is characterized by a brief period of neuronal excitability followed by a longer period of hypoexcitability, involving depletion of multiple neurotransmitters, including dopamine."
This research may open the door for further research on extended use of this medication and give severe TBI survivors a much-needed medical boost.
Fact sheet. "Get the Stats of Traumatic Brain Injury in the United States." CDC Injury Center. Prevention Center: Traumatic Brain Injury.
Giacino, Joseph T. Ph.D., Whyte, John M.D., Ph.D., Bagiella, Emilia, Ph.D., Kalmar, Kathleen, Ph.D., Childs, Nancy, M.D., Khademi, Allen, M.D., Eifert, Bernd, M.D., Long, David, M.D., Katz, Douglas, I. M.D., Cho, Sooja, M.D., Yablon, Stuart A, M.D., Luther, Marianne, M.D., Hammond, Flora, M, M.D., Nordenbo, Annette, M.D., Novak, Paul, O.T.R., Mercer, Walt, Ph.D., Maurer-Karattup, Petra, Dr.Rer.Nat., Sherer, Mark, Ph.D. "Placebo-Controlled Trial of Amantadine for Severe Traumatic Brain Injury." The New England Journal of Medicine 2012; 366:819-826 March 1, 2012.
Moisse, K. "Amantadine Speeds Recovery From Severe Traumatic Brain Injury." ABCNews.com. Februaruy 29, 2012.
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© HealthCentral Network, 2012.
Last updated September 11, 2012.
Published On: September 11, 2012