Ripley David L, Morey Clare E, Gerber Don, Harrison-Felix Cynthia, Brenner Lisa A, Pretz Christopher R, Cusick Chris, Wesnes Keith
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Rehabilitation Institute of Chicago , Chicago, IL , USA .
Brain Inj. 2014;28(12):1514-22. doi: 10.3109/02699052.2014.919530. Epub 2014 Sep 2.
To determine if atomoxetine would improve attention impairment following traumatic brain injury (TBI).
Outpatients from a free-standing, private, not-for-profit rehabilitation hospital.
Fifty-five adult participants with a history of a single moderate-to-severe TBI, who were at least 1 year from injury and with self-reported complaints of attention difficulties.
Atomoxetine, a selective norepinephrine re-uptake inhibitor with a primary indication for attention dosed at 40 mg twice a day for 2 weeks, compared to placebo.
Randomized double-blind placebo controlled trial, with placebo run-in.
Cognitive Drug Research (CDR), Computerized Cognitive Assessment System, Stroop Color and Word Test, Adult ADHD Self-Report Scale (ASRS-v1.1), Neurobehavioural Functioning Inventory (NFI).
Atomoxetine was well-tolerated by the subject sample. The use of atomoxetine by individuals with reported attention difficulty following TBI did not significantly improve scores on measures of attention, the CDR Power of Attention domain or the Stroop Interference score. In addition, no significant relationship was found between atomoxetine use and self-reported symptoms of attention or depression.
Atomoxetine did not significantly improve performance on measures of attention among individuals post-TBI with difficulties with attention. This study follows a trend of other pharmacological studies not demonstrating significant results among those with a history of TBI. Various possibilities are discussed, including the need for a more sophisticated system of classification of TBI.
确定托莫西汀是否能改善创伤性脑损伤（TBI）后的注意力损害。
来自一家独立的、私立的、非营利性康复医院的门诊患者。
55名有单次中度至重度TBI病史的成年参与者，受伤至少1年，且自我报告有注意力困难的症状。
托莫西汀，一种选择性去甲肾上腺素再摄取抑制剂，主要用于治疗注意力问题，剂量为每日两次，每次40毫克，持续2周，与安慰剂进行对照。
随机双盲安慰剂对照试验，有安慰剂导入期。
认知药物研究（CDR）、计算机化认知评估系统、斯特鲁普颜色和文字测试、成人注意力缺陷多动障碍自我报告量表（ASRS-v1.1）、神经行为功能量表（NFI）。
托莫西汀在受试者样本中耐受性良好。TBI后有注意力困难报告的个体使用托莫西汀并未显著提高注意力测量指标、CDR注意力领域得分或斯特鲁普干扰得分。此外，未发现托莫西汀的使用与自我报告的注意力或抑郁症状之间存在显著关系。
托莫西汀并未显著改善TBI后有注意力困难的个体在注意力测量指标上的表现。本研究遵循了其他药理学研究的趋势，即在有TBI病史的人群中未显示出显著结果。文中讨论了各种可能性，包括需要一个更复杂的TBI分类系统。
