Sharma Bhanu, Lawrence David W, Hutchison Michael G
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (Mr Sharma); Toronto Rehabilitation Institute (Dr Lawrence); Neuroscience Program of Keenan Research Centre for Biomedical Science at St Michael's Hospital (Dr Hutchison), St Michael's Hospital, Toronto, Ontario, Canada; and David L. MacIntosh Sport Medicine Clinic (Drs Lawrence and Hutchison), Faculty of Kinesiology & Physical Education (Dr Hutchison), University of Toronto, Toronto, Ontario, Canada.
J Head Trauma Rehabil. 2018 Jan/Feb;33(1):33-45. doi: 10.1097/HTR.0000000000000280.
Despite the prevalence of traumatic brain injury (TBI), pharmaceutical treatment options for brain injury remain limited. However, nutritional intervention (such as with branched chain amino acids [BCAAs]) has emerged as a promising treatment option for TBI.
(1) To determine whether TBI patients have lower levels of endogenous BCAAs postinjury; and (2) to evaluate whether post-TBI BCAA supplementation improves clinical outcome.
A systematic review of primary research articles examining the relationship between BCAAs and TBI recovery indexed in Ovid/MEDLINE, EMBASE, and PsycINFO.
Of the 11 studies identified, 3 examined the effects of TBI on endogenous BCAA levels and consistently reported that BCAA concentrations were depressed postinjury. The remaining 8 studies examined the effects of BCAA supplementation on TBI outcome in animals (n = 3) and humans (n = 5). The animal studies (in mild-to-moderate TBI) showed that BCAAs improved post-TBI outcome. Similar results were found in human trials (conducted primarily in patients with severe TBI), with 4 of the 5 studies reporting improved outcome with BCAA supplementation.
Although our review demonstrates an overall positive association between BCAAs and TBI outcome, the evidence of the efficacy of supplementation has been limited to severe TBI. To date, there is insufficient evidence to determine the benefits of BCAAs in mild TBI. Given the high frequency of mild TBI and the promise of BCAAs as an intervention in severe TBI, future research should examine the effects of BCAAs in milder brain injury.
尽管创伤性脑损伤（TBI）很常见，但针对脑损伤的药物治疗选择仍然有限。然而，营养干预（如使用支链氨基酸[BCAAs]）已成为一种有前景的TBI治疗选择。
（1）确定TBI患者受伤后内源性BCAAs水平是否较低；（2）评估TBI后补充BCAAs是否能改善临床结局。
对在Ovid/MEDLINE、EMBASE和PsycINFO中索引的研究BCAAs与TBI恢复之间关系的原始研究文章进行系统综述。
在确定的11项研究中，3项研究考察了TBI对内源性BCAAs水平的影响，并一致报告受伤后BCAA浓度降低。其余8项研究考察了补充BCAAs对动物（n = 3）和人类（n = 5）TBI结局的影响。动物研究（针对轻度至中度TBI）表明，BCAAs改善了TBI后的结局。在人体试验中（主要在重度TBI患者中进行）也发现了类似结果，5项研究中有4项报告补充BCAAs可改善结局。
尽管我们的综述表明BCAAs与TBI结局之间总体呈正相关，但补充BCAAs疗效的证据仅限于重度TBI。迄今为止，尚无足够证据确定BCAAs在轻度TBI中的益处。鉴于轻度TBI的高发性以及BCAAs作为重度TBI干预措施的前景，未来研究应考察BCAAs在较轻脑损伤中的作用。
