Trojian Thomas H, Wang David H, Leddy John J
1Division of Sports Medicine, Department of Family, Community & Preventative Medicine, Drexel University, College of Medicine, Philadelphia, PA 19127; 2Connecticut Children's Medical Center, Elite Sports Medicine, Farmington, CT; and 3UBMD Department of Orthopaedics and Sports Medicine, SUNY Buffalo Buffalo, NY.
Curr Sports Med Rep. 2017 Jul/Aug;16(4):247-255. doi: 10.1249/JSR.0000000000000387.
Concussions are common neurologic events that affect many athletes. Very little has been studied on the treatment of concussions with supplements and medications. The U.S. Food and Drug Administration (FDA) reminds us that no supplement has been proven to treat concussions. Many animal studies show that supplements have potential for improving the effects of a brain injury but none have been shown to be of consistent benefit in human studies. Animal studies on severe traumatic brain injury (TBI) may not therefore be applicable transfer to sports-related concussions (SRC).Of the many supplements reviewed in this article, omega-3 fatty acids (Ω-3 FA) have potential for SRC treatment but in the one human trial those taking higher dosages preinjury had more concussions. In animal studies, postinjury administration was as effective as pretreatment. N-acetyl-cysteine has demonstrated a positive short-term effect on blast injuries in soldiers if administered within 24 h, but there are no studies in SRC. Caffeine, conversely, may be detrimental if taken after SRC. Lower serum levels of vitamins D, C, or E preinjury have worse outcomes in animal studies. Preinjury correction of deficiencies may be of benefit. Current human trials for nicotinamide ribose, melatonin, and branched chain amino acids (BCAA) may soon provide more evidence for the use of these supplements to reduce the impact of SRC in athletes.
脑震荡是影响众多运动员的常见神经事件。关于使用补充剂和药物治疗脑震荡的研究非常少。美国食品药品监督管理局(FDA)提醒我们,尚无补充剂被证明可治疗脑震荡。许多动物研究表明,补充剂有改善脑损伤影响的潜力,但在人体研究中,尚无一种补充剂被证明具有持续的益处。因此,关于重度创伤性脑损伤(TBI)的动物研究可能不适用于与运动相关的脑震荡(SRC)。在本文所综述的众多补充剂中,ω-3脂肪酸(Ω-3 FA)有治疗SRC的潜力,但在一项人体试验中,受伤前服用较高剂量的人发生更多脑震荡。在动物研究中,受伤后给药与预处理一样有效。N-乙酰半胱氨酸如果在24小时内给药,已证明对士兵的爆炸伤有积极的短期影响,但尚无关于SRC的研究。相反,在发生SRC后服用咖啡因可能有害。在动物研究中,受伤前维生素D、C或E的血清水平较低会导致更差的结果。受伤前纠正缺乏可能有益。目前针对烟酰胺核糖、褪黑素和支链氨基酸(BCAA)的人体试验可能很快会提供更多证据,证明使用这些补充剂可减轻SRC对运动员的影响。