Ghate Prajakta Suresh, Bhanage Ashok, Sarkar Hrishikesh, Katkar Anand
Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India.
Department of Neurosurgery, Holy Family Hospital, Mumbai, Maharashtra, India.
Asian J Neurosurg. 2018 Jul-Sep;13(3):647-650. doi: 10.4103/ajns.AJNS_272_16.
Severe traumatic brain injury (TBI) is associated with disabling cognitive impairment. Currently available options to improve the cognitive function have been futile. However, recently, commonly used medicine for Parkinson's disease, amantadine, has been shown to assist in the improvement of cognitive function.
We conducted a single institution-based observational study in adult Indian population. Fifty consecutive patients with documented static or declining cognitive function at 2 months of severe TBI fulfilling the inclusion/exclusion criteria received amantadine 200 mg/day (100 mg twice a day) orally or through enteral feeding tube for the duration of 4 weeks. The functional assessment done with Full Outline of Unresponsiveness (FOUR) score, Disability Rating Scale (DRS), and Glasgow Outcome Scale (GOS) during 4 weeks of treatment and 2 weeks posttreatment was assessed.
The cognitive function improved progressively during the 4-week treatment interval as shown by significant improvement on FOUR score, DRS, and GOS. However, after discontinuation of the drug, the speed of recovery slowed down significantly, but the achieved recovery was not lost. Out of fifty, eight patients had convulsions as an adverse effect of amantadine, of which five patients required discontinuation of the drug with treatment for convulsions.
This study indicates the safety and efficacy of amantadine in partial reversal of cognitive dysfunction in adults with severe TBI in adult Indian population.
重度创伤性脑损伤（TBI）与致残性认知障碍相关。目前可用的改善认知功能的方法均未取得成效。然而，最近研究表明，治疗帕金森病的常用药物金刚烷胺有助于改善认知功能。
我们在成年印度人群中开展了一项基于单一机构的观察性研究。50例在重度TBI 2个月时符合纳入/排除标准且有记录显示认知功能处于静止或下降状态的连续患者，接受200毫克/天（100毫克，每日两次）的金刚烷胺口服或通过鼻饲管给药，持续4周。在治疗的4周期间以及治疗后2周，采用完全无反应量表（FOUR）评分、残疾评定量表（DRS）和格拉斯哥预后量表（GOS）进行功能评估。
在4周的治疗期间，认知功能逐渐改善，FOUR评分、DRS和GOS均有显著改善。然而，停药后，恢复速度明显减慢，但已取得的恢复并未丧失。50例患者中，8例出现惊厥，为金刚烷胺的不良反应，其中5例患者因惊厥需停药并接受治疗。
本研究表明，在成年印度人群中，金刚烷胺在部分逆转重度TBI成人认知功能障碍方面具有安全性和有效性。
