Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Korea.
J Rehabil Med. 2020 Feb 27;52(2):jrm00025. doi: 10.2340/16501977-2654.
Acquired brain injury can cause disorders of consciousness. An additive effect of cerebrolysin and amantadine has been postulated, but not systematically studied. The present study aimed to investigate this additive effect in patients with disorders of consciousness secondary to acquired brain injury.
The medical records of patients diagnosed with disorders of consciousness after acquired brain injury were reviewed. The patients were categorized into 2 groups: single regimen (amantadine only) and dual regimen (amantadine plus cerebrolysin). The patients' conscious states were assessed using the Coma Recovery Scale-Revised (CRS-R) before, and after 4 weeks of drug administration.
Data for a total of 84 patients were analysed. The degree of change in CRS-R and the proportion of patients in the disorders of consciousness category showing a change was higher in the dual regimen group than in the single regimen group. Analysis of patients who had initially been in a prolonged vegetative state or minimally conscious state minus before administration showed that the patients in the dual regimen group had greater increases in CRS-R scores than those in the single regimen group.
This study identified that an amantadine-plus-cerebrolysin regimen additively affects patients with prolonged disorders of consciousness. A future controlled trial is needed to investigate the efficacy of each regimen in patients with prolonged disorders of consciousness secondary to acquired brain injury, particularly for patients who have remained in a prolonged vegetative state after acquired brain injury.
获得性脑损伤可导致意识障碍。已经推测出脑活素和金刚烷胺具有附加作用,但尚未进行系统研究。本研究旨在调查脑活素和金刚烷胺联合治疗获得性脑损伤后意识障碍患者的这种附加作用。
回顾了诊断为获得性脑损伤后意识障碍的患者的病历。患者分为两组:单药治疗组(仅金刚烷胺)和联合治疗组(金刚烷胺加脑活素)。在药物治疗 4 周前后,使用昏迷恢复量表修订版(CRS-R)评估患者的意识状态。
对总共 84 名患者的数据进行了分析。联合治疗组的 CRS-R 变化程度和意识障碍类别中表现出变化的患者比例均高于单药治疗组。对最初处于持续性植物状态或最小意识状态减去治疗前的患者进行分析,发现联合治疗组的患者 CRS-R 评分增加幅度大于单药治疗组。
本研究表明,金刚烷胺加脑活素方案对持续性意识障碍患者具有附加作用。需要进行一项对照试验,以研究脑活素和金刚烷胺两种方案对获得性脑损伤后持续性意识障碍患者的疗效,特别是对获得性脑损伤后仍处于持续性植物状态的患者。