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脑活素对中重度创伤性脑损伤患者焦虑、抑郁和认知功能的影响:CAPTAIN II 回顾性试验分析。

The Effect of Cerebrolysin on Anxiety, Depression, and Cognition in Moderate and Severe Traumatic Brain Injury Patients: A CAPTAIN II Retrospective Trial Analysis.

机构信息

RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400354 Cluj-Napoca, Romania.

Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.

出版信息

Medicina (Kaunas). 2022 May 9;58(5):648. doi: 10.3390/medicina58050648.

Abstract

Traumatic brain injuries represent an important source of disease burden requiring emergency inpatient care and continuous outpatient tailored rehabilitation. Although most TBIs are mild, patients are still developing post-TBI depression, anxiety, and cognitive impairments. Our secondary retrospective trial analysis aimed to (1) analyze correlations between HADS-Anxiety/HADS-Depression and scales that measure cognitive and motor processes in patients treated with Cerebrolysin compared to the placebo group and (2) compare anxiety and depression scores among the two treatment groups. Our secondary retrospective analysis focused on TBI patients with moderate and severe disability divided into two groups: Cerebrolysin (treatment) and saline solution (procedural placebo). We analyzed data from 125 patients. We computed descriptive statistics for nominal and continuous variables. We used Spearman's correlation to find associations between HADS and other neuropsychological scales and the Mann-Whitney U test to compare HADS-Anxiety and HADS-Depression scores among the two study arms. Our sample consisted of patients with a mean age of 45.3, primarily men, and with a 24 h GCS (Glasgow Coma Scale) mean of 12.67. We obtained statistically significant differences for HADS-Anxiety during the second and third visits for patients treated with Cerebrolysin. Our results show that Cerebrolysin has a large effect size (0.73) on anxiety levels. In addition, there are positive and negative correlations between HADS-Anxiety and Depression subscales and other neuropsychological scales. Our secondary database analysis supports the existing body of evidence on the positive effect of Cerebrolysin on post-TBI mental health status. Future confirmatory trials are necessary to clarify the link between the intervention and measured outcomes.

摘要

创伤性脑损伤是导致疾病负担的一个重要原因,需要紧急住院治疗和持续的门诊个体化康复。尽管大多数 TBI 是轻度的,但患者仍会出现创伤后抑郁、焦虑和认知障碍。我们的二次回顾性试验分析旨在:(1)分析与 HADS 焦虑/HADS 抑郁相关的量表,这些量表用于评估接受 Cerebrolysin 治疗的患者与安慰剂组相比在认知和运动过程中的情况;(2)比较两组之间的焦虑和抑郁评分。

我们的二次回顾性分析重点关注中重度残疾的 TBI 患者,将他们分为两组:Cerebrolysin(治疗组)和生理盐水(程序安慰剂组)。我们分析了 125 名患者的数据。我们对分类变量和连续变量进行了描述性统计。我们使用 Spearman 相关分析来发现 HADS 与其他神经心理学量表之间的关联,使用 Mann-Whitney U 检验来比较两个研究臂之间的 HADS 焦虑和 HADS 抑郁评分。

我们的样本由平均年龄为 45.3 岁的患者组成,主要为男性,24 小时 GCS(格拉斯哥昏迷量表)平均为 12.67。我们发现接受 Cerebrolysin 治疗的患者在第二和第三次就诊时 HADS 焦虑存在统计学显著差异。我们的结果表明,Cerebrolysin 对焦虑水平有较大的效应量(0.73)。此外,HADS 焦虑与抑郁分量表和其他神经心理学量表之间存在正相关和负相关。

我们的二次数据库分析支持 Cerebrolysin 对创伤后心理健康状况的积极影响的现有证据。需要进一步的确认性试验来阐明干预措施与测量结果之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e9c/9147297/de529912b9c6/medicina-58-00648-g001.jpg

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