Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2024 Sep;28(18):4302-4312. doi: 10.26355/eurrev_202409_36790.
Behavioral and neuropsychological functions are frequent long-term sequelae of severe traumatic brain injury (TBI). Neuropeptides, such as nerve growth factor (NGF), can enhance neurogenesis and improve cognitive functions after TBI, playing a pivotal role in neuroplasticity. A limited number of studies documented the safety and efficacy of intranasal NGF administration in children with severe TBI.
A fourteen-year-old boy with a diffuse axonal injury secondary to severe TBI was treated with human-recombinant NGF administration. This patient underwent treatment with intranasal hr-NGF administration at a total dose of 50 gamma/kg, three times a day for seven consecutive days. The treatment schedule was performed for 4 cycles, at one month distance each. NGF administration improved radiologic functional assessment evaluated with positron emission tomography scan (PET) and single photon emission computed tomography (SPECT), with an important improvement in clinical conditions. Significant improvements were also observed, mainly in cognitive processes, memory, the planning of a communication strategy, execution skills, attention, and verbal expression. No side effects were reported.
Additional studies are required to gain a deeper insight into this neurotrophin's neuroprotective function, but our findings reveal a potential efficacy of intranasal hr-NGF administration in enhancing cognitive and clinical outcomes among children with diffuse axonal injury after severe TBI.
行为和神经心理学功能是严重创伤性脑损伤(TBI)的常见长期后遗症。神经肽,如神经生长因子(NGF),可以增强神经发生并改善 TBI 后的认知功能,在神经可塑性中发挥关键作用。少数研究记录了鼻内给予 NGF 在严重 TBI 儿童中的安全性和疗效。
一名 14 岁男孩因严重 TBI 继发弥漫性轴索损伤,接受了人重组 NGF 治疗。该患者接受了鼻内给予人重组 NGF 的治疗,总剂量为 50γ/kg,每天三次,连续七天。该治疗方案每一个月进行一次,共进行 4 个周期。NGF 给药改善了正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT)评估的影像学功能,临床状况有重要改善。还观察到显著的改善,主要在认知过程、记忆、沟通策略的规划、执行技能、注意力和言语表达方面。未报告任何副作用。
需要进一步研究以更深入地了解这种神经营养因子的神经保护功能,但我们的发现表明鼻内给予人重组 NGF 在增强严重 TBI 后弥漫性轴索损伤儿童的认知和临床结局方面具有潜在疗效。