WHOM is going to do the followup to see if this would help in stroke also? Nothing will occur since we have NO STROKE LEADERSHIP to contact with these suggestions.
The role of amantadine in cognitive recovery early after traumatic brain injury: a systematic review
Author links open overlay panelAndreaLoggini
Highlights
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- Cognitive dysfunction is a common sequela of traumatic brain injury.
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- Amantadine has been investigated in cognitive recovery after traumatic brain injury.
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- Amantadine is well tolerated; may hasten cognitive recovery in the intermediate-term.
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- Efficacy of amantadine in improving long-term cognitive recovery remains uncertain.
Abstract
We
conducted an updated systematic review on the safety and efficacy of
amantadine in cognitive recovery after traumatic brain injury (TBI), in
order to determine if the current literature justifies its use in this
clinical condition. A comprehensive search strategy was applied to three
databases (PubMed, Scopus, and Cochrane). Only randomized clinical
trials (RCTs) that compared the effect of amantadine and placebo in
adults within 3 months of TBI were included in the review. Study
characteristics, outcomes, and methodological quality were synthesized.
This systematic review was conducted and presented in accordance with
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA). A quantitative synthesis (meta-analysis) was not feasible due
to the large heterogeneity of studies identified.
Three
parallel RCTs and one cross-over RCT, with a total of 325 patients were
included. All of the studies evaluated only severe TBI in adults.
Amantadine was found to be well tolerated across the studies. Two RCTs
reported improvement in the intermediate-term cognitive recovery (four
to six weeks after end of treatment), using DRS (in both studies) and
MMSE, GOS, and FIM-Cog (in one study). The effect of amantadine on the
short-term (seven days to discharge) and long-term (six months from the
injury) cognitive outcome was found not superior to placebo in two RCTs.
The rate of severe adverse events was found to be consistently very low
across the studies (the incidence of seizures, elevation in liver
enzymes and cardiac death was 0.7%, 1.9%, and 0.3%, respectively). In
conclusion, amantadine seems to be well tolerated and might hasten the
rate of cognitive recovery in the intermediate-term outcome. However,
the long-term effect of amantadine in cognitive recovery is not well
defined and further large randomized clinical trials in refined
subgroups of patients are needed to better define its application.
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