Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis

Introduction: TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on mortality is about 10% across all ages. Amantadine hydrochloride is one of the most commonly prescribed medications for pat...

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Main Authors: Hantz Filbert C. Siy, Michael Louis A. Gimenez
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000298
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author Hantz Filbert C. Siy
Michael Louis A. Gimenez
author_facet Hantz Filbert C. Siy
Michael Louis A. Gimenez
author_sort Hantz Filbert C. Siy
collection DOAJ
description Introduction: TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on mortality is about 10% across all ages. Amantadine hydrochloride is one of the most commonly prescribed medications for patients undergoing inpatient neurorehabilitation who have disorders of consciousness.6 It is a dopamine (DA) receptor agonist and a N-Methyl-D-aspartate (NMDA) receptor antagonist via dopamine release and dopamine reuptake inhibition. The current study will synthesize the current available evidence and show the effect of Amantadine in functional improvement after TBI. Research question: Does Amantadine have an effect on functional improvement of TBI patients? Material and methods: This systematic review included all randomized placebo-controlled trials that compare the use of Amantadine versus placebo for functional improvement of patients after TBI. Outcome measures included DRS, GCS and/or GOS scores. Results: Three studies with a total of 281 patients were included in the quantitative analyses. GRADE assessments show that there was a high certainty of evidence for functional improvement in terms of DRS scores. Discussion and conclusion: Evidence of this review show that the use of Amantadine may have a beneficial effect on functional outcome in moderate to severe traumatic brain injuries among adult patients. Given the still-limited body of knowledge, more relevant studies must be made exploring the impact of Amantadine therapies on promoting functional recovery within the brain injury rehabilitation care continuum, with the goals of achieving larger sample sizes and establishing the early- or later-treatment beneficial effects.
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spelling doaj-art-a0593b0ffe4d42a9af8983c04835e7f72024-12-15T06:18:14ZengElsevierBrain and Spine2772-52942024-01-014102773Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysisHantz Filbert C. Siy0Michael Louis A. Gimenez1Corresponding author.; University of Santo Tomas Hospital, España Blvd., Sampaloc, Manila, PhilippinesUniversity of Santo Tomas Hospital, España Blvd., Sampaloc, Manila, PhilippinesIntroduction: TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on mortality is about 10% across all ages. Amantadine hydrochloride is one of the most commonly prescribed medications for patients undergoing inpatient neurorehabilitation who have disorders of consciousness.6 It is a dopamine (DA) receptor agonist and a N-Methyl-D-aspartate (NMDA) receptor antagonist via dopamine release and dopamine reuptake inhibition. The current study will synthesize the current available evidence and show the effect of Amantadine in functional improvement after TBI. Research question: Does Amantadine have an effect on functional improvement of TBI patients? Material and methods: This systematic review included all randomized placebo-controlled trials that compare the use of Amantadine versus placebo for functional improvement of patients after TBI. Outcome measures included DRS, GCS and/or GOS scores. Results: Three studies with a total of 281 patients were included in the quantitative analyses. GRADE assessments show that there was a high certainty of evidence for functional improvement in terms of DRS scores. Discussion and conclusion: Evidence of this review show that the use of Amantadine may have a beneficial effect on functional outcome in moderate to severe traumatic brain injuries among adult patients. Given the still-limited body of knowledge, more relevant studies must be made exploring the impact of Amantadine therapies on promoting functional recovery within the brain injury rehabilitation care continuum, with the goals of achieving larger sample sizes and establishing the early- or later-treatment beneficial effects.http://www.sciencedirect.com/science/article/pii/S2772529424000298AmantadineTraumatic brain injuryTraumaBrain injuryFunctional outcome
spellingShingle Hantz Filbert C. Siy
Michael Louis A. Gimenez
Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
Brain and Spine
Amantadine
Traumatic brain injury
Trauma
Brain injury
Functional outcome
title Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
title_full Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
title_fullStr Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
title_full_unstemmed Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
title_short Amantadine for functional improvement in patients with traumatic brain injury: A systematic review with meta-analysis and trial sequential analysis
title_sort amantadine for functional improvement in patients with traumatic brain injury a systematic review with meta analysis and trial sequential analysis
topic Amantadine
Traumatic brain injury
Trauma
Brain injury
Functional outcome
url http://www.sciencedirect.com/science/article/pii/S2772529424000298
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