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- Title
Modulated Neuroprotection in Unresponsive Wakefulness Syndrome after Severe Traumatic Brain Injury.
- Authors
Daia, Cristina; Scheau, Cristian; Spinu, Aura; Andone, Ioana; Popescu, Cristina; Toader, Corneliu; Bumbea, Ana Maria; Verenca, Madalina Codruta; Onose, Gelu
- Abstract
Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.
- Subjects
BRAIN injuries; WAKEFULNESS; MONTREAL Cognitive Assessment; GLASGOW Coma Scale; PHYSICAL mobility; POSTCONCUSSION syndrome
- Publication
Brain Sciences (2076-3425), 2021, Vol 11, Issue 8, p1044
- ISSN
2076-3425
- Publication type
Article
- DOI
10.3390/brainsci11081044