Amantadine Use for Postconcussion Syndrome

Carabenciov, Ivan D.; Bureau, Britta L.; Cutrer, Michael; Savica, Rodolfo

doi:10.1016/j.mayocp.2018.10.021

Cited by 12 publications

(6 citation statements)

References 3 publications

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“…Even though the subgroup analysis did not show a statistically significant difference between the subgroups of different onset of treatment, the metaregression model showed that the effect size of amantadine was related to the onset of treatment. Our findings are in contrast with the study of Carabenciov et al, 12 which stated that timing of amantadine administration after TBI does not affect its efficacy.…”

Section: Discussioncontrasting

confidence: 99%

Assessment of the effect of amantadine in patients with traumatic brain injury: A meta-analysis

Mohamed

Sayed

Zaki

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:Traumatic brain injury is a global burden. We aimed to perform a meta-analysis to determine the efficacy of amantadine for cognitive performance after traumatic brain injury. METHODS:The systematic review was prospectively registered on the International Prospective Register of Systematic Reviews website under the registration number CRD42017080044. We used Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to report the steps of meta-analysis. The search included electronic databases (PubMed, PsycINFO, Embase, Cochrane Library databases, CENTRAL, ProQuest and ClinicalTrials.gov trial registry). Critical care medicine journals and clinical neurology specialty were searched using www.scimagojr.com. There was no publication date restriction. Two authors assessed studies' relevance and extracted data. Studies were assessed for quality using the Cochrane risk of bias tool. Data were analyzed using Comprehensive Meta-analysis Program versions 2.0 and 3.0. RESULTS:Twenty-six studies out of 3,440 records were included in the systematic review, of which only 14 clinical trials and 6 observational studies were included in the meta-analysis. Amantadine significantly enhanced the cognitive function relative to control group (mean difference [MD], 0.50; 95% confidence interval [CI], 0.33-0.66; p < 0.001, 16 studies, 1,127 participants, low certainty evidence). Consistent significant difference in favor of amantadine relative to control group was found (MD of 0.79 [95% CI, 0.34-1.24], very low certainty evidence, for cohort studies vs. MD of 0.40 [95% CI, 0.25-0.56], moderate certainty evidence, for RCTS). Starting amantadine in the first week after TBI had a significant effect on improving cognitive function (MD, 0.97; 95% CI, 0.45-1.49; 16 studies, 1,127 participants, low certainty). Amantadine showed a better effect when administered for less than 1 month (MD, 0.83; 95% CI, 0.56-1.11; low certainty) and to patients below 18 years of age (MD, 0.66; 95% CI, 0.32-0.99; low certainty) or to patients with less severe traumatic brain injury (MD, 0.40; 95% CI, 0.18-0.62; low certainty). No statistically significant difference existed between amantadine and the control concerning the adverse events (OR, 1.74; 95% CI, 0.88-3.44; p = 0.11, moderate certainty). Metaregression of the different clinical parameters, which are onset of treatment, age, and severity of traumatic brain injury, showed a statistically significant relation between onset of treatment and the effect size of amantadine. The relation between the other two parameters and the effect size of amantadine showed a marginal statistical significance. CONCLUSION:Amantadine may improve the cognitive function when used after TBI. Further research with high validity is needed to reach a solid conclusion about the use of amantadine in traumatic brain injury.

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Section: Discussioncontrasting

confidence: 99%

Assessment of the effect of amantadine in patients with traumatic brain injury: A meta-analysis

Mohamed

Sayed

Zaki

et al. 2021

J Trauma Acute Care Surg

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“…The hydrogels could be removed by a mixture of amantadine [61] and urea, [59] owning to the damage to the cohesion of the hydrogel (Figure S11a,b, Supporting Information) and interfacial adhesion between the hydrogel and porcine skin at the same time. [23,62] After treated with the mixture, the adhesive strength of PNIPAm-AA/QCS-CD/PPY1 to porcine skin decreased to 3.9 kPa, while the original adhesive strength reached as high as 16.9 kPa (Figure 5b; Figure S11d, Supporting Information).…”

Section: Tissue Adhesion On-demand Removability Thermo-responsiveness...mentioning

confidence: 99%

Supramolecular Thermo‐Contracting Adhesive Hydrogel with Self‐Removability Simultaneously Enhancing Noninvasive Wound Closure and MRSA‐Infected Wound Healing

et al. 2022

Adv Healthcare Materials

133

100

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Conventional wound closure and dressing are two crucial, time-consuming but isolated principles in wound care. Even though tissue adhesive opens a new era for wound closure, the method and biomaterial that can simultaneously achieve noninvasive wound closure and promote wound healing are highly appreciated. Herein, a novel supramolecular poly(N-isopropylacrylamide) hybrid hydrogel dressing composed of quaternized chitosan-graft-𝜷-cyclodextrin, adenine, and polypyrrole nanotubes via host-guest interaction and hydrogen bonds is developed. The hydrogel demonstrates thermal contraction of 47% remaining area after 2 h at 37 °C and tissue adhesion of 5.74 kPa, which are essential for noninvasive wound closure, and multiple mechanical and biological properties including suitable mechanical properties, self-healing, on-demand removal, antioxidant, hemostasis, and photothermal/intrinsic antibacterial activity (higher 99% killing ratio within 5 min after irradiation). In both full-thickness skin incision and excision wound models, the hydrogel reveals significant wound closure after 24 h post-surgery. In acute and methicillin-resistant Staphylococcus aureus-infected wound and photothermal/intrinsic antibacterial activity assays, wounds treated with the hydrogel demonstrate enhanced wound healing with rapid wound closure rate, mild inflammatory response, advanced angiogenesis, and well-arranged collagen fibers. Altogether, the results indicate the hydrogel is promising in synchronously noninvasive wound closure and enhanced wound healing.

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“…In a retrospective study involving 32 patients, posttraumatic headaches were improved in 80% of patients who completed a full trial of amantadine (NMDA antagonist). The study indicated 1/3 of the patients stopped the medication due to side effects, and the medication appeared to have no benefit for other co-morbid symptoms [74].…”

Section: Pharmacological Interventionmentioning

confidence: 99%

Addressing chronic persistent headaches after MTBI as a neuropathic pain state

Leung

2020

J Headache Pain

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An increasing number of patients with chronic persistent post-traumatic headache (PPTH) after mild traumatic brain injury (MTBI) are being referred to headache or pain specialists as conventional treatment options for primary headache disorders have not been able to adequately alleviate their debilitating headache symptoms. Evolving clinical and mechanistic evidences support the notation that chronic persistent MTBI related headaches (MTBI-HA) carry the hallmark characteristics of neuropathic pain. Thus, in addition to conventional treatment options applicable to non-traumatic primary headache disorders, other available treatment modalities for neuropathic pain should be considered. In this comprehensive review article, the author reveals the prevalence of MTBI-HA and its clinical manifestation, discusses existing clinical and mechanistic evidence supporting the classification of chronic persistent MTBI-HA as a neuropathic pain state, and explores current available treatment options and future directions of therapeutic research related to MTBI-HA.

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Amantadine Use for Postconcussion Syndrome

Cited by 12 publications

References 3 publications

Assessment of the effect of amantadine in patients with traumatic brain injury: A meta-analysis

Assessment of the effect of amantadine in patients with traumatic brain injury: A meta-analysis

Supramolecular Thermo‐Contracting Adhesive Hydrogel with Self‐Removability Simultaneously Enhancing Noninvasive Wound Closure and MRSA‐Infected Wound Healing

Addressing chronic persistent headaches after MTBI as a neuropathic pain state

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