Pharmacotherapy for mild traumatic brain injury: an overview of the current treatment options

Gao, Chuang; Nie, Meng; Huang, Jinhao; Tian, Ye; Wang, Dong; Zhang, Jianning; Jiang, Rongcai

doi:10.1080/14656566.2022.2054328

Cited by 5 publications

(4 citation statements)

References 99 publications

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“…No symptom change was observed [ 47 ]. However, melatonin has been shown to be effective at treating children with TBI-associated insomnia [ 145 ] and was also independently shown to exert neuroprotective effects in the neonatal and pediatric TBI populations [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Brain Injury, Sleep, and Melatonin—Intrinsic Changes with Therapeutic Potential

et al. 2023

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Traumatic brain injury (TBI) is one of the most prevalent causes of morbidity in the United States and is associated with numerous chronic sequelae long after the point of injury. One of the most common long-term complaints in patients with TBI is sleep dysfunction. It is reported that alterations in melatonin follow TBI and may be linked with various sleep and circadian disorders directly (via cellular signaling) or indirectly (via free radicals and inflammatory signaling). Work over the past two decades has contributed to our understanding of the role of melatonin as a sleep regulator and neuroprotective anti-inflammatory agent. Although there is increasing interest in the treatment of insomnia following TBI, a lack of standardization and rigor in melatonin research has left behind a trail of non-generalizable data and ambiguous treatment recommendations. This narrative review describes the underlying biochemical properties of melatonin as they are relevant to TBI. We also discuss potential benefits and a path forward regarding the therapeutic management of TBI with melatonin treatment, including its role as a neuroprotectant, a somnogen, and a modulator of the circadian rhythm.

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Section: Discussionmentioning

confidence: 99%

Traumatic Brain Injury, Sleep, and Melatonin—Intrinsic Changes with Therapeutic Potential

et al. 2023

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“…A large amount of experimental evidence shows that melatonin may be a neuroprotective agent for acute brain injury and chronic neurodegenerative diseases. [16][17][18] Abu-Elfotuh K 19 repeatedly tested the neuroprotective effect of melatonin in different experimental models of intracerebral hemorrhage. Liang F et al 20 pointed out that melatonin can alleviate mitochondrial damage of neurons by activating the PPARδ/PGC-1α pathway, so as to reduce brain damage.…”

Section: Table-i: Comparison Of Baseline Data Between the Observation...mentioning

confidence: 99%

Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage

Hou¹,

2023

Pak J Med Sci

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Objective: To investigate the clinical changes of serum melatonin and intercellular adhesion molecule-1 (ICAM-1) levels in patients with basal ganglia hypertensive intracerebral hemorrhage (HICH). Methods: In this retrospective observational study, patients with HICH in Suzhou Hospital of Traditional Chinese and Western Medicine from January 2020 to January 2021 were included as the observation group (n=120), and 120 healthy volunteers who underwent physical examination were included as the control group. According to the Glasgow Coma Scale (GCS), the observation group was divided into four subgroups: normal group (n=27), mild group (n=51), moderate group (n=24), and severe group (n=18). Differences in serum melatonin and ICAM-1 were compared between the observation group and the control group, and between the subgroups. Logistic regression was used to analyze the risk factors of poor prognosis, and the ROC curve was used to analyze the influence of melatonin and ICAM-1 levels on patient prognosis. Results: Serum melatonin levels were lower in the observation group compared to the control group, while ICAM-1 levels were higher (P<0.05). With the aggravation of brain injury, serum melatonin decreased and ICAM increased (P<0.05). Decreased serum melatonin and increased ICAM-1 were independent risk factors for poor prognosis in patients with HICH. The combined AUC of serum melatonin and ICAM-1 for the detection of poor prognosis in patients with HICH was 0.860, which was higher than that of the two alone (P<0.05). Conclusions: Low serum melatonin levels and high ICAM-1 levels are associated with poor prognosis in patients with HICH and can be used as predictors of patients’ prognosis. doi: https://doi.org/10.12669/pjms.39.4.7252 How to cite this: Hou H, Li X. Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7252 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…1 Nearly 90% of TBIs are mild, injuries that are commonly referred to as "concussions." 2 The two most concerning sequelae of concussion injuries are the possibility of early dementia (including manifestations such as chronic traumatic encephalopathy [CTE]) 3 and the development of persistent post-concussive symptoms (PPCS). 4 Because of these concerns, tremendous efforts are being spent to address concussion injuries.…”

Section: Introductionmentioning

confidence: 99%

“…Traumatic brain injury (TBI) cases in the United States approach 2 million annually. 1 Nearly 90% of TBIs are mild, injuries that are commonly referred to as “concussions.” 2 The two most concerning sequelae of concussion injuries are the possibility of early dementia (including manifestations such as chronic traumatic encephalopathy [CTE]) 3 and the development of persistent post-concussive symptoms (PPCS). 4 …”

Section: Introductionmentioning

confidence: 99%

Circadian therapy interventions for glymphatic dysfunction in concussions injuries: A narrative review

Kureshi¹,

Stowe²,

Francis³

et al. 2023

Science Progress

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There are two primary threats to the brain after concussion. The first is a buildup of neurotoxic proteins in the brain. The second, a partial consequence of the first, is a sustained neuroinflammatory response that may lead to central sensitization and the development of persistent post-concussive symptoms. These threats make neurotoxin clearance a high clinical priority in the acute period after injury. The glymphatic system is the brain's primary mechanism for clearing neurotoxic waste. The glymphatic system is intimately tied to the sleep cycle and circadian dynamics. However, glymphatic dysfunction and sleep disturbances are nearly ubiquitous in the acute period after concussion injury. Because of this, sleep optimization via circadian therapy is a time-sensitive and critical tool in acute concussion management.

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Pharmacotherapy for mild traumatic brain injury: an overview of the current treatment options

Cited by 5 publications

References 99 publications

Traumatic Brain Injury, Sleep, and Melatonin—Intrinsic Changes with Therapeutic Potential

Traumatic Brain Injury, Sleep, and Melatonin—Intrinsic Changes with Therapeutic Potential

Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage

Circadian therapy interventions for glymphatic dysfunction in concussions injuries: A narrative review

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