Study: Drug speeds recovery of patients with severe traumatic brain injury

By Chelsea Conaboy, Globe Staff

The pace of recovery for patients with severe brain injuries that leave them in a vegetative state or with limited consciousness may be quickened with the use of a drug commonly used to treat Parkinsons disease, a study published in the latest New England Journal of Medicine found.

Patients who received the drug, amantadine, over four weeks improved more quickly and were more likely to gain the ability to understand and communicate with others within that time period than those who received a placebo.

Doctors have long used amantadine and a variety of other psychoactive drugs in patients with severe traumatic brain injury, though they had little more than anecdotes to show that they worked. Researching their effectiveness has been difficult largely because the patients are hard to find, said Joseph Giacino, lead author of the study and director of rehabilitation neuropsychology at Spaulding Rehabilitation Hospital.

The vast majority of these patients never see rehabilitation, he said. They are sent from the trauma center to skilled nursing facilities, because coverage for rehabilitation is usually denied by health insurance plans.

It is widely thought that little can be done to help them in a rehab setting, but Giacino said these results show otherwise.

We really have cause, now, for optimism, he said.

The researchers recruited 184 patients from 11 facilities over more than six years, with 97 receiving a placebo. Among those who received amantadine, fewer people remained in a vegetative state after four weeks.

Both groups improved significantly in that time. However, using a scoring system that ranked the level of disability among participants, the researchers found that those on the drug improved more quickly on average. At four weeks, more of the patients on the drug were consistently able to follow simple commands, recognize and use common objects, communicate, and sustain attention.

While the effects of amantadine in these patients is not fully understood, the drug increases the availability of dopamine, a neurotransmitter that is critical in areas of the brain that affect wakefulness, drive, and attention.

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Study: Drug speeds recovery of patients with severe traumatic brain injury