Can amantadine ameliorate neurocognitive functions after subarachnoid hemorrhage? A preliminary study
Eren Fatma Akcil1, Ozlem Korkmaz Dilmen1, Hayriye Vehid2, Yusuf Tunali1
1University of Istanbul, Cerrahpasa School of Medicine, Department of Anesthesiology and Intensive Care
2University of Istanbul, Cerrahpasa School of Medicine, Department of Bioistatistics
BACKGROUND AND AIM: Aneurysmal subarachnoid hemorrhage (SAH) may have devastating effects on patients. The motor and neurocognitive abilities may be affected by depending on the localization and the grade of the SAH. Although the effects of amantadine on neurocognitive functions after traumatic brain injury is widely studied, it’s not studied in human SAH. The aim of the present study is evaluate the effects of amantadine on improvement of neurocognitive functions in patients after aneurysmal SAH for a period of six months.
MATERIAL AND METHODS: This preliminary study included 12 patients admitted to neuro-intensive care unit with aneurysmal SAH. The Group A (n=5) received a standart treatment of SAH with amantadine for thirty day, the Group C (n=7) received only the standart treatment. The neurocognitive functions were evaluated with coma recovery scale revisited and disability rating scale in the admission, in the fifth day, third and sixth month of the amantadine administration. The main endpoint of the present study is to compare the effects of amantadine in combination with standart treatment to the standart treatment on neurocognitive functions in SAH patients during a 6 months periods of time.
RESULTS AND DISCUSSION: This study showed that amantadine administration with standart treatment in early period of SAH may improve recovery compared to standart treatment alone. Amantadine was found to improve neurocognitive functions and arousal after TBI due to its dopaminergic effect. The studies conducted with amantadine were performed in moderate to severe TBI patients (GCS=3-10/15). In our study too, the patients had SAH at Fisher grade III-IV and GCS were below 8/15. In Huang et al’s study, memantine was found to be protective against SAH induced vasospasm in rats. The incidence of the vasospasm was similar between the groups in our study.
CONCLUSION(S): Amantadine with standart treatment can ameliorate neurocognitive functions after subarachnoid hemorrhage.
|