A Retrospective Study of Cerebrolysin in Patients with Moderate to Severe Traumatic Brain Injury: Cognitive and Functional Outcomes

Overview

Journal J Med Life

Specialty General Medicine

Date 2023 Oct 30

PMID 37900065

Authors

Claudio Soto

Pablo Salinas

Daniel Munoz

Sandra Olivares

Javiera Gonzalez

Virginia Saez

Violeta Romero

Affiliations

Soon will be listed here.

Abstract

In this retrospective study, we aimed to evaluate the effects of the neurotrophic compound Cerebrolysin on executive, cognitive, and functional performance in patients with traumatic brain injury (TBI) with a highly severe disability level. A total of 44 patients were included in the study, with 33 patients in the control group and 11 patients in the interventional group who received intravenous infusions of 30 mL Cerebrolysin. Both groups received standard rehabilitation therapy following the rehabilitation protocol for patients with TBI at Hospital Clínico Mutual de Seguridad. Functional and cognitive scales were evaluated at baseline, at four months, and at the endpoint of the intervention therapy at seven months (on average). The results revealed a significant improvement in the Cerebrolysin-treated group compared to the control group. Specifically, patients who received Cerebrolysin showed a moderate residual disability and a significant reduction in the need for care. Concerning the promising results and considering the limitations of the retrospective study design, we suggest that randomized controlled studies be initiated to corroborate the positive findings for Cerebrolysin in patients with moderate to severe brain trauma.

References

Muresanu D, Florian S, Homberg V, Matula C, von Steinbuchel N, Vos P . Efficacy and safety of cerebrolysin in neurorecovery after moderate-severe traumatic brain injury: results from the CAPTAIN II trial. Neurol Sci. 2020; 41(5):1171-1181. DOI: 10.1007/s10072-019-04181-y. View

Wronski R, Tompa P, Hutter-Paier B, Crailsheim K, Friedrich P, Windisch M . Inhibitory effect of a brain derived peptide preparation on the Ca++-dependent protease, calpain. J Neural Transm (Vienna). 2000; 107(2):145-57. DOI: 10.1007/s007020050013. View

Katz N, Bar-Haim Erez A, Livni L, Averbuch S . Dynamic Lowenstein Occupational Therapy Cognitive Assessment: evaluation of potential to change in cognitive performance. Am J Occup Ther. 2012; 66(2):207-14. DOI: 10.5014/ajot.2012.002469. View

Onose G, Muresanu D, Ciurea A, Daia Chendreanu C, Mihaescu A, Mardare D . Neuroprotective and consequent neurorehabilitative clinical outcomes, in patients treated with the pleiotropic drug cerebrolysin. J Med Life. 2010; 2(4):350-60. PMC: 3019019. View

Alvarez X, Sampedro C, Figueroa J, Tellado I, Gonzalez A, Garcia-Fantini M . Reductions in qEEG slowing over 1 year and after treatment with Cerebrolysin in patients with moderate-severe traumatic brain injury. J Neural Transm (Vienna). 2008; 115(5):683-92. DOI: 10.1007/s00702-008-0024-9. View

Dewan M, Rattani A, Gupta S, Baticulon R, Hung Y, Punchak M . Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018; 130(4):1080-1097. DOI: 10.3171/2017.10.JNS17352. View

Hyder A, Wunderlich C, Puvanachandra P, Gururaj G, Kobusingye O . The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007; 22(5):341-53. View

Andelic N, Bautz-Holter E, Ronning P, Olafsen K, Sigurdardottir S, Schanke A . Does an early onset and continuous chain of rehabilitation improve the long-term functional outcome of patients with severe traumatic brain injury?. J Neurotrauma. 2011; 29(1):66-74. DOI: 10.1089/neu.2011.1811. View

Stein D, Hoffman S . Concepts of CNS plasticity in the context of brain damage and repair. J Head Trauma Rehabil. 2005; 18(4):317-41. DOI: 10.1097/00001199-200307000-00004. View

10.

Roozenbeek B, Maas A, Menon D . Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013; 9(4):231-6. DOI: 10.1038/nrneurol.2013.22. View

11.

Hetherington H, Earlam R . Measurement of disability after multiple injuries: the functional independence measure. Clinical review. Eur J Surg. 1995; 161(8):549-55. View

12.

Muresanu D, Buzoianu A, Florian S, von Wild T . Towards a roadmap in brain protection and recovery. J Cell Mol Med. 2012; 16(12):2861-71. PMC: 4393716. DOI: 10.1111/j.1582-4934.2012.01605.x. View

13.

Muresanu D . Neuromodulation with pleiotropic and multimodal drugs -- future approaches to treatment of neurological disorders. Acta Neurochir Suppl. 2009; 106:291-4. DOI: 10.1007/978-3-211-98811-4_54. View

14.

Dubois B, Slachevsky A, Litvan I, Pillon B . The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000; 55(11):1621-6. DOI: 10.1212/wnl.55.11.1621. View

15.

Wong G, Zhu X, Poon W . Beneficial effect of cerebrolysin on moderate and severe head injury patients: result of a cohort study. Acta Neurochir Suppl. 2006; 95:59-60. DOI: 10.1007/3-211-32318-x_13. View

16.

RAPPAPORT M, Hall K, Hopkins K, Belleza T, Cope D . Disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil. 1982; 63(3):118-23. View

17.

Poon W, Matula C, Vos P, Muresanu D, von Steinbuchel N, von Wild K . Safety and efficacy of Cerebrolysin in acute brain injury and neurorecovery: CAPTAIN I-a randomized, placebo-controlled, double-blind, Asian-Pacific trial. Neurol Sci. 2019; 41(2):281-293. DOI: 10.1007/s10072-019-04053-5. View