Neuroprotective Effects of Methylphenidate on Diffuse Axonal Injury in Acute Traumatic Brain Injury Patients

Document Type : Original Article

Authors

1 Associate Professor of Neurosurgery, Spine Fellowship, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

2 Assistant Professor of Neurosurgery, Functional Fellowship, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

3 Associate Professor of Psychiatry, Department of Psychiatry, School of Medicine, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

4 Assistant Professor of Critical Care Medicine, Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

5 MD, Department of Neurosurgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

6 MD, Ph.D. of Epidemiology, Department of Community Health, Mazandaran University of Medical Sciences, Sari, Iran.

10.30491/tm.2022.328724.1445

Abstract

Background: This study aimed to evaluate the effect of methylphenidate on the level of consciousness and length of hospitalization of patients with moderate to severe acute Traumatic Brain Injury (TBI) categorized as diffuse axonal injury.
Methods: This randomized, double-blind clinical trial comprised 62 patients with moderate to severe traumatic brain injury with a Glasgow Coma Scale (GCS ) between 5 and 12 referred to our emergency department. Methylphenidate tablets were administrated from the second day with a dose of 0.3 mg/kg up to a maximum of 20 mg daily. A placebo was administered in the same manner and the patient's level of consciousness, delirium using the Confusion Assessment Method for the intensive care unit (CAM-ICU), agitation using Richmond Agitation Sedation Scale (RASS), and predicting the outcome of patients with GOS, were assessed.
Results: The patients' GOS on the day of discharge was significantly higher in the intervention group (P=0.013). The duration of hospitalization was significantly shorter in the intervention group (P<0.001). The patients' GCS upon discharge was significantly higher in the intervention group (P=0.01).
Conclusion: Our results suggest that methylphenidate has some beneficial effects on the consciousness level and outcomes of patients with acute TBI. The use of methylphenidate also reduces the length of ICU stay and hospitalization and improves the outcome in patients with moderate to severe TBI not requiring surgery.

Keywords


Volume 27, Issue 6
November and December 2022
Pages 616-625
  • Receive Date: 08 February 2022
  • Revise Date: 21 November 2022
  • Accept Date: 31 December 2022
  • First Publish Date: 31 December 2022