Abstract:
:Amantadine and modafinil are neurostimulants that may improve cognitive and functional recovery post-stroke, but the existing study results vary, and no comprehensive review has been published. This systematic review describes amantadine and modafinil administration practices post-stroke, evaluates timing and impact on clinical effectiveness measures, and identifies the incidence of potential adverse drug effects. A librarian-assisted search of the MEDLINE (PubMed) and EMBASE databases identified all English-language publications with "amantadine" or "modafinil" in the title or abstract from inception through February 1, 2020. Publications meeting predefined Patient, Intervention, Comparator, Outcome (PICO) criteria were included: Patients (≥ 18 years of age post-stroke); Intervention (amantadine or modafinil administration); Comparison (pretreatment baseline or control group); Outcomes (cognitive or functional outcome). Amantadine and modafinil administration practices, cognitive and functional outcomes, and incidence of potential adverse drug effects were collected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance. Quantitative analyses were not performed due to heterogeneity in the clinical effectiveness measures; descriptive data are presented as number (percent) or median (interquartile range). Of 12,620 publications initially identified, 10 amantadine publications (n = 121 patients) and 12 modafinil publications (n = 120 patients) were included. Amantadine was initiated 39 (16, 385) days post-stroke, with most common initial doses of 100 mg once or twice daily (range 100-200 mg/day), and final daily dose of 200 (188, 200) mg/day. Modafinil was initiated 170 (17, 496) days post-stroke, with initial and final daily doses of 100 (100, 350) mg/day and 200 (100, 350) mg/day, respectively. The most common indication was consciousness disorders for amantadine (n = 3/10 publications; 30%) and fatigue for modafinil (n = 5/12; 42%). Forty unique clinical effectiveness measures (1.8 per study) with 141 domains (6.4 per study) were described across all studies. A positive response in at least one clinical effectiveness measure was reported in 70% of amantadine publications and 83% of modafinil publications. Only one publication each for amantadine (10%; n = 5 patients) and modafinil (8%; n = 21 patients) studied acutely hospitalized or ICU patients; both were randomized studies showing improvements in neurocognitive function for amantadine and fatigue for modafinil. Potential adverse drug effects were reported in approximately 50% of publications, most commonly visual hallucinations with amantadine (2% of patients) and dizziness (5% of patients) and dry eyes or mouth (5% of patients). Amantadine and modafinil may improve cognitive and functional recovery post-stroke, but higher-quality data are needed to confirm this conclusion, especially in the acute care setting.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Gagnon DJ,Leclerc AM,Riker RR,Brown CS,May T,Nocella K,Cote J,Eldridge A,Seder DBdoi
10.1007/s12028-020-00977-5subject
Has Abstractpub_date
2020-08-01 00:00:00pages
283-297issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-020-00977-5journal_volume
33pub_type
杂志文章,评审abstract::A farmer's wife was slapped by her cow's tail during milking. There was no obvious injury, but afterward she first developed unusual headaches of unknown origin and then a severe stroke 7 days later. Further diagnostics, including magnetic resonance imaging techniques, revealed a dissection of the carotid artery to be...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:3:3:254
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N(2)O) an...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9363-0
更新日期:2010-08-01 00:00:00
abstract::Acute liver failure (ALF), the abrupt loss of liver function in a patient without previous liver disease, remains a highly mortal condition. Patients with ALF often succumb to their liver injury after the development of cerebral edema, resulting in intracranial hypertension and brain herniation. While the management o...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9090-y
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Global cerebral edema (GCE) is a manifestation of early brain injury (EBI) after subarachnoid hemorrhage (SAH) and is an independent risk factor for poor outcome. The lack of a quantitative method to measure GCE limits the study of its pathophysiology. The goal of this study is to develop a quantitative surr...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-015-0229-3
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Prompt management of aneurysmal subarachnoid hemorrhage (SAH) is critical. Literature is inconclusive regarding outcomes for patients directly admitted to specialized centers versus transferred from lower-volume hospitals. Providers are often unclear about the safety of transferring critical patients. This...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9740-y
更新日期:2012-12-01 00:00:00
abstract::Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:4:1:018
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:The primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando,...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0148-3
更新日期:2015-12-01 00:00:00
abstract::Computed tomography (CT) scan of the brain transitioned clinical neurology from the educated-guess world to the real computer-age world. One of the first CT scans-published by the British neuroradiologist James Ambrose-showed an intracranial hemorrhage and also suggested the use of iodine to demonstrate abnormal blood...
journal_title:Neurocritical care
pub_type: 历史文章,杂志文章
doi:10.1007/s12028-017-0495-3
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. NPE usually appears within minutes to hours after injury and has a high mortality rate if not recognized and treated appropriately. Lung ultrasound quickly provides at the b...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9828-z
更新日期:2013-06-01 00:00:00
abstract::Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In large part critical care for TBI is focused on the identification and management of secondary brain injury. This requires effective neuromonitoring that traditionally has centered on intracranial pressure (ICP). The purpose of this pap...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0048-y
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Levetiracetam (LEV) is used in the setting of acute brain injury for seizure treatment or prophylaxis but its safety and efficacy in this setting is unknown. METHOD:We retrospectively analyzed the patterns of use and safety/efficacy of LEV in 379 patients treated in the neuroscience intensive care unit (N...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0042-8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Angiographic vasculitis affecting the spine has been rarely described. The use of immunosuppression as a primary treatment and a review of the literature is presented. METHODS:Case report. RESULTS:A 61-year-old female presented with sudden onset back pain and headache. The patient was found to have acute s...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9667-8
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O2) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at lim...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-017-0380-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Subclinical seizures are common in critically ill children and are best detected by continuous EEG (cEEG) monitoring. Timely detection of seizures requires pediatric intensive care unit (PICU) physicians to identify patients at risk of seizures and request cEEG monitoring. A recent consensus statement from t...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01053-8
更新日期:2020-07-21 00:00:00
abstract:BACKGROUND:Fever control plays a key role in therapy of patients with acute brain injury. The infusion of cold saline could serve as an alternative or additional method for targeted temperature management. However, it is difficult to estimate the amount of fluid required to achieve normothermia merely on the basis of b...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0588-7
更新日期:2019-02-01 00:00:00
abstract::Drug shortages have become all too familiar in the health care environment, with over 200 drugs currently on shortage. In the wake of Hurricane Maria in September 2017, hospitals across the USA had to quickly and creatively adjust medication preparation and administration techniques in light of decreased availability ...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-019-00730-7
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Physiological reactions of the stress hormone cortisol include hyperglycemia, hypertension, and endothelium dysfunction. In patients with aneurysmal subarachnoid hemorrhage (SAH), hyperglycemia, hypertension, and endothelium dysfunction are associated with the occurrence of delayed cerebral ischemia (DCI). T...
journal_title:Neurocritical care
pub_type: 杂志文章,随机对照试验
doi:10.1007/s12028-010-9331-8
更新日期:2010-06-01 00:00:00
abstract:INTRODUCTION:Syringohydromyelia associated with supratentorial space-occupying lesion has rarely been reported. We present a 28-year-old woman was admitted to the hospital with head and neck pain. Upon examination, there was only left central facial paralisia, with no evidence of papilledema. METHODS AND RESULTS:Crani...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:2:1:051
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Intravenous (IV) lacosamide use for status epilepticus has increased in recent years and is recommended for refractory status epilepticus by current guidelines. Per the lacosamide package labeling, the preferred route of administration is diluted and infused over 30-60 min; however, administration ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0560-6
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0409-4
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients with acute brain injuries require strict physiologic control to minimize morbidity and mortality. This study aimed to assess in-hospital compliance to strict physiologic parameters (BP, HR, ICP, SpO2) in these populations. METHODS:Patients with severe cerebrovascular events were admitte...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0116-y
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:Over-the-counter herbal and alternative medicines are classified as dietary supplements and, unlike drugs, are not rigorously regulated by the United States Food and Drug Administration. Their potential adverse effects are often poorly characterized. METHOD:Red clover, dong quai, and Siberian ginseng are ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0075-z
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Liver transplant (LT) recipients are at significant risk for the development of neurological complications, such as altered mental status and seizures, in the postoperative period. Identifying accurate predictors of these events may allow optimal selection and preparation of candidates, and minimize risk a...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9020-4
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The objectives of this study were to determine effects of severe traumatic brain injury (TBI) on cerebrospinal fluid (CSF) concentrations of myelin basic protein (MBP) and to assess relationships between clinical variables and CSF MBP concentrations. METHODS:We measured serial CSF MBP concentrations in chil...
journal_title:Neurocritical care
pub_type: 杂志文章,随机对照试验
doi:10.1007/s12028-012-9767-0
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Pooled European trial results of early decompressive craniectomy (DC) for severe hemispheric stroke did not require radiographic mass effect as an inclusion criterion. Early surgery for supratentorial cerebral hemorrhage does not improve functional status or survival compared to initial conservative medical ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0270-x
更新日期:2016-08-01 00:00:00
abstract:: ...
journal_title:Neurocritical care
pub_type: 评论,信件
doi:10.1007/s12028-018-0605-x
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to ev...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-010-9451-1
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Fever is associated with worse outcome after intracerebral hemorrhage (ICH). Autonomic dysfunction, commonly seen after brain injury, results in reduced heart rate variability (HRV). We sought to investigate whether HRV was associated with the development of fever in patients with ICH. METHODS:We prospectiv...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00684-w
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Hyponatremia frequently complicates acute brain injury and may precipitate neurological worsening by promoting cerebral edema. An increase in brain water may be better managed through water excretion than with fluid restriction or hypertonic fluids. Vasopressin-receptor antagonists such as conivaptan, whic...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9179-3
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:An oculomotor palsy in the setting of aneurysmal subarachnoid hemorrhage is often due to compression by a posterior communicating artery aneurysm. Anterior communicating artery (ACOM) aneurysms may produce ophthalmologic symptoms of the anterior visual pathways, but rarely ever lead to a 3rd nerve palsy. T...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0054-4
更新日期:2007-01-01 00:00:00