Phase II Clinical Trial of Atorvastatin in Mild Traumatic Brain Injury.

Abstract:

:Statins constitute a class of medications commonly used in the treatment of elevated cholesterol. However, in experimental studies, statins also have other non-cholesterol-mediated mechanisms of action, which may have neuroprotective effects. The aim of this study was to determine whether administration of atorvastatin for 7 days post-injury would improve neurological recovery in patients with mild traumatic brain injury (mTBI). The hypothesis was that atorvastatin administration would reduce post-concussion symptoms and also that atorvastatin administration for 1 week post-injury would be safe. One hundred forty patients with mTBI were planned to be enrolled and randomly assigned to receive atorvastatin 1 mg/kg (up to 80 mg/kg) per day or placebo for 7 days starting within 24 h of injury. Assessments of post-concussion syndrome, post-traumatic stress and depressive symptoms, cognition, memory, verbal fluency, functional, and work status were performed at baseline, 1 week, and 1 and 3 months. The result on the Rivermead Post-Concussion Symptoms Questionnaire at 3 months was the primary outcome. Enrollment in the trial was stopped early because of difficulty in recruiting sufficient numbers of subjects. Fifty-two patients with mTBI were enrolled; 28 patients received atorvastatin and 24 received placebo. The median Rivermead score was 2 for the atorvastatin group, compared to 3.5 for the placebo group, at 3 months post-injury (χ2(1) = 0.0976; p = 0.7547). The change in the Rivermead score between baseline and 3 months was also analyzed. The median decrease in score was 4 for the atorvastatin group and 10.5 for the placebo group (χ2(1) = 0.8750; p = 0.3496). No serious adverse events occurred, and there was no significant difference in the incidence of adverse events in the two treatment groups. Atorvastatin administration for 7 days post-injury was safe, but there were no significant differences in neurological recovery post-mTBI with atorvastatin.

journal_name

J Neurotrauma

journal_title

Journal of neurotrauma

authors

Robertson CS,McCarthy JJ,Miller ER,Levin H,McCauley SR,Swank PR

doi

10.1089/neu.2016.4717

subject

Has Abstract

pub_date

2017-02-27 00:00:00

eissn

0897-7151

issn

1557-9042

pub_type

杂志文章
  • High Thoracic Contusion Model for the Investigation of Cardiovascular Function after Spinal Cord Injury.

    abstract::Cardiovascular disease is the leading cause of death for individuals with spinal cord injury (SCI). Because of a lack of a standardized and accessible animal model for cardiovascular disease after SCI, few laboratories have conducted pre-clinical trials aimed at reinstating descending cardiovascular control. Here, we ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2016.4518

    authors: Squair JW,West CR,Popok D,Assinck P,Liu J,Tetzlaff W,Krassioukov AV

    更新日期:2017-02-01 00:00:00

  • Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Systematic Review and Meta-Analysis.

    abstract::Previous meta-analyses of methylprednisolone (MPS) for patients with acute traumatic spinal cord injuries (TSCIs) have not addressed confidence in the quality of evidence used for pooled effect estimates, and new primary studies have been recently published. We aimed to determine whether MPS improves motor recovery an...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,meta分析,评审

    doi:10.1089/neu.2015.4192

    authors: Evaniew N,Belley-Côté EP,Fallah N,Noonan VK,Rivers CS,Dvorak MF

    更新日期:2016-03-01 00:00:00

  • Apoptotic versus necrotic characteristics of retinal ganglion cell death after partial optic nerve injury.

    abstract::We have investigated time course and characteristics of retinal ganglion cell (RGC) death after partial optic nerve injury. In situ end labeling of DNA fragments with the terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine (dUTP)-biotin nick end labeling (TUNEL) method revealed the presence of apoptotic ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.1999.16.153

    authors: Bien A,Seidenbecher CI,Böckers TM,Sabel BA,Kreutz MR

    更新日期:1999-02-01 00:00:00

  • Risk of Dementia in Patients with Spinal Cord Injury: A Nationwide Population-Based Cohort Study.

    abstract::Spinal cord injury (SCI) can cause physical disability and psychological distress; however, whether SCI is a risk factor for dementia is unclear. This study evaluated the incidence of dementia in patients with SCI. Study participants were recruited from a nationwide cohort during 2004-2007 and categorized into SCI (pa...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2016.4525

    authors: Huang SW,Wang WT,Chou LC,Liou TH,Lin HW

    更新日期:2017-02-01 00:00:00

  • Age, outcome, and rehabilitation costs after paraplegia caused by traumatic injury of the thoracic spinal cord, conus medullaris, and cauda equina.

    abstract::The object of this study was to investigate the relationships of age on neurologic and functional outcome, hospitalization length of stay (LOS), and hospital charges after spinal cord injury (SCI). At 20 medical centers, 2,169 consecutive adult patients with paraplegia SCI were assessed in acute care and inpatient reh...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,多中心研究

    doi:10.1089/neu.1999.16.805

    authors: Cifu DX,Huang ME,Kolakowsky-Hayner SA,Seel RT

    更新日期:1999-09-01 00:00:00

  • Cationic liposome-mediated GDNF gene transfer after spinal cord injury.

    abstract::Glial cell line-derived neurotrophic factor (GDNF) has been shown to protect cranial and spinal motoneurons, which suggests potential uses of GDNF in the treatment of spinal cord injury (SCI) and motor neuron disease. We examined neuroprotective effect of cationic liposome-mediated GDNF gene transfer in vivo on axonal...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/089771502760341983

    authors: Lu KW,Chen ZY,Jin DD,Hou TS,Cao L,Fu Q

    更新日期:2002-09-01 00:00:00

  • Effects of nimodipine on posttraumatic spinal cord ischemia in baboons.

    abstract::Posttraumatic ischemia appears to be largely responsible for the extension of lesions in acute injury of the spinal cord. In the present study, we have evaluated the putative improvement of axonal function by the calcium channel blocker nimodipine after acute trauma of the spinal cord. Three techniques were used: (1) ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.1993.10.201

    authors: Pointillart V,Gense D,Gross C,Bidabé AM,Gin AM,Rivel J,Caillé JM,Sénégas J

    更新日期:1993-07-01 00:00:00

  • Statistical parametric mapping and cluster counting analysis of [18F] FDG-PET imaging in traumatic brain injury.

    abstract::In this study we investigated regional cerebral glucose metabolism abnormalities of [(18)F] fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in traumatic brain injury (TBI). PET images of 81 TBI patients and 68 normal controls were acquired and a word list learning task was administered during the u...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2009.1049

    authors: Zhang J,Mitsis EM,Chu K,Newmark RE,Hazlett EA,Buchsbaum MS

    更新日期:2010-01-01 00:00:00

  • Near infrared light reduces oxidative stress and preserves function in CNS tissue vulnerable to secondary degeneration following partial transection of the optic nerve.

    abstract::Traumatic injury to the central nervous system (CNS) is accompanied by the spreading damage of secondary degeneration, resulting in further loss of neurons and function. Partial transection of the optic nerve (ON) has been used as a model of secondary degeneration, in which axons of retinal ganglion cells in the ventr...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2010.1426

    authors: Fitzgerald M,Bartlett CA,Payne SC,Hart NS,Rodger J,Harvey AR,Dunlop SA

    更新日期:2010-11-01 00:00:00

  • Predicting Outcomes after Severe and Moderate Traumatic Brain Injury: An External Validation of Impact and Crash Prognostic Models in a Large Spanish Cohort.

    abstract::Prognostic models that were developed by the International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) study group and the Corticosteroid Randomization After Signification Head injury (CRASH) collaborators are the most commonly used prognostic models for outcome after trauma...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2015.4182

    authors: Castaño-Leon AM,Lora D,Munarriz PM,Cepeda S,Paredes I,de la Cruz J,Gómez Lopez PA,Lagares A

    更新日期:2016-09-01 00:00:00

  • Multiple Mild Traumatic Brain Injuries Lead to Visual Dysfunction in a Mouse Model.

    abstract::Visual dysfunction is a common occurrence after traumatic brain injury (TBI). We investigated in this study effects of single or multiple mild TBI on visual function in mice using a closed head injury model that permits unconstrained head movement after impact. Adult mice were briefly anesthetized with isoflurane and ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2019.6602

    authors: Desai A,Chen H,Kim HY

    更新日期:2020-01-15 00:00:00

  • Functional Changes after Recombinant Human Growth Hormone Replacement in Patients with Chronic Traumatic Brain Injury and Abnormal Growth Hormone Secretion.

    abstract::We explored the effects of recombinant human growth hormone (rhGH) replacement on physical and cognitive functioning in subjects with a moderate-to-severe traumatic brain injury (TBI) with abnormal growth hormone (GH) secretion. Fifteen individuals who sustained a TBI at least 12 months prior to study enrollment were ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2016.4552

    authors: Mossberg KA,Durham WJ,Zgaljardic DJ,Gilkison CR,Danesi CP,Sheffield-Moore M,Masel BE,Urban RJ

    更新日期:2017-02-15 00:00:00

  • Acute cerebral perfusion CT abnormalities associated with posttraumatic amnesia in mild head injury.

    abstract::Posttraumatic amnesia (PTA) is a common symptom following traumatic brain injury. Although this transient memory deficit implies specific impairment of higher brain function, the actual pathophysiology of PTA is not well understood. The aim of this study was to assess regional cerebral hemodynamics with perfusion comp...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2010.1395

    authors: Metting Z,Rödiger LA,de Jong BM,Stewart RE,Kremer BP,van der Naalt J

    更新日期:2010-12-01 00:00:00

  • Modeling the Kinetics of Serum Glial Fibrillary Acidic Protein, Ubiquitin Carboxyl-Terminal Hydrolase-L1, and S100B Concentrations in Patients with Traumatic Brain Injury.

    abstract::Glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1), and S100B have been shown to be predictive of patients with brain injury. Kinetics of these biomarkers in injured humans have not been extensively examined. This prospective multi-center study included patients with mild-to-mode...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,多中心研究

    doi:10.1089/neu.2016.4772

    authors: Welch RD,Ellis M,Lewis LM,Ayaz SI,Mika VH,Millis S,Papa L

    更新日期:2017-06-01 00:00:00

  • Enduring vulnerability to transient reinstatement of hemiplegia by prazosin after traumatic brain injury.

    abstract::A single dose of an alpha1-noradrenergic antagonist transiently reinstates hemiplegia after recovery from brain injury, which suggests that noradrenaline (NA) is required to maintain recovery. No systematic studies have determined the postinjury duration of this vulnerability. This study used a within-subject, dose-re...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/08977150151070955

    authors: Stibick DL,Feeney DM

    更新日期:2001-03-01 00:00:00

  • Characterization of a cervical spinal cord hemicontusion injury in mice using the infinite horizon impactor.

    abstract::The majority of clinical spinal cord injuries (SCIs) are contusive and occur at the cervical level of the spinal cord. Most scientists and clinicians agree that the preclinical evaluation of novel candidate treatments should include testing in a cervical SCI contusion model. Because mice are increasingly used because ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2012.2405

    authors: Streijger F,Beernink TM,Lee JH,Bhatnagar T,Park S,Kwon BK,Tetzlaff W

    更新日期:2013-05-15 00:00:00

  • Neuroprotective anti-apoptosis effect of estrogens in traumatic brain injury.

    abstract::Traumatic brain injury (TBI) is a leading cause of death and functional disability in western countries, affecting mostly young patients. Despite intense and sustained efforts deployed for the development of new therapeutic strategies, no clinical benefit has been shown by any of the investigated compounds. Increasing...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2005.22.345

    authors: Soustiel JF,Palzur E,Nevo O,Thaler I,Vlodavsky E

    更新日期:2005-03-01 00:00:00

  • Blood Aggravates Histological and Functional Damage after Acute Subdural Hematoma in Rats.

    abstract::Acute subdural hematoma (ASDH) is associated with high morbidity and mortality. Whether the volume effect of the hematoma and increase of intracranial pressure (ICP) or the local effect of blood are responsible for this severe pathophysiology is unclear. Therefore, we compared subdural infusion of autologous blood and...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2016.4464

    authors: Jussen D,Krenzlin H,Papaioannou C,Ens S,Kempski O,Alessandri B

    更新日期:2017-02-15 00:00:00

  • Efficacy of progesterone following a moderate unilateral cortical contusion injury.

    abstract::Traumatic brain injury (TBI) results in an accumulation of edema and loss of brain tissue. Progesterone (PROG) has been reported to reduce edema and cortical tissue loss in a bilateral prefrontal cortex injury. This study tests the hypothesis that PROG is neuroprotective following a unilateral parietal cortical contus...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2007.0477

    authors: Gilmer LK,Roberts KN,Scheff SW

    更新日期:2008-06-01 00:00:00

  • Neuroimaging Biomarkers of a History of Concussion Observed in Asymptomatic Young Athletes.

    abstract::Participation in contact sports places athletes at elevated risk for repeated head injuries and is associated with negative mental health outcomes later in life. The current study identified changes observable on neuroimaging that persisted beyond the apparent resolution of acute symptoms of concussion. Sixteen young ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2014.3721

    authors: Orr CA,Albaugh MD,Watts R,Garavan H,Andrews T,Nickerson JP,Gonyea J,Hipko S,Zweber C,Logan K,Hudziak JJ

    更新日期:2016-05-01 00:00:00

  • Changes in cellular bioenergetic state following graded traumatic brain injury in rats: determination by phosphorus 31 magnetic resonance spectroscopy.

    abstract::Phosphorus 31 magnetic resonance spectroscopy (31P MRS) was used to study noninvasively the intracellular free Mg2+ concentration and cellular bioenergetic state of rat brain in vivo before and after fluid percussion-induced traumatic brain injury of graded severity. Brain injury was induced at four levels: low (1.0 +...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.1988.5.315

    authors: Vink R,Faden AI,McIntosh TK

    更新日期:1988-01-01 00:00:00

  • CD11d Antibody Treatment Improves Recovery in Spinal Cord-Injured Mice.

    abstract::Acute administration of a monoclonal antibody (mAb) raised against the CD11d subunit of the leukocyte CD11d/CD18 integrin after spinal cord injury (SCI) in the rat greatly improves neurological outcomes. This has been chiefly attributed to the reduced infiltration of neutrophils into the injured spinal cord in treated...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2011.1976

    authors: Geremia NM,Bao F,Rosenzweig TE,Hryciw T,Weaver L,Dekaban GA,Brown A

    更新日期:2012-02-10 00:00:00

  • Mechanical Design and Analysis of a Unilateral Cervical Spinal Cord Contusion Injury Model in Non-Human Primates.

    abstract::Non-human primate (NHP) models of spinal cord injury better reflect human injury and provide a better foundation to evaluate potential treatments and functional outcomes. We combined finite element (FE) and surrogate models with impact data derived from in vivo experiments to define the impact mechanics needed to gene...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2015.3974

    authors: Sparrey CJ,Salegio EA,Camisa W,Tam H,Beattie MS,Bresnahan JC

    更新日期:2016-06-15 00:00:00

  • Functional and histological outcome after focal traumatic brain injury is not improved in conditional EphA4 knockout mice.

    abstract::We investigated the role of the axon guidance molecule EphA4 following traumatic brain injury (TBI) in mice. Neutralization of EphA4 improved motor function and axonal regeneration following experimental spinal cord injury (SCI). We hypothesized that genetic absence of EphA4 could improve functional and histological o...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.2012.2376

    authors: Hånell A,Clausen F,Djupsjö A,Vallstedt A,Patra K,Israelsson C,Larhammar M,Björk M,Paixão S,Kullander K,Marklund N

    更新日期:2012-11-20 00:00:00

  • Mechanisms of calpain proteolysis following traumatic brain injury: implications for pathology and therapy: implications for pathology and therapy: a review and update.

    abstract::Much recent research has focused on the pathological significance of calcium accumulation in the central nervous system (CNS) following cerebral ischemia, spinal cord injury (SCI), and traumatic brain injury (TBI). Disturbances in neuronal calcium homeostasis may result in the activation of several calcium-sensitive e...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,评审

    doi:10.1089/neu.1997.14.121

    authors: Kampfl A,Posmantur RM,Zhao X,Schmutzhard E,Clifton GL,Hayes RL

    更新日期:1997-03-01 00:00:00

  • The manifestation of anxiety disorders after traumatic brain injury: a review.

    abstract::The development of anxiety disorders after a traumatic brain injury (TBI) is a strong predictor of social, personal, and work dysfunction; nevertheless, the emergence of anxiety has been largely unexplored and poorly understood in the context of TBI. This article provides an overview of the limited published research ...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,评审

    doi:10.1089/neu.2014.3504

    authors: Mallya S,Sutherland J,Pongracic S,Mainland B,Ornstein TJ

    更新日期:2015-04-01 00:00:00

  • Caspase pathways, neuronal apoptosis, and CNS injury.

    abstract::Caspases are a family of mammalian proteases related to the ced-3 gene of Caenorhabditis elegans. They mediate many of the morphological and biochemical features of apoptosis, including structural dismantling of cell bodies and nuclei, fragmentation of genomic DNA, destruction of regulatory proteins, and propagation o...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,评审

    doi:10.1089/neu.2000.17.811

    authors: Eldadah BA,Faden AI

    更新日期:2000-10-01 00:00:00

  • Effects of dorsal column demyelination on evoked potentials in nucleus gracilis.

    abstract::Intraspinal injections of lysolecithin were used to produce unilateral demyelination in the dorsal columns of the rat spinal cord. The purpose of this study was to evaluate the effects of demyelination on the conductive properties of axons belonging to a spinal pathway of known origin and site of termination. At 5 and...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/neu.1992.9.231

    authors: Yezierski RP,Devon RM,Vicedomini JP,Broton JG

    更新日期:1992-10-01 00:00:00

  • The impact of hypercarbia on the evolution of brain injury in a porcine model of traumatic brain injury and systemic hemorrhage.

    abstract::Carbon dioxide is perhaps the most potent available modulator of cerebrovascular tone and thus cerebral blood flow (CBF). These experiments evaluate the impact of induced hypercarbia on the matching of blood flow and metabolism in the injured brain. We explore the hypothesis that hypercarbia will restore the relations...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章

    doi:10.1089/089771501750055776

    authors: Glass TF,Fabian MJ,Schweitzer JB,Weinberg JA,Proctor KG

    更新日期:2001-01-01 00:00:00

  • Cytokines and metabolic dysfunction after severe head injury.

    abstract::Patients with head injury must overcome central as well as peripheral metabolic insults. In addition to specific tissue damage to the brain, a cellular biochemical cascade occurs that can negatively affect organ function, cause a systemic response to injury, and may cause secondary tissue injury. The metabolites invol...

    journal_title:Journal of neurotrauma

    pub_type: 杂志文章,评审

    doi:10.1089/neu.1994.11.447

    authors: Ott L,McClain CJ,Gillespie M,Young B

    更新日期:1994-10-01 00:00:00