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Type: Journal article
Title: Impact of early pharmacological treatment on cognitive and behavioral outcome after traumatic brain injury in adults A meta-analysis
Author: Wheaton, P.
Mathias, J.
Vink, R.
Citation: Journal of Clinical Psychopharmacology, 2009; 29(5):468-477
Publisher: Lippincott Williams & Wilkins
Issue Date: 2009
ISSN: 0271-0749
Statement of
Wheaton Patricia, Mathias Jane and Vink Robert
Abstract: Early pharmacological treatment has the potential to reduce some of the disabling cognitive and behavioral problems that result from traumatic brain injury (TBI). Although a large number of treatments have been developed, clinical research has yielded inconsistent findings with respect to the effectiveness of these pharmacological treatments on cognitive and behavioral outcomes. Furthermore, their relative efficacy has not been evaluated, thereby hindering advances in the treatment of TBI. A meta-analysis of research that examined the impact of pharmacological treatments on cognitive and behavioral outcomes in the early stages after TBI between January 1980 and May 2008 was therefore undertaken. The PubMed and PsycINFO databases were searched using 35 terms. All articles were screened using detailed inclusion criteria. Weighted Cohen's d effect sizes, percent overlap statistics, and fail-safe N statistics were calculated for each pharmacological agent. Studies that used different experimental designs were examined separately. Eleven pharmacological treatments were investigated by 22 clinical studies, comprising 6472 TBI patients in the treatment groups and 6460 TBI controls. One dopamine agonist (amantadine) and 1 bradykinin antagonist (CP-0127 [Bradycor]) produced marked treatment benefits (d > or = 0.8) for a single measure of arousal (Glasgow Coma Scale). Notably, drug dosage and the measure chosen to assess outcome influenced the probability of finding a treatment benefit.
Keywords: Humans; Brain Injuries; Amantadine; Peptides; Treatment Outcome; Behavior; Cognition Disorders; Neuropsychological Tests; Time Factors; Adult; Female; Male; Controlled Clinical Trials as Topic
Rights: © 2009 Lippincott Williams & Wilkins, Inc.
RMID: 0020092818
DOI: 10.1097/JCP.0b013e3181b66f04
Appears in Collections:Psychology publications

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