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Effects of Memantine in Patients with Traumatic Brain Injury: A Systematic Review

1
Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
2
Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK
3
Surgical Reconstruction and Microbiology Research Centre, National Institute for Health Research, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
*
Author to whom correspondence should be addressed.
Received: 8 December 2020 / Revised: 29 December 2020 / Accepted: 13 January 2021 / Published: 27 January 2021
Traumatic brain injury (TBI) affects millions of people around the world and amongst other effects, causes cognitive decline, neurodegenerative disease and increased risk of seizures and sensory disturbances. Excitotoxicity and apoptosis occur after TBI and are mediated through the N-methyl-D-aspartate (NMDA)-type glutamate receptor. Memantine is effective in blocking excessive activity of NMDA-type glutamate receptors and reduces the progression of dementia and may have benefits after TBI. Here, we performed a systematic review of the literature to evaluate whether memantine is effective in improving outcomes, including cognitive function in patients with TBI. Our search yielded only 4 randomized control trials (RCTs) that compared the effects of memantine to placebos, standard treatment protocols or piracetam. A single RCT reported that serum neuron-specific enolase (NSE) levels were significantly reduced (p = 0.009) in the memantine compared to the control group, and this coincided with reported significant day-to-day improvements in Glasgow Coma Scale (GCS) for patients receiving memantine. The remaining RCTs investigated the effects of memantine on cognitive function using 26 standardized tests for assessing cognition function. One RCT reported significant improvements in cognitive function across all domains whilst the other two RCTs, reported that patients in the memantine group underperformed in all cognitive outcome measures. This review shows that despite laboratory and clinical evidence reporting reduced serum NSE and improved GCS, supporting the existence of the neuroprotective properties, there is a lack of reported evidence from RCTs to suggest that memantine directly leads to cognitive improvements in TBI patients. View Full-Text
Keywords: memantine; cognitive function; neuroprotection; traumatic brain injury; head injury memantine; cognitive function; neuroprotection; traumatic brain injury; head injury
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MDPI and ACS Style

Khan, S.; Ali, A.S.; Kadir, B.; Ahmed, Z.; Di Pietro, V. Effects of Memantine in Patients with Traumatic Brain Injury: A Systematic Review. Trauma Care 2021, 1, 1-14. https://0-doi-org.brum.beds.ac.uk/10.3390/traumas1010001

AMA Style

Khan S, Ali AS, Kadir B, Ahmed Z, Di Pietro V. Effects of Memantine in Patients with Traumatic Brain Injury: A Systematic Review. Trauma Care. 2021; 1(1):1-14. https://0-doi-org.brum.beds.ac.uk/10.3390/traumas1010001

Chicago/Turabian Style

Khan, Sungeen, Ayesha S. Ali, Bryar Kadir, Zubair Ahmed, and Valentina Di Pietro. 2021. "Effects of Memantine in Patients with Traumatic Brain Injury: A Systematic Review" Trauma Care 1, no. 1: 1-14. https://0-doi-org.brum.beds.ac.uk/10.3390/traumas1010001

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