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Use of Neurostimulants in Traumatic Brain Injury2020
Type: New Practice Management Guideline (PMG)
Category: Surgical Critical Care
Committee Liaison: Rachel S. Morris, MD, FACS
Team leader(s)
Statement:
Neurostimulants have been used off-label to reverse neurochemical changes associated with traumatic brain injury (TBI) with the expectation of neurologic functional recovery. Examples of neurostimulants include methylphenidate, amantadine, modafinil, and bromocriptine, among others. The mechanism of functional improvement with neurostimulants has not been proven, but one possible explanation is that stimulants increase activity of spared neurons. Previous studies show that functional improvements associated with neurostimulants includes increased arousal, awareness, wakefulness, emotional regulation, attention, learning, and memory. Although neurostimulants are frequently used in TBI, little data is available in support of their efficacy, optimal timing of initiation, and optimal duration of therapy. Therefore, we are proposing a systematic review and meta-analysis to assess the effect of neurostimulants on neuro-recovery after traumatic brain injury.
Team members:
• Brett M. Tracy, MD
• Benjamin Borg
• Cassandra Renfro, MD
• Shrikiriti Rajan
• Zachary Ballinger
• Laura Brown
• Kristen Bamberg
• Joshua Hagan