Big disappointment in brain injury treatment study

  • Posted: Wednesday, November 21, 2012 7:37 a.m.

CHICAGO — The hunt for brain injury treatments has suffered a big disappointment in a major study that found zero benefits from a supplement that the U.S. military had hoped would help wounded troops.

The supplement is marketed as a memory booster online and in over-the-counter powders and drinks. It is also widely used by doctors in dozens of countries to treat traumatic brain injuries and strokes, although evidence on whether it works has been mixed.

U.S. scientists had high hopes that in large doses it would help speed recovery in patients with brain injuries from car crashes, falls, sports accidents and other causes. But in the most rigorous test yet, citicoline (see-tee-KOH’-leen) worked no better than dummy treatments at reducing forgetfulness, attention problems, difficulty concentrating and other symptoms.

“We very much were disappointed,” said Dr. Ross Zafonte, the lead author and a traumatic brain injury expert at Harvard Medical School.

The study involved 1,213 patients aged 18 and older hospitalized at eight U.S. trauma centers. They had mild to severe traumatic brain injuries. Half of the patients received citicoline – also known as CDP choline – in pills or in liquid within 24 hours of being injured.

The dose of 2,000 milligrams was much higher than used in over-the-counter products and it was given daily for three months.

The rest got a dummy treatment, and all were followed for six months.

Most patients improved on measures of memory, learning and other mental functions, but those on the supplement fared no better than those given dummy treatment.

A total of 73 patients died during the study, about equal numbers in both groups.

Zafonte noted that citicoline patients with the mildest injuries did slightly worse than those who’d been given dummy treatments.

The study appears in today’s Journal of the American Medical Association.

“The military would have been overjoyed if this had been the one,” said Dr. Robert Ruff, neurology chief at the Cleveland Veterans Affairs Medical Center. “The study results imply that a single drug alone won’t be sufficient to help these patients improve.”

“It’s back to the drawing board,” he said. “We all had such hope this would make some difference.”

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