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Prescribing multiple neurostimulants during rehabilitation for severe brain injury.

Herrold AA, Pape TL, Guernon A, Mallinson T, Collins E, Jordan N - ScientificWorldJournal (2014)

Bottom Line: Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI).Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis.Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.

View Article: PubMed Central - PubMed

Affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Chicago, IL 60611, USA.

ABSTRACT

Background: Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.

Method: Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful neurobehavioral improvement during rehabilitation defined as either at least a 4.7 unit (minimal detectable change) or 2.58 unit (minimal clinically important difference) gain on the Disorders of Consciousness Scale-25 (DOCS-25).

Results: Number of neurostimulants was not significantly (P > 0.05) associated with recovery of full consciousness during rehabilitation, within one year of injury, or meaningful neurobehavioral improvement using the DOCS-25.

Conclusions: Receiving multiple neurostimulants during rehabilitation may not influence recovery of full consciousness or meaningful neurobehavioral improvement. Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.

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Related in: MedlinePlus

Study sample.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Study sample.

Mentions: Of the 191 people in the larger study, medication data could not be obtained for 58 participants (i.e., missing medication data) (Figure 1). Sixteen people were not provided any neurostimulants and two people recovered full consciousness within two days of the baseline neurobehavioral assessment. After excluding these people, the final analytic sample for the current study included 115 participants. Of these 115 participants, 84 (73%) received more than one stimulant and 31 (27%) received only one neurostimulant.


Prescribing multiple neurostimulants during rehabilitation for severe brain injury.

Herrold AA, Pape TL, Guernon A, Mallinson T, Collins E, Jordan N - ScientificWorldJournal (2014)

Study sample.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4283254&req=5

fig1: Study sample.
Mentions: Of the 191 people in the larger study, medication data could not be obtained for 58 participants (i.e., missing medication data) (Figure 1). Sixteen people were not provided any neurostimulants and two people recovered full consciousness within two days of the baseline neurobehavioral assessment. After excluding these people, the final analytic sample for the current study included 115 participants. Of these 115 participants, 84 (73%) received more than one stimulant and 31 (27%) received only one neurostimulant.

Bottom Line: Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI).Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis.Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.

View Article: PubMed Central - PubMed

Affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Chicago, IL 60611, USA.

ABSTRACT

Background: Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.

Method: Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful neurobehavioral improvement during rehabilitation defined as either at least a 4.7 unit (minimal detectable change) or 2.58 unit (minimal clinically important difference) gain on the Disorders of Consciousness Scale-25 (DOCS-25).

Results: Number of neurostimulants was not significantly (P > 0.05) associated with recovery of full consciousness during rehabilitation, within one year of injury, or meaningful neurobehavioral improvement using the DOCS-25.

Conclusions: Receiving multiple neurostimulants during rehabilitation may not influence recovery of full consciousness or meaningful neurobehavioral improvement. Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.

Show MeSH
Related in: MedlinePlus