4.6 Article

Branched-chain amino acids may improve recovery from a vegetative or minimally conscious state in patients with traumatic brain injury: A pilot study

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2008.02.023

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amino acids; branched-chain; minimally conscious state; rehabilitation

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Objective: To investigate whether Supplementation With branched-chain amino acids (BCAAs) may improve recovery of patients with a posttramatic vegetative or minimally conscious state. Design: Patients were randomly assigned to 15 days of intravenous BCAA Supplementation (n=22., 19.6g/d) or all isonitrogenous placebo (n = 19). Setting: Tertiary care rehabilitation setting. Participants: Patients (N=41: 29 men, 12 women, mean age,49.5 +/- 21y) with a posttraumatic vegetative or minimally conscious state. 47 24 days after the index traumatic event. Intervention: Supplementation with BCAAs. Main Outcome Measure: Disability Rating Scale (DRS) as log(10)DRS. Results: Fifteen days after admission to the rehabilitation department, the log(10)DRS score improved significantly only in patients who had received BCAAs (log(10)DRS score, 1.365 +/- 0.08 to 1.294 +/- 0.05-, P<.001), while the log(10)DRS score in the placebo recipients remained virtually unchanged (log(10)DRS score, 1.373 +/- 10.03 to 1.37 +/- 10.03; P not significant). The difference in improvement of log(10)DRS score between the 2 groups was highly significant (P<.000). Moreover 682% (n 15) of treated patients achieved a log(10))DRS point score of 477 or higher Q as geometric mean) that allowed them to exit the vegetative or minimally Conscious state. Conclusions: Supplemented BCAAs may improve the recovery from a vegetative or minimally conscious state in patients with posttraumatic vegetative or minimally conscious state.

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