Branched-Chain Amino Acids May Improve Recovery From a Vegetative or Minimally Conscious State in Patients With Traumatic Brain Injury: A Pilot Study

Aquilani R, Boselli M, Boschi F, Viglio S, Iadarola P, Dossena M, Pastoris O, Verri M. Branched-chain amino acids may improve recovery from a vegetative or minimally conscious state in patients with traumatic brain injury: a pilot study.

Objective

To investigate whether supplementation with branched-chain amino acids (BCAAs) may improve recovery of patients with a posttraumatic vegetative or minimally conscious state.

Design

Patients were randomly assigned to 15 days of intravenous BCAA supplementation (n=22; 19.6g/d) or an 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 log10DRS.

Results

Fifteen days after admission to the rehabilitation department, the log10DRS score improved significantly only in patients who had received BCAAs (log10DRS score, 1.365±0.08 to 1.294±0.05; P<.001), while the log10DRS score in the placebo recipients remained virtually unchanged (log10DRS score, 1.373±0.03 to 1.37±0.03; P not significant). The difference in improvement of log10DRS score between the 2 groups was highly significant (P<.000). Moreover, 68.2% (n=15) of treated patients achieved a log10DRS point score of .477 or higher (3 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.