Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1642-1647, September 2008

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

  • Roberto Aquilani, MD

      Affiliations

    • Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica, Fondazione S. Maugeri, Istituto Scientifico di Montescano, Montescano, Pavia, Italy
    • ,
  • Mirella Boselli, MD

      Affiliations

    • Divisione II di Neuroriabilitazione, Fondazione S. Maugeri, Istituto Scientifico di Montescano, Montescano, Pavia, Italy
    • ,
  • Federica Boschi, PhD

      Affiliations

    • Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Pavia, Italy
    • ,
  • Simona Viglio, PhD

      Affiliations

    • Dipartimento di Biochimica “A. Castellani” Università degli Studi di Pavia, Pavia, Italy
    • ,
  • Paolo Iadarola, PhD

      Affiliations

    • Dipartimento di Biochimica “A. Castellani” Università degli Studi di Pavia, Pavia, Italy
    • ,
  • Maurizia Dossena, PhD

      Affiliations

    • Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Pavia, Italy
    • ,
  • Ornella Pastoris, PhD

      Affiliations

    • Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Pavia, Italy
    • Corresponding Author InformationReprint requests to Ornella Pastoris, PhD, Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Facoltà di Scienze MM. FF. NN., Università degli Studi di Pavia-Piazza Botta, Pavia, 11-27100, Italy
    • ,
  • Manuela Verri, PhD

      Affiliations

    • Dipartimento di Scienze Fisiologiche-Farmacologiche Cellulari-Molecolari, Sezione di Farmacologia e Biotecnologie Farmacologiche, Pavia, Italy

Abstract 

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.

Key Words: Amino acids, branched-chain, Minimally conscious state, Rehabilitation

List of Abbreviations: ATP, adenosine triphosphate, BCAA, branched-chain amino acid, CMRO2, cerebral metabolic rate of oxygen, DRS, Disability Rating Scale, GABA, γ-aminobutyric acid, TBI, traumatic brain injury

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00406-1

doi:10.1016/j.apmr.2008.02.023

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1642-1647, September 2008

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