Additive effect of cerebrolysin and amantadine on disorders of consciousness secondary to acquired brain injury: A retrospective case-control study

Abstract

Background: Acquired brain injury can cause disorders of consciousness. An additive effect of cerebrolysin and amantadine has been postulated, but not systematically studied. The present study aimed to investigate this additive effect in patients with disorders of consciousness secondary to acquired brain injury. Methods: The medical records of patients diagnosed with disorders of consciousness after acquired brain injury were reviewed. The patients were categorized into 2 groups: single regimen (amantadine only) and dual regimen (amantadine plus cerebrolysin). The patients? conscious states were assessed using the Coma Recovery Scale-Revised (CRS-R) before, and after 4 weeks of drug administration. Results: Data for a total of 84 patients were analysed. The degree of change in CRS-R and the proportion of patients in the disorders of consciousness category showing a change was higher in the dual regimen group than in the single regimen group. Analysis of patients who had initially been in a prolonged vegetative state or minimally conscious state minus before administration showed that the patients in the dual regimen group had greater increases in CRS-R scores than those in the single regimen group. Conclusion: This study identified that an amantadine-plus-cerebrolysin regimen additively affects patients with prolonged disorders of consciousness. A future controlled trial is needed to investigate the efficacy of each regimen in patients with prolonged disorders of consciousness secondary to acquired brain injury, particularly for patients who have remained in a prolonged vegetative state after acquired brain injury.