ABSTRACT

Studies on the efficacy of amantadine as a treatment for apathy after brain injury are scarce and of low quality. We examined the efficacy and safety of amantadine for treatment of apathy in two individuals with brain injury.

Two double-blind, randomized, single-case experimental (baseline-amantadine-placebo-withdrawal) design (SCED) studies. Apathy measures included a Visual Analogue Scale (VAS), the Neuropsychiatric Inventory (NPI) apathy subscale and the Behavior Rating Inventory of Executive Function for Adults “Initiate” subscale. Safety measures included a rating scale of possible side effects of amantadine and physical examinations.

No difference in apathy symptoms (VAS) between baseline and amantadine phase was found in case 1 (NAP = 0.55). Surprisingly, in case 2, apathy symptoms deteriorated from baseline to amantadine phase (NAP = 0.28, 90% CI = −0.69 to −0.20) and improved from amantadine to placebo phase (NAP = 0.92, 90% CI = 0.60–1.00). This improvement was also found on the NPI apathy subscale. Side effects of amantadine were observed in case 2.

In this SCED study, amantadine did not improve apathy symptoms in two individuals with brain injury. However, this study shows that side effects of amantadine can occur which lead to a significant decrease in well-being. More high quality studies are required.

摘要

关于金刚烷胺治疗脑损伤后冷漠疗效的研究很少且质量低下。我们检查了金刚烷胺治疗两名脑损伤患者冷漠的疗效和安全性。

两项双盲、随机、单病例实验（基线-金刚烷胺-安慰剂-戒断）设计 (SCED) 研究。冷漠测量包括视觉模拟量表 (VAS)、神经精神量表 (NPI) 冷漠子量表和成人“启动”子量表执行功能的行为评定量表。安全措施包括金刚烷胺可能的副作用评定量表和身体检查。

在病例 1 (NAP = 0.55) 中，基线期和金刚烷胺期之间的冷漠症状 (VAS) 没有差异。令人惊讶的是，在病例 2 中，冷漠症状从基线阶段恶化到金刚烷胺阶段（NAP = 0.28, 90% CI = -0.69 到 -0.20），并从金刚烷胺阶段改善到安慰剂阶段（NAP = 0.92, 90% CI = 0.60–1.00）。在 NPI 冷漠分量表上也发现了这种改进。在病例 2 中观察到金刚烷胺的副作用。

在这项 SCED 研究中，金刚烷胺并未改善两名脑损伤患者的冷漠症状。然而，这项研究表明，金刚烷胺的副作用可能会导致幸福感显着下降。需要更多高质量的研究。