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Amantadine did not Positively Impact Cognition in Chronic Traumatic Brain Injury: A Multi-Site, Randomized Controlled Trial

Categories: Cognition - Thinking and Emotional Skills

The Question

Does Amantadine help cognition in people with chronic brain injury?

This Study

The long-term effects on thinking and memory which develop after a traumatic brain injury (TBI) can impact an individual’s ability to perform many day-to-day activities including homemaking, leisure pursuits and work tasks. In fact, difficulties in performing such tasks have been reported in up to 65% of individuals who have sustained moderate-severe TBIs. Many physicians prescribe medications to help improve thinking and memory; however there is very little scientific evidence proving their effectiveness for this purpose. A medication called amantadine is an example of a medication which has historically been used in this way. Amantadine was approved by the food and drug administration (FDA) for use with influenza prevention and treatment of Parkinson’s disease. While some small scale studies have indicated that amantadine is an effective drug to help improve thinking and memory in the years after a TBI, they are based on flawed study designs. One well-designed large scale study found significant effects of amantadine on the acute recovery of persons with disorders of consciousness; however the study did not extend to patients in post-acute stages of recovery who are functioning at higher levels.

In contrast, the Amantadine Irritability Multi-site Study (AIMS) was a large-scale masked and randomized controlled trial (with 119 participants) conducted between 2009 and 2013 to assess the effect of amantadine on persons with TBI with irritability. A secondary question was to evaluate effects on thinking and memory. Findings indicated that those participants who were given amantadine during the AIMS study did not show any significant improvement in cognition when compared to their matched peers who were given a placebo pill only (a sugar pill). The results of this large scale study suggest that the application of amantadine may even have some very small negative effects on thinking skills after a TBI. This study, therefore, provides no evidence that the administration of amantadine improves thinking and memory during the post-acute stages of TBI.

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Find This Study

Find this study: Hammond, F., Sherer, M., Malec J., Zafonte R., Dikmen, S., Bogner J., Bell K.,Barber J., Temkin N. (2018). Amantadine did not positively impact cognition in chronic traumatic brain injury: A multi-site, randomized controlled trial. Journal of Neurotrauma, 35, 1-8. doi: 10.1089/neu.2018.5767

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