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Brain & Spine 2024TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on... (Review)
Review
INTRODUCTION
TBIs contribute in over one-third of injury-related deaths with mortality rates as high as 50% in trauma centers serving the most severe TBI. The effect of TBI on mortality is about 10% across all ages. Amantadine hydrochloride is one of the most commonly prescribed medications for patients undergoing inpatient neurorehabilitation who have disorders of consciousness. It is a dopamine (DA) receptor agonist and a N-Methyl-D-aspartate (NMDA) receptor antagonist via dopamine release and dopamine reuptake inhibition. The current study will synthesize the current available evidence and show the effect of Amantadine in functional improvement after TBI.
RESEARCH QUESTION
Does Amantadine have an effect on functional improvement of TBI patients?
MATERIAL AND METHODS
This systematic review included all randomized placebo-controlled trials that compare the use of Amantadine versus placebo for functional improvement of patients after TBI. Outcome measures included DRS, GCS and/or GOS scores.
RESULTS
Three studies with a total of 281 patients were included in the quantitative analyses. GRADE assessments show that there was a high certainty of evidence for functional improvement in terms of DRS scores.
DISCUSSION AND CONCLUSION
Evidence of this review show that the use of Amantadine may have a beneficial effect on functional outcome in moderate to severe traumatic brain injuries among adult patients. Given the still-limited body of knowledge, more relevant studies must be made exploring the impact of Amantadine therapies on promoting functional recovery within the brain injury rehabilitation care continuum, with the goals of achieving larger sample sizes and establishing the early- or later-treatment beneficial effects.
PubMed: 38465280
DOI: 10.1016/j.bas.2024.102773 -
Bioactive Materials Jul 2023Despite decades of efforts, state-of-the-art synthetic burn dressings to treat partial-thickness burns are still far from ideal. Current dressings adhere to the wound...
Despite decades of efforts, state-of-the-art synthetic burn dressings to treat partial-thickness burns are still far from ideal. Current dressings adhere to the wound and necessitate debridement. This work describes the first "supramolecular hybrid hydrogel (SHH)" burn dressing that is biocompatible, self-healable, and on-demand dissoluble for easy and trauma-free removal, prepared by a simple, fast, and scalable method. These SHHs leverage the interactions of a custom-designed cationic copolymer via host-guest chemistry with cucurbit[7]uril and electrostatic interactions with clay nanosheets coated with an anionic polymer to achieve enhanced mechanical properties and fast on-demand dissolution. The SHHs show high mechanical strength (>50 kPa), self-heal rapidly in ∼1 min, and dissolve quickly (4-6 min) using an amantadine hydrochloride (AH) solution that breaks the supramolecular interactions in the SHHs. Neither the SHHs nor the AH solution has any adverse effects on human dermal fibroblasts or epidermal keratinocytes . The SHHs also do not elicit any significant cytokine response . Furthermore, murine experiments show no immune or inflammatory cell infiltration in the subcutaneous tissue and no change in circulatory cytokines compared to sham controls. Thus, these SHHs present excellent burn dressing candidates to reduce the time of pain and time associated with dressing changes.
PubMed: 37056249
DOI: 10.1016/j.bioactmat.2022.09.003 -
PloS One 2023Bangladesh has been ranked as one of the world's top countries affected by climate change, particularly in terms of agricultural crop sector. The purpose of this study...
Bangladesh has been ranked as one of the world's top countries affected by climate change, particularly in terms of agricultural crop sector. The purpose of this study is to identify spatial and temporal changes and trends in long-term climate at local and national scales, as well as their implications for rice yield. In this study, Modified Mann-Kendall and Sen's slope tests were used to detect significant trends and the magnitude of changes in temperature and rainfall. The temperature and rainfall data observed and recorded at 35 meteorological stations in Bangladesh over 65-years in the time span between the years 1949 and 2013 have been used to detect these changes and trends of variation. The results show that mean annual Tmean, Tmin, and Tmax have increased significantly by 0.13°C, 0.13°C, and 0.13°C/decade, respectively. The most significant increasing trend in seasonal temperatures for the respective Tmean, Tmin, and Tmax was 0.18°C per decade (post-monsoon), 0.18°C/decade (winter), and 0.23°C/decade (post-monsoon), respectively. Furthermore, the mean annual and pre-monsoon rainfall showed a significant increasing trend at a rate of 4.20 mm and 1.35 mm/year, respectively. This paper also evaluates climate variability impacts on three major rice crops, Aus, Aman, and Boro during 1970-2013. The results suggest that crop yield variability can be explained by climate variability during Aus, Aman, and Boro seasons by 33, 25, and 16%, respectively. Maximum temperature significantly affected the Aus and Aman crop yield, whereas rainfall significantly affected all rice crops' yield. This study sheds light on sustainable agriculture in the context of climate change, which all relevant authorities should investigate in order to examine climate-resilient, high-yield crop cultivation.
Topics: Temperature; Oryza; Climate Change; Bangladesh; Meteorology; Crops, Agricultural; Amantadine
PubMed: 37824463
DOI: 10.1371/journal.pone.0292668 -
American Journal of Ophthalmology Case... Dec 2023To describe a case of bilateral interface fluid formation 2 years after laser-assisted in situ keratomileusis (LASIK) surgery caused by the side effect of amantadine.
PURPOSE
To describe a case of bilateral interface fluid formation 2 years after laser-assisted in situ keratomileusis (LASIK) surgery caused by the side effect of amantadine.
OBSERVATIONS
A 47-year-old male patient with a history of Parkinson's disease treated with amantadine who had uneventful LASIK surgery in both eyes 2 years ago, presented with a decline in vision over the past 6 weeks. Results: Best corrected vision was 20/200 and 20/400 in the right and left eye respectively. Intraocular pressures were measured within the normal range. Biomicroscopic exam showed bilateral corneal edema. Anterior segment optical coherence tomography (AS-OCT) revealed fluid accumulation within the LASIK flap interface in both corneas. The patient's corneal edema and fluid in the interface began to gradually resolve, and vision improved 2 weeks after discontinuing amantadine.
CONCLUSIONS AND IMPORTANCE
Although there is no previous report, it is possible that amantadine may cause interface fluid formation in patients with LASIK surgery.
PubMed: 38161515
DOI: 10.1016/j.ajoc.2023.101895 -
Behavioural Neurology 2023Alzheimer's disease (AD), as the main cause of dementia, has a progressive and neurodegenerative pattern with number of cases increasing over the next decades....
Alzheimer's disease (AD), as the main cause of dementia, has a progressive and neurodegenerative pattern with number of cases increasing over the next decades. Therefore, discovering an effective treatment with the ability to invert memory impairment and pathophysiological events of AD seems to be required. The present study performed to investigate the probable effects of Edaravone (EDV) in AD-like disorder induced by intracerebroventricular streptozotocin (ICV-STZ) administration in mice. This study also compares the two different methods of ICV-STZ in the memory impairment induction. NMRI male mice were administrated with 3 mg/kg of STZ for two times during 48 hours span, and after 24 hours, animals were treated with EDV (5 and 10 mg/kg), Donepezil, and Memantine for 14 days. After behavioral tests regarding memory and cognitive function, animals were sacrificed, and the hippocampi were utilized for further analyses. Our results demonstrated that administration of STZ induced memory impairment in the Morris water maze (MWM) test and decreased the discriminative factor in novel object recognition (NOR). The biochemical output shows a significant decrease in ferric reducing antioxidant power (FRAP) and glutathione (GSH) levels followed by increase in malondialdehyde (MDA) and protein carbonylation (PCO) levels. The output showed no difference between the patterns of AD-like disorder induction. Following our treatment groups, administration of EDV (5 and 10 mg/kg), Donepezil, and Memantine significantly improved memory performance and discriminatory behavior. Aforementioned treatments managed to improve FRAP and GSH content of hippocampus, while significantly attenuating MDA, PCO, and nitric oxide overproduction. In addition, no significant difference has been observed between the effect of 5 and 10 mg/kg EDV application. It was supposed that EDV managed to ameliorate memory dysfunction, discriminatory behavior, oxidative stress, and cellular antioxidant power in a dose-independent pattern in mice.
Topics: Rats; Male; Mice; Animals; Edaravone; Streptozocin; Antioxidants; Memantine; Rats, Wistar; Donepezil; Oxidative Stress; Memory Disorders; Alzheimer Disease; Inflammation; Maze Learning; Disease Models, Animal
PubMed: 37476485
DOI: 10.1155/2023/9652513 -
Journal of the American Medical... Sep 2023Alzheimer's disease (AD) is a progressive neurological disorder with no specific curative medications. Sophisticated clinical skills are crucial to optimize treatment...
BACKGROUND
Alzheimer's disease (AD) is a progressive neurological disorder with no specific curative medications. Sophisticated clinical skills are crucial to optimize treatment regimens given the multiple coexisting comorbidities in the patient population.
OBJECTIVE
Here, we propose a study to leverage reinforcement learning (RL) to learn the clinicians' decisions for AD patients based on the longitude data from electronic health records.
METHODS
In this study, we selected 1736 patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. We focused on the two most frequent concomitant diseases-depression, and hypertension, thus creating 5 data cohorts (ie, Whole Data, AD, AD-Hypertension, AD-Depression, and AD-Depression-Hypertension). We modeled the treatment learning into an RL problem by defining states, actions, and rewards. We built a regression model and decision tree to generate multiple states, used six combinations of medications (ie, cholinesterase inhibitors, memantine, memantine-cholinesterase inhibitors, hypertension drugs, supplements, or no drugs) as actions, and Mini-Mental State Exam (MMSE) scores as rewards.
RESULTS
Given the proper dataset, the RL model can generate an optimal policy (regimen plan) that outperforms the clinician's treatment regimen. Optimal policies (ie, policy iteration and Q-learning) had lower rewards than the clinician's policy (mean -3.03 and -2.93 vs. -2.93, respectively) for smaller datasets but had higher rewards for larger datasets (mean -4.68 and -2.82 vs. -4.57, respectively).
CONCLUSIONS
Our results highlight the potential of using RL to generate the optimal treatment based on the patients' longitude records. Our work can lead the path towards developing RL-based decision support systems that could help manage AD with comorbidities.
Topics: Humans; Alzheimer Disease; Memantine; Cholinesterase Inhibitors; Artificial Intelligence; Learning
PubMed: 37463858
DOI: 10.1093/jamia/ocad135 -
Biosensors Dec 2023Amantadine (AMD) is an antiviral drug that is prohibited for use in livestock and poultry. In this study, carboxyl-modified magnetic nanoparticles (MNPs) were...
Amantadine (AMD) is an antiviral drug that is prohibited for use in livestock and poultry. In this study, carboxyl-modified magnetic nanoparticles (MNPs) were synthesized using the solvothermal method in one step with harmless and inexpensive regents, and they were used to label monoclonal antibodies (mAbs) of AMD in microwells with electrostatic adsorption. Then, a magnetic immunochromatography assay (MICA) method was successfully established. Under optimal conditions, the MICA showed a good performance, with a linear range of 0.2~10.0 µg/L. The limit of detection (LOD) was 0.068 µg/L with the instrument, and the visual LOD (vLOD) was 0.5 µg/L. There was no cross-reaction with rimantadine and ribavirin. The vLOD in real samples was 1.0 µg/kg. The developed MICA has the advantages of convenience, speed, and sensitivity, which make it suitable for the on-site rapid detection of AMD residues in chicken tissues and eggs.
Topics: Amantadine; Antiviral Agents; Chromatography, Affinity; Nanoparticles; Static Electricity
PubMed: 38248400
DOI: 10.3390/bios14010023 -
Neurobiology of Disease Apr 2024A common adverse effect of Parkinson's disease (PD) treatment is L-dopa-induced dyskinesia (LID). This condition results from both dopamine (DA)-dependent and...
A common adverse effect of Parkinson's disease (PD) treatment is L-dopa-induced dyskinesia (LID). This condition results from both dopamine (DA)-dependent and DA-independent mechanisms, as glutamate inputs from corticostriatal projection neurons impact DA-responsive medium spiny neurons in the striatum to cause the dyskinetic behaviors. In this study, we explored whether suppression of presynaptic corticostriatal glutamate inputs might affect the behavioral and biochemical outcomes associated with LID. We first established an animal model in which 6-hydroxydopamine (6-OHDA)-lesioned mice were treated daily with L-dopa (10 mg/kg, i.p.) for 2 weeks; these mice developed stereotypical abnormal involuntary movements (AIMs). When the mice were pretreated with the NMDA antagonist, amantadine, we observed suppression of AIMs and reductions of phosphorylated ERK1/2 and NR2B in the striatum. We then took an optogenetic approach to manipulate glutamatergic activity. Slc17a6 (vGluT2)-Cre mice were injected with pAAV5-Ef1a-DIO-eNpHR3.0-mCherry and received optic fiber implants in either the M1 motor cortex or dorsolateral striatum. Optogenetic inactivation at either optic fiber implant location could successfully reduce the intensity of AIMs after 6-OHDA lesioning and L-dopa treatment. Both optical manipulation strategies also suppressed phospho-ERK1/2 and phospho-NR2B signals in the striatum. Finally, we performed intrastriatal injections of LDN 212320 in the dyskenesic mice to enhance expression of glutamate uptake transporter GLT-1. Sixteen hours after the LDN 212320 treatment, L-dopa-induced AIMs were reduced along with the levels of striatal phospho-ERK1/2 and phospho-NR2B. Together, our results affirm a critical role of corticostriatal glutamate neurons in LID and strongly suggest that diminishing synaptic glutamate, either by suppression of neuronal activity or by upregulation of GLT-1, could be an effective approach for managing LID.
Topics: Rats; Mice; Animals; Levodopa; Parkinson Disease; Oxidopamine; Glutamic Acid; Rats, Sprague-Dawley; Dopamine; Corpus Striatum; Dyskinesias; Disease Models, Animal; Antiparkinson Agents
PubMed: 38401650
DOI: 10.1016/j.nbd.2024.106452 -
Frontiers in Psychiatry 2023Antipsychotic-induced catatonia is an iatrogenic and debilitating adverse reaction, but there is a dearth of recent documented cases. This report describes a 35-year-old...
Antipsychotic-induced catatonia is an iatrogenic and debilitating adverse reaction, but there is a dearth of recent documented cases. This report describes a 35-year-old incarcerated Korean-American male with a history of unspecified psychosis who presented for antipsychotic induced catatonia after administration of haloperidol decanoate intramuscular (200 mg across the span of 1 week). Neurologic workup was performed including MRI, lumbar puncture, and electroencephalography. Despite an approximate month long hospitalization, benzodiazepine challenge, benztropine trial, and amantadine adjunct, our patient continued to experience bradykinesia, waxy flexibility, and mask-like facies, and was minimally verbally responsive. Several challenges in the treatment of incarcerated individuals at the hospital are highlighted in this case report, including adverse reaction to medication, difficulty of care coordination, and limited access to health records among providers.
PubMed: 37720901
DOI: 10.3389/fpsyt.2023.1092253 -
Revista de Saude Publica 2023To analyze the consumption of drugs for Alzheimer's disease on the Brazilian private market and its geographical distribution from 2014 to 2020.
OBJECTIVE
To analyze the consumption of drugs for Alzheimer's disease on the Brazilian private market and its geographical distribution from 2014 to 2020.
METHODS
National data from the Brazilian National System of Controlled Product Management were used, regarding sales of donepezil, galantamine, rivastigmine, and memantine from January 2014 to December 2020. Sales data were used as a proxy for drug consumption and expressed as defined daily dose/1,000 inhabitants/year at national, regional, federative unit and microregion levels.
RESULTS
Drug consumption went from 5,000 defined daily doses/1,000 inhabitants, in 2014, to more than 16,000/1,000 inhabitants, in 2020, and all federative units showed positive variation. The Brazilian Northeast had the highest cumulative consumption in the period but displayed microregional disparities while the North region had the lowest consumption. Donepezil and memantine were the most consumed drugs, with the highest growth in consumption from 2014 to 2020.
CONCLUSION
The consumption of medicines indicated to treat Alzheimer's disease tripled in Brazil between 2014 and 2020, which may relate to the increase in the prevalence of the disease in the country, greater access to health services, and inappropriate use. This challenges managers and healthcare providers due to population aging and the increased prevalence of chronic-degenerative diseases.
Topics: Humans; Alzheimer Disease; Donepezil; Memantine; Brazil; Cholinesterase Inhibitors; Piperidines; Phenylcarbamates; Indans
PubMed: 37971177
DOI: 10.11606/s1518-8787.2023057005128