Main Article Content

Abstract

Brain traumatic injury (BTI) is one of the causes of death and disability worldwide that affects people regardless of sex, age, income and social status, race, or nationality. In patients with brain traumatic injury, one of the problems that occurs is Diffuse Axonal Injury (DAI) that can produce a direct clinical effect, leading to coma and death. Adrenocorticotropin analogues (ACTH) is one of neuroprotective therapy in brain injury. The aim of this study was to analyze the effect of ACTH analogue on the clinical output (Glasgow Outcome Score/GOS and Bartle Index) in patients with DAI at hospital discharge, 3 months and 6 months post-treatment. This study revealed that ACTH analogue administration resulted in higher GOS and Barthel Index scores than that in control. Further study will required with other variables, such as cognitive and motor examination, and some biomarkers can also be examined serially.

Brain traumatic injury (BTI) is one of the causes of death and disability worldwide that affects people regardless of sex, age, income and social status, race, or nationality. In patients with brain traumatic injury, one of the problems that occurs is Diffuse Axonal Injury (DAI) that can produce a direct clinical effect, leading to coma and death. Adrenocorticotropin analogues (ACTH) is one of neuroprotective therapy in brain injury. The aim of this study was to analyze the effect of ACTH analogue on the clinical output (Glasgow Outcome Score/GOS and Bartle Index) in patients with DAI at hospital discharge, 3 months and 6 months post-treatment. This study revealed that ACTH analogue administration resulted in higher GOS and Barthel Index scores than that in control. Further study will required with other variables, such as cognitive and motor examination, and some biomarkers can also be examined serially.

Keywords

Diffuse Axonal Injury adrenocorticotropin Glasgow Outcome Score Barthel Index

Article Details

How to Cite
Wahyuhadi, J., Wicaksono, P., & Notobroto, H. B. (2018). Clinical Outcome of Patients with Diffuse Axonal Injury Receiving Adrenocorticotropin Analogue at Dr. Soetomo Hospital. Folia Medica Indonesiana, 54(3), 222–227. https://doi.org/10.20473/fmi.v54i3.10019

References

  1. Ashmarin IP, Nezavibat’ko VN, Levitskaya NG, Koshelev VB, Kamensky AA (1995) Design and investigation of ACTH(4–10) analog deprived of D-aminoacids and hydrophobic radicals. Neurosci Res Commun 16, 105-112
  2. Bashkatova V, et al (2009). Attenuation by a novel synthetic analogue of ACTH4-7 of the learning and memory deficits in juvenile rats treated with amphetamine in utero: role of nitric oxide. BMC Pharmacol 9, 1
  3. Cherkasova KA, Lyapina LA (2001). Comparative study of modulatory effect of semax and primary proline-containing peptides on hemostatic reactions. Bulletin of Experimental Biology and Medicine 1, 625-626
  4. Dmitrieva V, et al (2010). Semax and pro-gly-pro activate the transcription of neurotrophins and their receptor genes after cerebral ischemia. Cell Mol Neurobiol 30, 71-79
  5. Dolotov OV, et al (2006). Semax, an analog of ACTH(4–10) with cognitive effects, regulates BDNF and trkB expression in the rat hippocampus. Brain Research 1117, 54-60
  6. Ivanova DM, Levitskaya NG (2007). Comparative study of analgesic potency of ACTH4-10 fragment and its analog semax. Bulletin of Experimental Biology and Medicine 143, 5-8
  7. Jallo J, Lotus CM (2009). Neurotrauma and critical care of the brain. New York, Thieme Medical Publishers Inc.
  8. Jennett B (2005). Development of glasgow coma and outcome scales. Journal of Neuroscience 2, 24-28
  9. Jennett B, Snoek J, Bond MR, Brooks N (1981). Disability after severe head injury: observation on the use of the glasgow outcome scale. J Neurol, Neurosurg 44, 285-293
  10. Van de Kar LD, Javed A, Zhang Y, Serres F, Raap DK, Gray TS (2001). 5-HT2A receptors stimulate ACTH, corticosterone, oxytocin, renin, and prolactin release and activate hypothalamic CRF and oxytocin- expressing cells. The Journal of Neuroscience 21, 3572-3579
  11. Mahoney FI, Barthel DW (1965). Functional evaluation: The Barthel Index. Md State Med J 14, 1-4
  12. Marmarou, A, Beaumont, A (2011). Physiology of cerebrospinal fluid and inracranial pressure. In Winn HR (eds.), Youmans Neurological Surgery, 6th ed. United States, Elsevier Saunders, 169
  13. Narayan RK, Wilberger James E, Povlishock JT (1996). The Neurotrauma. New York, McGraw-Hill Companies, 779-829
  14. Nakao S, et al (2010). Relationship between Barthel Index Scores during the acute phase or rehabilitation and subsequent ADL in stroke patients. The Journal of Medical Investigation 57, 81-8
  15. Ramamurthi, Tandons (2014). Manual of neurosurgery. Mumbai, Jaypee brothers medical publishers LTD, 224-228
  16. Reilly P (1997). Head Injury. London, Chapman & Hall 2-6 Boundary Row, p 40-49. ‘
  17. Schouten JW, Maas AIR (2007). Epidemiology of traumatic brain injury. In Winn HR (eds.), Youmans Neurological Surgery, 6th ed. United States, Elsevier Saunders, p 3270-3275
  18. Storozhevykh TP, Tukhbatova GR, Senilova YAE, Pinelis VG, Andreeva LA, Myasoyedov NF (2007). Effects of semax and its pro-gly-pro fragment on calcium homeostasis of neurons and their survival under conditions of glutamate toxicity. Bulletin of Experimental Biology and Medicine 143, p 601-604
  19. Timoshenko TV, Poletaeva II, Pavlova GV, Revishchin AV (2008). Effect of neonatal injections of the neuropeptide semax on cell proliferation in hippocampal dentate area in rats of two genotypes. Doklady Biological Sciences 424, 78-80
  20. Vink R, Van Den Heuvel C (2004). Recent advances in the development of multifactorial therapies for the treatment of traumatic brain injury. Expert Opin. Investig. Drugs 13, 1263-1274
  21. Wahyuhadi J, Suryaningtyas W, Indarto R, Faris M, Apriawan T (2014). Pedoman tatalaksanan cedera otak (guideline in management of traumatic brain injury). Surabaya, RSU Dr. Soetomo, Faculty of Medicine, Universitas Airlangga
  22. Wilson JT, Pettigrew LE, Teasdale GM (1998). Structured interviews for the glasgow outcome scale and the extended glasgow outcome scale: Guidelines for their use. J Neurotrauma 15, 573-585
  23. Ying W (2008). The nose may help the brain: intranasal drug delivery for treating neurological diseases. Future neurol 3, 1-4