Critical appraisal of neuroprotection trials in head injury: what have we learned? - PubMed (original) (raw)
Review
Critical appraisal of neuroprotection trials in head injury: what have we learned?
Christos M Tolias et al. NeuroRx. 2004 Jan.
Abstract
To date, despite very encouraging preclinical results, almost all phase II/III clinical neuroprotection trials in traumatic brain injury (TBI) have failed to show any consistent improvement in outcome for TBI patients. To understand the reasons behind such developments we need to review and evaluate the evolution of trial design as a result of our changing understanding of the pathophysiology of brain cell death and progress of translational research from the laboratory bench to the bedside. This paper attempts to critically appraise these neuroprotection trials, rationalize the paucity of effectiveness, review any recent developments in the field, and try to draw some conclusions on how to move forward.
Similar articles
- Neuroprotection: challenges and opportunities.
Faden AI, Stoica B. Faden AI, et al. Arch Neurol. 2007 Jun;64(6):794-800. doi: 10.1001/archneur.64.6.794. Arch Neurol. 2007. PMID: 17562927 Review. - Evaluation of designs for clinical trials of neuroprotective agents in head injury. European Brain Injury Consortium.
Machado SG, Murray GD, Teasdale GM. Machado SG, et al. J Neurotrauma. 1999 Dec;16(12):1131-8. doi: 10.1089/neu.1999.16.1131. J Neurotrauma. 1999. PMID: 10619192 - Neuroprotection for traumatic brain injury.
Loane DJ, Stoica BA, Faden AI. Loane DJ, et al. Handb Clin Neurol. 2015;127:343-66. doi: 10.1016/B978-0-444-52892-6.00022-2. Handb Clin Neurol. 2015. PMID: 25702227 Free PMC article. Review. - Anesthetic neuroprotection: antecedents and an appraisal of preclinical and clinical data quality.
Ishida K, Berger M, Nadler J, Warner DS. Ishida K, et al. Curr Pharm Des. 2014;20(36):5751-65. doi: 10.2174/1381612820666140204111701. Curr Pharm Des. 2014. PMID: 24502575 Review. - Neuroprotection Trials in Traumatic Brain Injury.
Chakraborty S, Skolnick B, Narayan RK. Chakraborty S, et al. Curr Neurol Neurosci Rep. 2016 Apr;16(4):29. doi: 10.1007/s11910-016-0625-x. Curr Neurol Neurosci Rep. 2016. PMID: 26883431 Review.
Cited by
- Neuroprotective and neurorestorative effects of thymosin β4 treatment following experimental traumatic brain injury.
Xiong Y, Mahmood A, Meng Y, Zhang Y, Zhang ZG, Morris DC, Chopp M. Xiong Y, et al. Ann N Y Acad Sci. 2012 Oct;1270:51-8. doi: 10.1111/j.1749-6632.2012.06683.x. Ann N Y Acad Sci. 2012. PMID: 23050817 Free PMC article. - COG1410, an apolipoprotein E-based peptide, improves cognitive performance and reduces cortical loss following moderate fluid percussion injury in the rat.
Kaufman NA, Beare JE, Tan AA, Vitek MP, McKenna SE, Hoane MR. Kaufman NA, et al. Behav Brain Res. 2010 Dec 25;214(2):395-401. doi: 10.1016/j.bbr.2010.06.017. Epub 2010 Jun 19. Behav Brain Res. 2010. PMID: 20600347 Free PMC article. - Interaction of aquaporin 4 and N-methyl-D-aspartate NMDA receptor 1 in traumatic brain injury of rats.
Chen LH, Zhang HT, Xu RX, Li WD, Zhao H, Yang Y, Sun K. Chen LH, et al. Iran J Basic Med Sci. 2018 Nov;21(11):1148-1154. doi: 10.22038/IJBMS.2018.29135.7037. Iran J Basic Med Sci. 2018. PMID: 30483388 Free PMC article. - Outcome prediction within twelve hours after severe traumatic brain injury by quantitative cerebral blood flow.
Kaloostian P, Robertson C, Gopinath SP, Stippler M, King CC, Qualls C, Yonas H, Nemoto EM. Kaloostian P, et al. J Neurotrauma. 2012 Mar 20;29(5):727-34. doi: 10.1089/neu.2011.2147. J Neurotrauma. 2012. PMID: 22111910 Free PMC article. - Phase I randomized clinical trial of N-acetylcysteine in combination with an adjuvant probenecid for treatment of severe traumatic brain injury in children.
Clark RSB, Empey PE, Bayır H, Rosario BL, Poloyac SM, Kochanek PM, Nolin TD, Au AK, Horvat CM, Wisniewski SR, Bell MJ. Clark RSB, et al. PLoS One. 2017 Jul 7;12(7):e0180280. doi: 10.1371/journal.pone.0180280. eCollection 2017. PLoS One. 2017. PMID: 28686657 Free PMC article. Clinical Trial.
References
- Kay A, Teasdale GM. Head injury in the United Kingdom. World J Surg 25: 1210–1220, 2001. - PubMed
- Murray CJL, Lopez AD. Global mortality, disability and the contribution of the risk factors: global burden of disease study. Lancet 349: 1436–1442, 1997. - PubMed
- Bullock R, Lyeth BG, Muizelaar JP. Current status of neuroprotection trials for traumatic brain injury: lessons from animal models and clinical studies. Neurosurgery 45: 207–220, 1999. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical