Effects of dopaminergic combination therapy for frontal lobe dysfunction in traumatic brain injury rehabilitation.
Traumatic brain injury poses significant and diverse challenges to rehabilitation efforts. Neurobehavioural deficits represent a particularly difficult barrier to rehabilitative progress and societal reintegration. Early studies have identified dopaminergic drugs such as amantadine, bromocriptine and sinemet as potentially assistive in countering these deficits. To date, side effect profiles have been relatively benign, noted most frequently in small-scale case trials. The case of a 40-year-old patient with bilateral frontal traumatic brain injuries, and previous arteriovenous malformation (AVM) bleed with significant ataxia, dysarthria and neurobehavioural deficits is presented. This long range study demonstrates, through multiple varied dosing schedules, a trade off between the benefits and side effects of dopaminergic therapy, with implications for a larger brain injury population.
Karli
D C
DC
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Burke
D T
DT
Kim
H J
HJ
Calvanio
R
R
Fitzpatrick
M
M
Temple
D
D
Macneil
M
M
Pesez
K
K
Lepak
P
P
D000058:Accidental Falls; D000328:Adult; D017109:Akathisia, Drug-Induced; D000547:Amantadine / Q000009:adverse effects / Q000627:therapeutic use; D001930:Brain Injuries / Q000188:drug therapy* / Q000534:rehabilitation; D001971:Bromocriptine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000293:injuries*; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans