Cholinomimetic agents and neurocognitive impairment following head injury: a systematic review.
OBJECTIVE
There has been increasing interest in the role of cholinomimetic agents in the long-term management of cognitive impairment following traumatic brain injury. This paper aims to assess the evidence accumulated thus far.


METHODS
Studies are identified by searching MEDLINE, EMBASE and PsychINFO, contacting experts and pharmaceutical companies and hand searching bibliographies. All study designs are included.


RESULTS
This study identified 25 papers that studied cholinesterase inhibitors, physostigmine and choline in mild-to-severe traumatic brain injury. The outcome with cholinesterase inhibitors and choline is suggestive but not conclusive while physostigmine appears of little benefit. A lack of rigorous studies and a plethora of outcome measures preclude drawing definitive conclusions. Further randomized controlled trials are urgently required.
Clare House, St George's Hospital, London, UK.
Norman A
NA
Poole
Niruj
N
Agrawal
D001930:Brain Injuries / Q000150:complications*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use; D006801:Humans; D054709:Lecithins / Q000627:therapeutic use; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use; D010830:Physostigmine / Q000627:therapeutic use*; D013501:Surface-Active Agents / Q000627:therapeutic use; D013997:Time Factors
D002800:Cholinesterase Inhibitors; D054709:Lecithins; D018697:Nootropic Agents; D013501:Surface-Active Agents; D003566:Cytidine Diphosphate Choline; D010830:Physostigmine