title: Prescribing multiple neurostimulants during rehabilitation for severe brain injury.
abstract: BACKGROUND
  Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI.
  
  
  METHODS
  Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful neurobehavioral improvement during rehabilitation defined as either at least a 4.7 unit (minimal detectable change) or 2.58 unit (minimal clinically important difference) gain on the Disorders of Consciousness Scale-25 (DOCS-25).
  
  
  RESULTS
  Number of neurostimulants was not significantly (P > 0.05) associated with recovery of full consciousness during rehabilitation, within one year of injury, or meaningful neurobehavioral improvement using the DOCS-25.
  
  
  CONCLUSIONS
  Receiving multiple neurostimulants during rehabilitation may not influence recovery of full consciousness or meaningful neurobehavioral improvement. Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.
authors.affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Chicago, IL 60611, USA.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Herrold
authors.affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Office of Medical Education (1574), 345 E. Superior Street Chicago, IL 60611, USA.
authors.forename: Theresa Louise-Bender
authors.initials: TL
authors.lastname: Pape
authors.affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Research Department, Marianjoy Rehabilitation Hospital, 26W171 Roosevelt Road, Wheaton, IL 60187, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Guernon
authors.affiliation: Department of Clinical Research and Leadership, The George Washington University, 2100 Pennsylvania Avenue, Washington, DC 20037, USA.
authors.forename: Trudy
authors.initials: T
authors.lastname: Mallinson
authors.affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Avenue, Room 716, Chicago, IL 60612, USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Collins
authors.affiliation: Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA ; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Chicago, IL 60611, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Jordan
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000188:drug therapy* / Q000534:rehabilitation*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic
chemical_list: D000697:Central Nervous System Stimulants