title: Effects of low-dose milnacipran on event-related potentials and neuropsychological tests in persons with traumatic brain injury: A preliminary study.
abstract: BACKGROUND
  Psychostimulants are among the most commonly used pharmacological agents for countering cognitive dysfunction and/or enhancing rehabilitation in persons with brain injury. It was postulated that milnacipran, a serotonin-norepinephrine reuptake inhibitor, would be effective against cognitive dysfunction in non-depressed persons with brain injury.
  
  
  METHODS
  Eighteen patients were recruited with at least moderate disability more than 4 months after a traumatic brain injury (TBI) and they were randomized to an 8-week, placebo-controlled, double-blind trial. Cognitive dysfunction was assessed at baseline with the Trail Making Test, the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Wechsler Memory Scale-Revised (WMS-R) and measurement of event-related potentials (ERPs) both before randomization and after an 8-week administration of milnacipran or placebo.
  
  
  RESULTS
  N2 and P3 latencies in the milnacipran group were significantly shortened by the intervention. Moreover, the Verbal Intelligence Quotient and Full Intelligence Quotient scores of the WAIS-R and the delayed recall score of the WMS-R were significantly higher than baseline after milnacipran intervention.
  
  
  CONCLUSIONS
  Milnacipran administration improved ERP measures of attention and information processing in non-depressed persons with brain injury and also improved scores on three sub-scales of standard neuropsychological tests of cognitive dysfunction. Therefore, this intervention merits validation by additional, larger studies.
authors.affiliation: a Department of Rehabilitation Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Iwanaga
authors.affiliation: a Department of Rehabilitation Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kato
authors.affiliation: a Department of Rehabilitation Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Okazaki
authors.affiliation: a Department of Rehabilitation Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hachisuka
keywords: Cognition; event-related potential; milnacipran; neuropsychological test; trauasatic brain injury