Pharmacotherapy for mild traumatic brain injury: an overview of the current treatment options

ABSTRACT

Introduction

Accounting for 90% of all traumatic brain injuries (TBIs), mild traumatic brain injury (mTBI) is currently the most frequently seen type of TBI. Although most patients can recover from mTBI, some may suffer from prolonged symptoms for months to years after injury. Growing evidence indicates that mTBI is associated with neurodegenerative diseases, including dementia and Parkinson’s disease (PD). Pharmacological interventions are necessary to address the symptoms and avoid the adverse consequences of mTBI.

Areas covered

To provide an overview of the current treatment options, the authors herein review the potential drugs to reduce the secondary damage and symptom-targeted therapy, as well as the ongoing clinical trials of pharmacotherapy for mTBI.

Expert opinion

There has been no consensus on pharmacotherapy for mTBI. Several candidates, including n-3 PUFAs, melatonin, NAC, and statins show potential benefits in lessening the secondary injury and improving neurological deficits in preclinic studies, which, however, still need further investigation in clinical trials. The current pharmacotherapy for mTBI is empirical in nature and mainly targets to mitigate the symptoms. Well-designed clinical trials are now warranted to provide high-level evidence.

KEYWORDS:

• Concussion
• clinical trial
• mild traumatic brain injury
• mitigate symptom
• pharmacotherapy
• secondary injury

Article highlights

• Accounting for 90% of all TBIs, mTBI is currently the most common type of TBI.

• mTBI is associated with dementia, PD, and other neurodegenerative diseases.

• There has been no consensus on the pharmacotherapy of mTBI.

• n-3 PUFAs, melatonin, NAC, and statins show potential benefits in lessening the secondary injury and improving neurological deficits in pre-clinic studies.

• The current pharmacotherapy for mTBI is mostly an empirical treatment and mainly targets to mitigate the symptoms.

• Well-designed clinical trials were warranted to provide high-level evidence.

Acknowledgments

The authors thank Z Li for their assistance with language editing in the manuscript.

Declaration of Interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The authors are funded by the National Natural Science Foundation of China (via grants no. 81671221 and 82071390 to R. Jiang, grant no. 82001323 to C. Gao and grant no. 82171359 to D. Wang. They are also supported by the Beijing Tianjin Hebei Basic Research Cooperation Project (via grant no. 19JCZDJC64600(Z) to D. Wang) and the Tianjin Research Program of Application Foundation and Advanced Technology (via grant no. 19YFZCSY00650 to R Jiang)