Citicoline for traumatic brain injury: a systematic review & meta-analysis
Ali Meshkini, Mohammad Meshkini1, Homayoun Sadeghi-Bazargani
1Tabriz University of Medical Sciences (Bio-Medicine), Tabriz, Iran.
Journal of Injury & Violence Research
|January 1, 2017
Summary
Citicoline does not improve outcomes for acute Traumatic Brain Injury (TBI) but may benefit neurocognitive function in chronic TBI patients. Psychological First Aid is recommended for acute TBI management.
Area of Science:
- Neuroscience
- Clinical Medicine
- Pharmacology
Background:
- Traumatic Brain Injury (TBI) is a major cause of death and disability, particularly in younger populations.
- Despite decades of research into neuroprotective agents for TBI, no definitive treatment has been established.
- Existing neuroprotective strategies for TBI lack absolute recommended agents.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of citicoline in managing Traumatic Brain Injury (TBI).
- To assess the impact of citicoline on patient outcomes, including mortality and adverse effects, in both acute and chronic TBI cases.
- To evaluate the quality of reporting in randomized clinical trials (RCTs) investigating citicoline for TBI.
Main Methods:
- A comprehensive literature search was conducted across multiple databases up to September 2015.
- Included studies were limited to Randomized Clinical Trials (RCTs) specifically using citicoline for TBI management.
- Data were extracted and meta-analyses were performed using the Glasgow Outcome Scale (GOS) and neuropsychological assessments, with study quality assessed using the CONSORT checklist.
Main Results:
- Analysis of four RCTs involving 1196 participants indicated no significant difference in favorable Glasgow Outcome Scale (GOS) outcomes for acute TBI patients.
- Neuropsychological assessments in 971 participants across three studies showed significantly better outcomes in the placebo/control groups compared to citicoline.
- Meta-analysis of mortality and adverse effects in 1429 patients from two studies revealed no significant differences between citicoline and control groups.
Conclusions:
- Current evidence suggests citicoline offers no significant benefit for acute Traumatic Brain Injury (TBI) management.
- Citicoline may demonstrate potential benefits in enhancing neurocognitive status for patients with chronic TBI.
- Acute TBI management should consider interventions such as Psychological First Aid (PFA).
