Efficacy and Safety of Cerebrolysin on Prolonged Disorders of Consciousness

Efficacy and Safety of Cerebrolysin on Prolonged Disorders of Consciousness in Patients With Hemorrhagic Stroke: A Pilot Study

Object: To determine the effect of cerebrolysin on prolonged disorders of consciousness caused by hemorrhagic stroke. Participants: patients with prolonged disorders of consciousness due to severe traumatic brain injury Intervention: 30 ml cerebrolysin + 70 ml normal saline, days 4-17, once/day, intravenously or 100 ml normal saline, days 4-17, once/day, IV Comparison: cerebrolysin group versus control group Outcome: Coma Recovery Scale-revised, FDG-PET signal

Inclusion Criteria Patients with hemorrhagic stroke confirmed by CT or MRI Patients who have been in disorders of consciousness for more than 4 weeks after the onset of hemorrhagic stroke Patients in a vegetative state or minimally conscious state (Coma Recovery Scale -revised: CRS-R assessment) Age: 19 to 80 years of age Patients who have voluntarily given written informed consent to participate in the study by themselves or their legal representative. Exclusion Criteria Patients with confirmed epileptiform discharges on EEG Patients with brain parenchymal defects Patients with advanced liver, kidney, cardiac, or pulmonary disease. Chronic treatment with medications that may affect consciousness, such as antidepressants, antipsychotic drugs, nootropic drugs, and vasodilators. History of serious illness within the last two years (cancer, hematologic, renal, hepatic, or coronary artery disease, psychiatric illness, diabetes, myocardial infarction, epilepsy), no evidence of secondary damage to major organs, and well-controlled diabetes or hypertension. Alcohol or drug abuse or dependence within the last 2 years (DSM-V criteria). Significant systemic disease or unstable medical condition that may compromise compliance with the study protocol. Administration of a contraindicated drug is essential for medical purposes. Contraindications to the study drug (cerebrolysin). Participation in another therapeutic study

Lee S, Lee HH, Lee Y, Lee J. Additive effect of cerebrolysin and amantadine on disorders of consciousness secondary to acquired brain injury: A retrospective case-control study. J Rehabil Med. 2020 Feb 27;52(2):jrm00025. doi: 10.2340/16501977-2654.

Giacino JT, Whyte J, Bagiella E, Kalmar K, Childs N, Khademi A, Eifert B, Long D, Katz DI, Cho S, Yablon SA, Luther M, Hammond FM, Nordenbo A, Novak P, Mercer W, Maurer-Karattup P, Sherer M. Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med. 2012 Mar 1;366(9):819-26. doi: 10.1056/NEJMoa1102609.