Neuroprotective Effects of Vitamin D on Patients With Traumatic Brain Injury: A Clinical Trial

Sajjad Shafiei, Mohammad Sardar Zaheriani, Misagh Sahfizad, Saeid Ehteshami, Mahmoud Mosazadeh, Kaveh Haddadi
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Abstract

Background and Aim: Traumatic brain injury (TBI) is a globally-critical socioeconomic and public health problem. Introducing medications and strategies to treat and improve the prognosis of TBI is crucial. Current literature not only supports the key role of vitamin D on normal brain function, but also helps recovering from a myriad of pathologies. The present research was conducted to evaluate the neuroprotective effects of vitamin D on patients with TBI presenting to Imam Khomeini Hospital, Sari, Iran. Methods and Materials/Patients: This randomized clinical trial assigned patients with vitamin D levels of over30 ng/ml to an intervention group (n=42) and a control group (n=42), who respectively received a single dose (150,000 units) of vitamin D and a placebo upon admission. The Glasgow Coma Score (GCS) and mortality were recorded at the beginning of the study and three months after the final prescription. Results: The mean GCS score upon admission was obtained as 8.64±2.29 in the vitamin D group and 8.42±2.93 in the placebo group. This score was respectively obtained as 13.50±1.85 and 10.97±2.37 upon discharge, suggesting a significant difference as per the t-test (P=0.04).The mean Glasgow Outcome Score (GOS) upon discharge was obtained as 4.24±1.51 in the intervention group and 4.10±1.40in the controls. The t-test suggested insignificant differences in the GOS between the two groups upon admission (P=0.823). After three months, the GOS respectively reaching desirable levels in 49.7% and 62.8% of cases in the placebo and intervention groups revealed statistically significant differences among the two groups (P=0.03). Conclusion: The present results showed the improving effects of vitamin D on level of consciousness and outcomes in patients with acute TBI. More studies are suggested to be performed to investigate the effects of other medications, including amantadine and methylphenidate with a larger sample size.
维生素D对外伤性脑损伤患者神经保护作用的临床研究
背景与目的:创伤性脑损伤(TBI)是一个全球性的关键社会经济和公共卫生问题。引入药物和策略来治疗和改善TBI的预后是至关重要的。目前的文献不仅支持维生素D在正常脑功能中的关键作用,而且还有助于从无数的病理中恢复过来。本研究旨在评估维生素D对伊朗萨里伊玛目霍梅尼医院TBI患者的神经保护作用。方法和材料/患者:该随机临床试验将维生素D水平超过30 ng/ml的患者分为干预组(n=42)和对照组(n=42),他们在入院时分别接受单剂量(150,000单位)维生素D和安慰剂。格拉斯哥昏迷评分(GCS)和死亡率记录在研究开始时和最后处方后三个月。结果:维生素D组入院时GCS平均评分为8.64±2.29,安慰剂组入院时GCS平均评分为8.42±2.93。出院时的评分分别为13.50±1.85和10.97±2.37,经t检验差异有统计学意义(P=0.04)。干预组患者出院时格拉斯哥预后评分(GOS)平均为4.24±1.51,对照组为4.10±1.40。经t检验,两组患者入院时GOS差异无统计学意义(P=0.823)。3个月后,安慰剂组和干预组GOS达到理想水平的分别为49.7%和62.8%,两组差异有统计学意义(P=0.03)。结论:维生素D对急性脑外伤患者的意识水平和转归有改善作用。建议进行更多的研究,以调查其他药物的影响,包括金刚烷胺和哌甲酯,样本量更大。
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