Research Reports - Effects of low-dose milnacipran on event-related potentials and neuropsychological tests in persons with traumatic brain injury

Brain Inj. 2015 Jun 17:1-6

Iwanaga M(1), Kato N, Okazaki T, Hachisuka K.

INTRODUCTION: 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.
CONCLUSION: 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.

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