The Effects of Memantine on the Glasgow Coma Scale, Sequential Organ Failure Assessment Score, and Neuron-Specific Enolase Serum Levels in Traumatic Brain Injury Patients

Background: Traumatic brain injury (TBI) causes disability and death in many patients. Objectives: We investigated the effect of memantine on the Glasgow Coma Scale (GCS), serum levels of neuron-specific enolase (NSE), and its effect on sequential organ failure assessment (SOFA) score in TBI patients with GCS 6-12 on days 1, 3, and 7. Methods: Fifty-nine patients were randomly divided into intervention (n = 29) and control (n = 30) groups who received 30mg drug/placebo every 12 hours for seven days with standard treatment, respectively. The acute physiology and chronic health evaluation II and head CT scan findings were collected on the first day, and the Glasgow Outcome Scale Extended 90 was collected three months later. Results: Considering patients with GCS 6 - 12, the SOFA and NSE decreased from day 1 - 7 in both memantine and control groups, about NSE by 21% and 12.6%, respectively. In GCS6-8 subgroup, the NSE decreased by 19.1% in the memantine group and increased by 8.45%, in the control group. In GCS 9 - 12 subgroup, the NSE decreased by 52.6% and 24.43% in the memantine and control groups, respectively. The SOFA changes were significant between memantine and control groups on day 3 in GCS 9 - 12 subgroup ( P= 0.01). In the memantine group with GCS 6 - 12, the increase of GCS from day 1 - 7 was significant (29.6%, P = 0.002), and also in both GCS subgroups. Comparing memantine and control groups, the improvement of GCS was significant on days 3 and 7 in GCS 9 - 12 subgroup. Conclusions: This trial showed that memantine improved the neurohormonal and clinical status of TBI patients with GCS 6 - 12.