Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury
Traumatic Brain Injury (TBI) is a significant contributor to disability across the world. TBIs vary in severity, and most cases are designated mild TBI (mTBI), involving only brief loss of consciousness and no intracranial findings on imaging. Despite this categorization, many persons continue to re...
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| Language: | English |
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Mary Ann Liebert
2024-11-01
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| Series: | Neurotrauma Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/neur.2023.0124 |
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| author | Siddharth Khasnavis Timothy Belliveau Amy Arnsten Arman Fesharaki-Zadeh |
| author_facet | Siddharth Khasnavis Timothy Belliveau Amy Arnsten Arman Fesharaki-Zadeh |
| author_sort | Siddharth Khasnavis |
| collection | DOAJ |
| description | Traumatic Brain Injury (TBI) is a significant contributor to disability across the world. TBIs vary in severity, and most cases are designated mild TBI (mTBI), involving only brief loss of consciousness and no intracranial findings on imaging. Despite this categorization, many persons continue to report persistent cognitive changes in the months to years after injury, with particular impairment in the cognitive and executive functions of the pre-frontal cortex. For these persons, there are no currently approved medications, and treatment is limited to symptom management and cognitive or behavioral therapy. The current case studies explored the use of the alpha-2A adrenoreceptor agonist, guanfacine, combined with the antioxidant, N-acetylcysteine (NAC), in the treatment of post-TBI cognitive symptoms, based on guanfacine's ability to strengthen pre-frontal cortical function, and the open-label use of NAC in treating TBI. Two persons from our TBI clinic were treated with this combined regimen, with neuropsychological testing performed pre- and post-treatment. Guanfacine + NAC improved attention, processing speed, memory, and executive functioning with minimal side effects in both persons. These results encourage future placebo-controlled trials to more firmly establish the efficacy of guanfacine and NAC for the treatment of cognitive deficits caused by TBI. |
| format | Article |
| id | doaj-art-eacf0d2c9c474e13a2a032ce8e9d0e5e |
| institution | DOAJ |
| issn | 2689-288X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Neurotrauma Reports |
| spelling | doaj-art-eacf0d2c9c474e13a2a032ce8e9d0e5e2025-08-20T02:59:07ZengMary Ann LiebertNeurotrauma Reports2689-288X2024-11-015122623110.1089/neur.2023.0124Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain InjurySiddharth Khasnavis0Timothy Belliveau1Amy Arnsten2Arman Fesharaki-Zadeh3Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Traumatic Brain Injury (TBI) is a significant contributor to disability across the world. TBIs vary in severity, and most cases are designated mild TBI (mTBI), involving only brief loss of consciousness and no intracranial findings on imaging. Despite this categorization, many persons continue to report persistent cognitive changes in the months to years after injury, with particular impairment in the cognitive and executive functions of the pre-frontal cortex. For these persons, there are no currently approved medications, and treatment is limited to symptom management and cognitive or behavioral therapy. The current case studies explored the use of the alpha-2A adrenoreceptor agonist, guanfacine, combined with the antioxidant, N-acetylcysteine (NAC), in the treatment of post-TBI cognitive symptoms, based on guanfacine's ability to strengthen pre-frontal cortical function, and the open-label use of NAC in treating TBI. Two persons from our TBI clinic were treated with this combined regimen, with neuropsychological testing performed pre- and post-treatment. Guanfacine + NAC improved attention, processing speed, memory, and executive functioning with minimal side effects in both persons. These results encourage future placebo-controlled trials to more firmly establish the efficacy of guanfacine and NAC for the treatment of cognitive deficits caused by TBI.https://www.liebertpub.com/doi/10.1089/neur.2023.0124cognitive symptomsguanfacineN-acetylcysteinetraumatic brain injury |
| spellingShingle | Siddharth Khasnavis Timothy Belliveau Amy Arnsten Arman Fesharaki-Zadeh Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury Neurotrauma Reports cognitive symptoms guanfacine N-acetylcysteine traumatic brain injury |
| title | Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury |
| title_full | Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury |
| title_fullStr | Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury |
| title_full_unstemmed | Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury |
| title_short | Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury |
| title_sort | combined use of guanfacine and n acetylcysteine for the treatment of cognitive deficits after traumatic brain injury |
| topic | cognitive symptoms guanfacine N-acetylcysteine traumatic brain injury |
| url | https://www.liebertpub.com/doi/10.1089/neur.2023.0124 |
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