514: EVALUATION OF AMANTADINE ON COGNITIVE OUTCOMES IN TRAUMATIC BRAIN INJURY PATIENTS
Bibliographic record
Abstract
Introduction: Traumatic brain injury (TBI) can result in complications of prolonged disorders of consciousness (DOC) including a coma, vegetative, or minimally conscious state. Patients with DOC are assessed utilizing the Glasgow Coma Scale (GCS) and Activity Measure for Post-Acute Care (AM-PAC) score. Amantadine may provide an accelerated rate of return to consciousness for TBI patients, but literature assessing its use in relation to cognitive recovery during acute hospitalization is lacking. This study aimed to evaluate the effect of amantadine in improving wakefulness for TBI patients during the acute phase of hospitalization. Methods: This was a retrospective, single-center, single-group cohort review of patients admitted to Carilion Roanoke Memorial Hospital receiving amantadine for TBI. Patients were excluded if they received amantadine for less than 3 consecutive days, prior to admission, or for alternative indications. The primary outcome was the median change in cognition 7 days after therapy initiation and at discharge. Descriptive statistics and an analysis of variance (ANOVA) were utilized for data analysis. Results: Of 96 subjects identified, 75 were included for analysis. The median change in cognition after initiation of amantadine as determined by the GCS was 2 (n=65) at day 7 and 6 (n=75) at discharge, in which the median hospital length of stay was 22 days. The median changes in AMPAC scores were 3 and 5, respectively. The median duration of amantadine therapy was 11 days with a usual daily dose of 100 to 200 mg. The most common adverse effect observed was tachycardia, followed by insomnia. A two-way ANOVA revealed that there was not a statistically significant interaction between TBI severity and the presence of alternative psychotropic medications at day 7 or discharge (p=0.84, p=0.22). TBI severity alone had a significant effect on GCS at discharge, but not at day 7 (p< 0.0001, p=0.12). Conclusions: Amantadine may play an important role in TBI patients, as GCS and AM-PAC scores increased after starting therapy. The severity of TBI likely contributed to the changes observed in GCS scores. Given the small sample size and lack of comparator group, it is difficult to determine the clinical significance of amantadine use. More data is needed to support the use of amantadine in acute TBI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".