A randomized pilot trial of topiramate for alcohol use disorder in veterans with traumatic brain injury: Effects on alcohol use, cognition, and post-concussive symptoms.
A randomized pilot trial of topiramate for alcohol use disorder in veterans with traumatic brain injury: Effects on alcohol use, cognition, and post-concussive symptoms.
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托吡酯对脑损伤的退伍军人的托吡酯的随机试验试验：对酒精使用，认知和脑震荡后症状的影响。
DOI：
10.1016/j.drugalcdep.2020.108149
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发表时间：
2020-09-01
影响因子：
4.2
通讯作者：
Batki SL
中科院分区：
文献类型：
--
作者：
Pennington DL;Bielenberg J;Lasher B;Herbst E;Abrams G;Novakovic-Agopian T;Batki SL
托吡酯是酒精使用障碍（AUD）的有效治疗药物，也已用于轻度创伤性脑损伤（mTBI）的护理。该初步研究旨在初步评估托吡酯在减少酒精使用和脑震荡后症状方面的疗效，以及其对32名合并AUD和mTBI的退伍军人认知功能的潜在负面影响。这是一项为期12周的前瞻性、随机、双盲、安慰剂对照的灵活剂量托吡酯或安慰剂的初步研究。主要结果是托吡酯组每周饮酒天数的减少，次要结果包括两组之间的饮酒和渴求、脑震荡后症状和认知功能的比较。托吡酯组和安慰剂组每周饮酒天数均显著减少。在意向治疗分析中，饮酒/渴求或脑震荡后症状与治疗周之间无显著相互作用。在符合方案的分析中，托吡酯与安慰剂相比显著减少了每周的饮酒次数。托吡酯短暂损害语言流畅性和工作记忆。无论治疗组如何，在治疗的第1周和第12周之间，处理速度、认知抑制和精神灵活性都有显著改善。在治疗的12周内，托吡酯组和安慰剂组在饮酒和脑震荡后症状方面都有显著改善。在完成治疗的患者中，托吡酯组的酒精使用减少更多。托吡酯对认知功能也有负面但短暂的影响。结果表明，托吡酯治疗在减少酒精使用方面可能具有益处，并且在患有AUD和mTBI的退伍军人中存在一些潜在的负面认知影响。
Topiramate is an effective treatment for alcohol use disorder (AUD) and has also been used in the care of mild traumatic brain injury (mTBI). This pilot study aimed to obtain a preliminary assessment of topiramate’s efficacy in reducing alcohol use and post-concussive symptoms, and its potential negative impact on cognitive function in 32 Veterans with co-occurring AUD and mTBI. This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot study of flexible-dose topiramate or placebo. Primary outcome was reduction of drinking days per week within the topiramate arm. Secondary outcomes included between group comparisons of alcohol use and craving, post-concussive symptoms, and cognitive function. Drinking days per week significantly decreased within both the topiramate and placebo arm. There were no significant treatment-by-week interactions on alcohol use/craving, or post-concussive symptoms in intent-to-treat analyses. In per-protocol analyses, topiramate significantly reduced number of drinks per week compared with placebo. Topiramate transiently impaired verbal fluency and working memory. Processing speed, cognitive inhibition, and mental flexibility significantly improved between weeks 1 and 12, regardless of treatment arm. Significant improvement occurred in both the topiramate and placebo groups over 12 weeks of treatment in alcohol use and post-concussive symptoms. Among treatment completers there was greater reduction of alcohol use in the topiramate arm. Topiramate was also associated with negative but transient effects on cognitive function. Results suggest both a possible benefit for topiramate treatment in reducing alcohol use and some potential for negative cognitive effects in Veterans with AUD and mTBI.
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DOI：
10.1111/acer.13431
发表时间：
2017-08
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Le Berre AP;Fama R;Sullivan EV
通讯作者：
Sullivan EV
影响因子：
5.9
作者：
GOLDEN, CJ;HAMMEKE, TA;PURISCH, AD
通讯作者：
PURISCH, AD
DOI：
10.1111/j.1530-0277.2011.01716.x
发表时间：
2012-08-01
影响因子：
3.2
作者：
Fertig, Joanne B.;Ryan, Megan L.;Stout, Robert
通讯作者：
Stout, Robert
影响因子：
2.4
作者：
Belanger, Heather G.;Uomoto, Jay M.;Vanderploeg, Rodney D.
通讯作者：
Vanderploeg, Rodney D.
影响因子：
2.9
作者：
Knapp CM;Ciraulo DA;Sarid-Segal O;Richardson MA;Devine E;Streeter CC;Oscar-Berman M;Surprise C;Colaneri L;Putnam M;Waters M;Richambault C
通讯作者：
Richambault C