DIFFUSE AXONAL INJURY

TREATING OR NOT TREATING? SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS

Abstract

Diffuse axonal injury (DAI) can bring irreversible deficits in brain connectivity. Although it’s one of the main outcomes of traumatic brain injury (TBI), there are no effective treatments. The objective was to analyze the effectiveness of treatments compared to control groups in the DAI. Systematic Review of Intervention, with searches in the Medical Publisher, Virtual Health Library, World Wide Science and Science Direct, using the descriptors "Diffuse Axonal Injury", Treatment and Progesterone. The Grades of Recommendation, Assessment, Development, and Evaluation was used to determine the reliability of the trials. Six studies were included. Of the 303 patients diagnosed, 56.7% received progesterone, which neuroprotective effects were moderation in cytokine levels, lesion reduction and antioxidant effect. Amantadine provided faster improvements in brain function. Citicoline and Boswellia Serrata caused neuroprotective effects. Adverse effects were mild or trifling. Even with the history of failure in TBI cases, patients with DAI have benefited from the long-term use of progesterone. Neuroprotective effects of Citicoline are evidenced in neurodegenerative diseases and Amantadine in extrapyramidal conditions. Boswellia Serrata had positive results in multiple sclerosis. Five out of the six treatments were effective on most evaluative parameters. For future studies, multicenter scenarios with larger populations are needed.