Branched-Chain Amino Acids May Improve Recovery From a Vegetative or Minimally Conscious State in Patients With Traumatic Brain Injury: A Pilot Study

Aquilani R, Boselli M, Boschi F, Viglio S, Iadarola P, Dossena M, Pastoris O, Verri M. Branched-chain amino acids may improve recovery from a vegetative or minimally conscious state in patients with traumatic brain injury: a pilot study. Objective: To investigate whether supplementation with branched-chain amino acids (BCAAs) may improve recovery of patients with a posttraumatic vegetative or minimally conscious state. Design: Patients were randomly assigned to 15 days of intravenous BCAA supplementation (n=22; 19.6g/d) or an isonitrogenous placebo (n=19). Setting: Tertiary care rehabilitation setting. Participants: Patients (N=41; 29 men, 12 women; mean age, 49.5±21y) with a posttraumatic vegetative or minimally conscious state, 47±24 days after the index traumatic event. Intervention: Supplementation with BCAAs. Main Outcome Measure: Disability Rating Scale (DRS) as log₁₀DRS. Results: Fifteen days after admission to the rehabilitation department, the log₁₀DRS score improved significantly only in patients who had received BCAAs (log₁₀DRS score, 1.365±0.08 to 1.294±0.05; P10DRS score in the placebo recipients remained virtually unchanged (log₁₀DRS score, 1.373±0.03 to 1.37±0.03; P not significant). The difference in improvement of log₁₀DRS score between the 2 groups was highly significant (P10DRS point score of .477 or higher (3 as geometric mean) that allowed them to exit the vegetative or minimally conscious state. Conclusions: Supplemented BCAAs may improve the recovery from a vegetative or minimally conscious state in patients with posttraumatic vegetative or minimally conscious state.