The favorable effect of statin treatment after traumatic brain injury (TBI) has been shown in animal studies and is probably true in humans as well. The objective of this study was to determine whether acute statin treatment following TBI could reduce inflammatory cytokines and improve functional outcomes in humans.
The authors performed a double-blind randomized clinical trial in patients with moderate to severe TBI. Exclusion criteria were as follows: prior severe disability; use of modifiers of statin metabolism; multisystem trauma; prior use of mannitol, barbiturates, corticosteroids, or calcium channel blockers; isolated brainstem lesions; allergy to statins; previous hepatopathy or myopathy; previous treatment at another clinic; and pregnancy. Patients were randomly selected to receive 20 mg of rosuvastatin or placebo for 10 days. The main goal was to determine the effect of rosuvastatin on plasma levels of tumor necrosis factor–α, interleukin (IL)–1β, IL-6, and IL-10 after 72 hours of TBI. Amnesia, disorientation, and disability were assessed 3 and 6 months after TBI.
Thirty-six patients were analyzed according to intention-to-treat analysis; 19 patients received rosuvastatin and 17 received placebo. The best-fit mixed model showed a significant effect of rosuvastatin on the reduction of tumor necrosis factor–α levels (p = 0.004). Rosuvastatin treatment did not appear to affect the levels of IL-1β, IL-6, and IL-10. The treatment was associated with a reduction in disability scores (p = 0.03), indicating a favorable functional outcome. Life-threatening adverse effects were not observed.
The authors' data suggest that statins may induce an antiinflammatory effect and may promote recovery after TBI. The role of statins in TBI therapy should be confirmed in larger clinical trials. Clinical trial registration no.: NCT00990028.
Abbreviations used in this paper:ALT = alanine transaminase; AST = aspartate transaminase; CK = creatine kinase; DRS = Disability Rating Scale; GCS = Glasgow Coma Scale; GOAT = Galveston Orientation Amnesia Test; IL = interleukin; TBI = traumatic brain injury; TCDB = Traumatic Coma Data Bank; TNFα = tumor necrosis factor–α.
* Drs. Sánchez-Aguilar and Tapia-Pérez contributed equally to this work.
Address correspondence to: Martin Sánchez-Aguilar, M.Sc., Department of Clinical Epidemiology, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, San Luis Potosí 78210, México. email: email@example.com.
Please include this information when citing this paper: published online January 4, 2013; DOI: 10.3171/2012.12.JNS121084.
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LuD, QuC, GoussevA, JiangH, LuC, SchallertT, : Statins increase neurogenesis in the dentate gyrus, reduce delayed neuronal death in the hippocampal CA3 region, and improve spatial learning in rat after traumatic brain injury. J Neurotrauma24:1132–1146, 2007)| false
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