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A Review of Cholinergic Agents in the Treatment of Neurobehavioral Deficits Following Traumatic Brain Injury

Received June 13, 2001; revised September 29, 2001; accepted October 11, 2001. From the Division of Behavioral Neurology and Cognitive Neuroscience, University of Iowa Hospitals and Clinics, Iowa City, Iowa (S.L.G.); Department of Psychiatry and Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto, Ontario, and Division of Geriatric Psychiatry, University of Toronto Toronto, Ontario, (R.v.R.); and Department of Medicine, McMaster University, Hamilton, Ontario (C.M.). Address correspondence to Dr. Griffin, Benton Neuropsychology Laboratory, Division of Behavioral Neurology and Cognitive Neuroscience, Department of Neurology, 2RCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242. E-mail: stefanie-griffin{at}uiowa.edu

Although traumatic brain injury (TBI) frequently results in significant handicap, empirical investigations of pharmacological treatment of the neurobehavioral sequelae of TBI are rare. This review presents evidence that supports hypotheses of a cholinergic mechanism underlying some neurobehavioral sequelae of TBI, as well as a critical review of the preliminary evidence supporting the efficacy of cholinergic agents in TBI. Despite numerous methodological limitations, preliminary evidence exists for the efficacy of cholinergic agents in ameliorating attention and memory deficits following TBI. The authors highlight the need for large, randomized, double-blind, placebo-controlled trials that include a broad range of cognitive and behavioral outcome measures.

Key Words: Cholinergic Agents • Traumatic Brain Injury • Cognitive Enhancers

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