Imperial College London
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ProfessorDavidSharp

Faculty of Medicine, Department of Brain Sciences

Professor of Neurology
 
 
 
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Contact

 

+44 (0)20 7594 7991david.sharp Website

 
 
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Location

 

UREN.927Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jenkins:2019:brain/awz149,
author = {Jenkins, PO and De, Simoni S and Bourke, NJ and Fleminger, J and Scott, G and Towey, DJ and Svensson, W and Khan, S and Patel, MC and Greenwood, R and Friedland, D and Hampshire, A and Cole, JH and Sharp, DJ},
doi = {brain/awz149},
journal = {Brain},
pages = {2367--2379},
title = {Stratifying drug treatment of cognitive impairments after traumatic brain injury using neuroimaging},
url = {http://dx.doi.org/10.1093/brain/awz149},
volume = {142},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Cognitive impairment is common following traumatic brain injury. Dopaminergic drugs can enhance cognition after traumatic brain injury, but individual responses are highly variable. This may be due to variability in dopaminergic damage between patients. We investigate whether measuring dopamine transporter levels using 123I-ioflupane single-photon emission computed tomography (SPECT) predicts response to methylphenidate, a stimulant with dopaminergic effects. Forty patients with moderate-severe traumatic brain injury and cognitive impairments completed a randomized, double-blind, placebo-controlled, crossover study. 123I-ioflupane SPECT, MRI and neuropsychological testing were performed. Patients received 0.3 mg/kg of methylphenidate or placebo twice a day in 2-week blocks. Subjects received neuropsychological assessment after each block and completed daily home cognitive testing during the trial. The primary outcome measure was change in choice reaction time produced by methylphenidate and its relationship to stratification of patients into groups with normal and low dopamine transporter binding in the caudate. Overall, traumatic brain injury patients showed slow information processing speed. Patients with low caudate dopamine transporter binding showed improvement in response times with methylphenidate compared to placebo [median change = -16 ms; 95% confidence interval (CI): -28 to -3 ms; P = 0.02]. This represents a 27% improvement in the slowing produced by traumatic brain injury. Patients with normal dopamine transporter binding did not improve. Daily home-based choice reaction time results supported this: the low dopamine transporter group improved (median change -19 ms; 95% CI: -23 to -7 ms; P = 0.002) with no change in the normal dopamine transporter group (P = 0.50). The low dopamine transporter group also improved on self-reported and caregiver apathy assessments (P = 0.03 and P = 0.02, respectively). Both groups reported improvements in fatigue (P = 0.03
AU  - Jenkins,PO
AU  - De,Simoni S
AU  - Bourke,NJ
AU  - Fleminger,J
AU  - Scott,G
AU  - Towey,DJ
AU  - Svensson,W
AU  - Khan,S
AU  - Patel,MC
AU  - Greenwood,R
AU  - Friedland,D
AU  - Hampshire,A
AU  - Cole,JH
AU  - Sharp,DJ
DO  - brain/awz149
EP  - 2379
PY  - 2019///
SN  - 1460-2156
SP  - 2367
TI  - Stratifying drug treatment of cognitive impairments after traumatic brain injury using neuroimaging
T2  - Brain
UR  - http://dx.doi.org/10.1093/brain/awz149
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31199462
UR  - https://academic.oup.com/brain/article/142/8/2367/5519011
UR  - http://hdl.handle.net/10044/1/70583
VL  - 142
ER  -
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