An Observational Study on the Effectiveness of Amantadine in EnhancingCognitive Recovery in Adults with Severe Traumatic Brain Injury

Background: Traumatic brain injury (TBI) is among the leading causes of chronic disability, particularly amongeconomically productive adults in India. Cognitive impairment after TBI is a major challenge in rehabilitation.Pharmacologic agents such as amantadine, which facilitate dopaminergic mechanisms, can potentially enhancerecovery but have not been properly investigated in India.Objective: To determine the effectiveness and safety of amantadine in inducing cognitive recovery in adults withsevere TBI.Methodology: Single-center, prospective observational study that recruited 60 adults (18–65 years) with severeTBI and persistent cognitive dysfunction. Patients were treated with amantadine 200 mg/day for 4 weeks.Cognitive and functional recovery was measured using the Full Outline of Unresponsiveness (FOUR) score,Disability Rating Scale (DRS), and Glasgow Outcome Scale (GOS) at baseline, 1 week, 4 weeks, and 6 weeks.Adverse events were recorded.Results: Statistically significant gains (p < 0.001) were seen on all the measuring tools. Median FOUR scoresincreased from 10.5 to 15.0, DRS decreased from 21.0 to 13.5, and GOS increased from 3.0 to 4.0 after 6 weeks.The most common adverse events were spasticity (20%), agitation (17%), and gastrointestinal (10%), but were,in general, manageable.Conclusion: Amantadine was linked to notable cognitive and functional improvement in extreme TBI in adultsand a favorable safety profile. The results warrant its use as an adjunct in neurorehabilitation treatment protocols.