Letter to the editor: Modafinil Augmentation Therapy in Patient with Traumatic Brain Injury

Discussion. TBI results in a complex alteration of various brain regions. Recent advances in neuroimaging studies support the hypothesis that symptomatology of TBI-induced depression and cognitive deficits are directly related to the altered functional connectivity between different brain networks.[2] The default mode network represents one of them. It has been previously proposed that this functional network mainly consists of the ventromedial prefrontal cortex, posterior cingulate/retrosplenial cortex, and inferior parietal lobule. The neurochemical underprint of this network is modulated by a combined input from cortical and subcortical catecholamine systems.[3] Modafinil is a United States Food and Drug Administration (FDA)-approved wakefulness-promoting agent with a direct effect on synaptic levels of norepinephrine (NE) and dopamine (DA). The proposed mechanism of actions of modafinil is related to its ability to inhibit the NE and DA transporters. In addition, modafinil indirectly effects extracellular levels of serotonin, glutamate, orexin, histamine, and gamma-aminobutyric acid.[4] With these considerations, the clinical relevance of catecholamine modulation was examined in different populations of patients with depressive symptoms and cognitive deficits.[5,6] Our patient’s robust response provides further support for the safety and efficacy of modafinil use as an adjunct agent in patients with TBI. References. Ghajar J. Traumatic brain injury. Lancet. 2000;356:92...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Depression Editor's Message: Issue Highlights Neurology Traumatic Brain Injury augmentation modafinil TBI Source Type: research