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The Scientific World Journal
Volume 2014 (2014), Article ID 964578, 7 pages
http://dx.doi.org/10.1155/2014/964578
Research Article

Prescribing Multiple Neurostimulants during Rehabilitation for Severe Brain Injury

1Edward Hines Jr. VA Hospital Research Service, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA
2The Department of Veterans Affairs (VA), Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, P.O. Box 5000, S. Fifth Avenue (M/C 151H), Hines, IL 60141, USA
3Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Chicago, IL 60611, USA
4Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Office of Medical Education (1574), 345 E. Superior Street Chicago, IL 60611, USA
5Research Department, Marianjoy Rehabilitation Hospital, 26W171 Roosevelt Road, Wheaton, IL 60187, USA
6Department of Clinical Research and Leadership, The George Washington University, 2100 Pennsylvania Avenue, Washington, DC 20037, USA
7Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Avenue, Room 716, Chicago, IL 60612, USA

Received 29 August 2014; Revised 26 November 2014; Accepted 30 November 2014; Published 22 December 2014

Academic Editor: Gabriel Y. F. Ng

Copyright © 2014 Amy A. Herrold et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Despite a lack of clear evidence, multiple neurostimulants are commonly provided after severe brain injury (BI). The purpose of this study is to determine if the number of neurostimulants received during rehabilitation was associated with recovery of full consciousness or improved neurobehavioral function after severe BI. Method. Data from 115 participants were extracted from a neurobehavioral observational study database for this exploratory, retrospective analysis. Univariate optimal data analysis was conducted to determine if the number of neurostimulants influenced classification of four outcomes: recovery of full consciousness during rehabilitation, recovery of full consciousness within one year of injury, and meaningful neurobehavioral improvement during rehabilitation defined as either at least a 4.7 unit (minimal detectable change) or 2.58 unit (minimal clinically important difference) gain on the Disorders of Consciousness Scale-25 (DOCS-25). Results. Number of neurostimulants was not significantly () associated with recovery of full consciousness during rehabilitation, within one year of injury, or meaningful neurobehavioral improvement using the DOCS-25. Conclusions. Receiving multiple neurostimulants during rehabilitation may not influence recovery of full consciousness or meaningful neurobehavioral improvement. Given costs associated with additional medication, future research is needed to guide physicians about the merits of prescribing multiple neurostimulants during rehabilitation after severe BI.