Research Projects

Traumatic Brain Injury (TBI) is a rapidly growing cause of death and disability in the economically productive age group of 25-40 years, particularly in low- and middle-income countries like India. Patients with disorders of consciousness and delayed recovery of consciousness following TBI face significant physical, social, and economic burdens. Amantadine remains one of the few evidence-based pharmacological treatment strategies in coma reversal therapy, with its beneficial effects attributed to its indirect dopaminergic agonistic action. However, there is limited literature on the beneficial effects of amantadine in the Indian setup and the outcomes of such patients due to their numerous medical, social, and financial constraints. Understanding the pathophysiological characteristics of patients who have a favorable response to amantadine is crucial for better patient selection and identifying causes for non-responsiveness to therapy. A study intends to use 18F-DOPA PET imaging to detect changes in dopamine metabolism induced by amantadine in patients with post-traumatic disorders of consciousness, and correlate these clinical improvements in consciousness with the Disability Rating Scale (DRS) and Coma Recovery Scale-Revised (CRS-R), both established tools to describe patients with disorder of consciousness. The other objective of the study is to identify predictors of outcome/response to treatment with amantadine if possible and to understand causes of non-responsiveness to amantadine. The hypothesis is that patients showing considerable improvement in DRS and CRS-R scores after 4 weeks of treatment with amantadine will show clearly observable changes in dopamine metabolism in the region of the striatum, as detected on F-DOPA PET MRI, with possible markers on the baseline scan at 2 weeks post injury to predict a favorable response to amantadine therapy.