本文由小咖机器人翻译整理

期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-023-02705-w

摘要内容如下：

创伤性脑损伤（TBI）是导致残疾的主要原因。后遗症可包括功能障碍和精神综合征，如创伤后应激障碍（PTSD）、抑郁和焦虑。特种作战部队（SOF）退伍军人（SOVs）出现这些并发症的风险可能较高，导致一些人寻求未充分探索的替代治疗方法，如伊博格碱（Oneirogen ibogaine），这是一种已知与多种神经递质系统相互作用的植物衍生化合物，主要用于治疗物质使用障碍。伊博格碱与致命性心律失常有关，但联合使用镁可能会减轻这种担忧。在本研究中，我们报告了一项关于镁-伊博格碱的前瞻性观察研究：斯坦福创伤性中枢神经系统损伤方案（MISTIC），与补充治疗模式一起，在30名主要患有轻度TBI的男性SOV中进行。我们评估了世界卫生组织残疾评估表从基线到治疗后即刻（主要结果）和1个月（次要结果）的变化。其他次要结果包括PTSD（DSM-5临床医师管理的PTSD量表）、抑郁（Montgomery-Åsberg抑郁量表）和焦虑（Hamilton焦虑量表）的变化。MISTIC在治疗后即刻（P校正<0.001，Cohen s d=0.74）和1个月（P校正<0.001，d=2.20）以及治疗后1个月的PTSD（P校正<0.001，d=2.54）、抑郁（P校正<0.001，d=2.80）和焦虑（P校正<0.001，d=2.13）均有显著改善。无意外或严重不良事件发生。需要进行对照临床试验来评估安全性和有效性，以验证这些最初的开放标签研究结果。ClinicalTrials.gov注册：NCT04313712。

英文原文如下：

Abstracts

Traumatic brain injury (TBI) is a leading cause of disability. Sequelae can include functional impairments and psychiatric syndromes such as post-traumatic stress disorder (PTSD), depression and anxiety. Special Operations Forces (SOF) veterans (SOVs) may be at an elevated risk for these complications, leading some to seek underexplored treatment alternatives such as the oneirogen ibogaine, a plant-derived compound known to interact with multiple neurotransmitter systems that has been studied primarily as a treatment for substance use disorders. Ibogaine has been associated with instances of fatal cardiac arrhythmia, but coadministration of magnesium may mitigate this concern. In the present study, we report a prospective observational study of the Magnesium-Ibogaine: the Stanford Traumatic Injury to the CNS protocol (MISTIC), provided together with complementary treatment modalities, in 30 male SOVs with predominantly mild TBI. We assessed changes in the World Health Organization Disability Assessment Schedule from baseline to immediately (primary outcome) and 1 month (secondary outcome) after treatment. Additional secondary outcomes included changes in PTSD (Clinician-Administered PTSD Scale for DSM-5), depression (Montgomery-Åsberg Depression Rating Scale) and anxiety (Hamilton Anxiety Rating Scale). MISTIC resulted in significant improvements in functioning both immediately (Pcorrected < 0.001, Cohen's d = 0.74) and 1 month (Pcorrected < 0.001, d = 2.20) after treatment and in PTSD (Pcorrected < 0.001, d = 2.54), depression (Pcorrected < 0.001, d = 2.80) and anxiety (Pcorrected < 0.001, d = 2.13) at 1 month after treatment. There were no unexpected or serious adverse events. Controlled clinical trials to assess safety and efficacy are needed to validate these initial open-label findings. ClinicalTrials.gov registration: NCT04313712 .

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