Effects of minocycline on neurological outcomes in patients with acute traumatic brain injury: a pilot study

Traumatic brain injury (TBI) is a public health problem worldwide. Secondary damage of brain injury begins within a few minutes after the trauma and can last a long time. It can be reversible, unlike primary injury. Therefore, therapeutic intervention can be used. The aims of this study were to assess the effects of minocycline on neurological function and serum S100B protein and neuron-specific enolase (NSE) levels in patients with moderate to severe TBI. Patients with acute onset of TBI and surgical evacuation of hematoma were randomized to receive either minocycline 100 mg orally twice daily or placebo for 7 days. The primary outcomes included changes in level of S100B and NSE at different time points during the trial. Additionally, changes in Glasgow coma scale (GCS) score were evaluated. The Glasgow Outcome Scale-Extended (GOS-E) score at 6 month after injury was assessed in discharge patients. Thirty four patients were randomized into the placebo (n=20) and treatment (n=14) groups. There was a marginal statistically significant differences in the normalized value of S100B between groups (p<0.1). The reduction in serum NSE level from baseline to day 5 was statistically significant (p=0.01) in minocycline group while it was not significantly decrease in placebo group (p=0.2). Also, GCS improvement over time within the minocycline group was significant (p=0.04) while was not significant in placebo group (p=0.11). The GOS-E scores were not significantly different between minocycline and placebo group. Based on this study, it seems that the use of minocycline may be effective in acute TBI.