HMG-CoA Reductase Inhibitors for Traumatic Brain Injury

Neurotherapeutics. 2023 Oct;20(6):1538-1545. doi: 10.1007/s13311-023-01399-9. Epub 2023 Jun 23.

Abstract

Traumatic brain injuries (TBIs) are associated with high morbidity and mortality due to both the original insult as well as the destructive biological response that follows. Medical management aims to slow or even halt secondary neurological injury while simultaneously laying the groundwork for recovery. Statins are one class of medications that is showing increased promise in the management of TBI. Used extensively in cardiovascular disease, these drugs were originally developed as competitive inhibitors within the cholesterol production pipeline. They are now used in diverse disease states due to their pleiotropic effects on other biological processes such as inflammation and angiogenesis. Preclinical studies, retrospective reviews, and randomized clinical trials have shown a variety of benefits in the management of TBI, but to date, no large-scale randomized clinical trial has been performed. Despite this limitation, statins' early promise and well-tolerated side effect profile make them a promising new tool in the management of TBIs. More bench and clinical studies are needed to delineate proper treatment regimens as well as understand their true potential.

Keywords: Cholesterol; Concussion; Inflammation; Statins; Trauma; Traumatic brain injury.

Publication types

  • Review

MeSH terms

  • Brain Injuries, Traumatic* / drug therapy
  • Cholesterol
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Inflammation / drug therapy
  • Randomized Controlled Trials as Topic
  • Retrospective Studies

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol