Effectiveness of Japanese herbal medicine yokukansan for alleviating psychiatric symptoms after traumatic brain injury.

Psychogeriatrics. 2010 Mar;10(1):45-8.

Saito S, Kobayashi T, Osawa T, Kato S.

Department of Psychiatry, Jichi Medical University, Shimotsuke City, Tochigi, Japan. saitoshinnosuke@gmail.com

Abstract

The Japanese herbal medicine, yokukansan, has been reported to improve behavioral and psychological symptoms of dementia and activities of daily living in patients with dementia. In the present case report, the authors report the effectiveness of yokukansan in treating psychiatric symptoms after traumatic brain injury. An 85-year-old man, who underwent surgery for hepatic portal cholangiocarcinoma, sustained traumatic brain injury after falling from bed as the result of postoperative delirium. He subsequently presented with psychiatric symptoms, showing markedly impulsive and aggressive behavior. Neuroleptics did not alleviate the symptoms. Ultimately, we succeeded in controlling the symptoms, without adverse effects, by giving the patient yokukansan. Yokukansan shows the potential for reducing aggressive and impulsive behavior in dementia as well as in other psychiatric diseases.

PMID: 20594286 [PubMed - indexed for MEDLINE]

Limbic Metabolic Abnormalities in Remote Traumatic Brain Injury and Correlation With Psychiatric Morbidity and Social Functioning

Limbic Metabolic Abnormalities in Remote Traumatic Brain Injury and Correlation With Psychiatric Morbidity and Social Functioning

Neuropsychiatry Clin Neurosci 22:370-377, Fall
doi: 10.1176/appi.neuropsych.22.4.370
© 2010 American Neuropsychiatric Association
Arístides A. Capizzano, M.D., Ricardo E. Jorge, M.D. and Robert G. Robinson, M.D.

Received August 5, 2009; revised October 21 and November 13, 2009; accepted November 16, 2009. Dr. Capizzano is affiliated with the Department of Radiology, Division of Neuroradiology, at the University of Iowa Carver College of Medicine in Iowa City, Iowa; Drs. Jorge and Robinson are affiliated with the Department of Psychiatry at the University of Iowa Carver College of Medicine in Iowa City. Address correspondence to Aristides A. Capizzano, M.D., Department of Radiology, Division of Neuroradiology, University of Iowa Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242; aristides-capizzano@uiowa.edu (e-mail).

The aim of this study was to investigate limbic metabolic abnormalities in remote traumatic brain injury (TBI) and their psychiatric correlates. Twenty patients and 13 age-matched comparison subjects received complete psychiatric evaluation and brain MRI and MR spectroscopy at 3 Tesla. Patients had reduced NAA to creatine ratio in the left hippocampus relative to comparison subjects (mean=1.3 [SD=0.21] compared with mean=1.55 [SD=0.21]; F=10.73, df=1, 30, p=0.003), which correlated with the Social Functioning Examination scores (r_s=–0.502, p=0.034). Furthermore, patients with mood disorders had reduced NAA to creatine ratio in the left cingulate relative to patients without mood disorders (1.47 compared with 1.68; F=3.393, df=3, 19, p=0.044). Remote TBI displays limbic metabolic abnormalities, which correlate to social outcome and psychiatric status.