{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:40:14Z","timestamp":1790098814766,"version":"4.0.1"},"reference-count":51,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n                    Concussion is a common injury in the adolescent and young adult populations. Although branched chain amino acid (BCAA) supplementation has shown improvements in neurocognitive and sleep function in pre-clinical animal models of mild-to-moderate traumatic brain injury (TBI), to date, no studies have been performed evaluating the efficacy of BCAAs in concussed adolescents and young adults. The goal of this pilot trial was to determine the efficacy, tolerability, and safety of varied doses of oral BCAA supplementation in a group of concussed adolescents and young adults. The study was conducted as a pilot, double-blind, randomized controlled trial of participants ages 11\u201334 presenting with concussion to outpatient clinics (sports medicine and primary care), urgent care, and emergency departments of a tertiary care pediatric children's hospital and an urban tertiary care adult hospital, between June 24, 2014 and December 5, 2020. Participants were randomized to one of five study arms (placebo and 15\u2009g, 30\u2009g, 45\u2009g, and 54\u2009g BCAA treatment daily) and followed for 21 days after enrollment. Outcome measures included daily computerized neurocognitive tests (processing speed, the\n                    <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                    primary outcome; and attention, visual learning, and working memory), symptom score, physical and cognitive activity, sleep\/wake alterations, treatment compliance, and adverse events. In total, 42 participants were randomized, 38 of whom provided analyzable data. We found no difference in our primary outcome of processing speed between the arms; however, there was a significant reduction in total symptom score (decrease of 4.4 points on a 0\u201354 scale for every 500\u2009g of study drug consumed,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    value for trend\u2009=\u20090.0036, [uncorrected]) and return to physical activity (increase of 0.503 points on a 0\u20135 scale for every 500\u2009g of study drug consumed,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    value for trend\u2009=\u20090.005 [uncorrected]). There were no serious adverse events. Eight of 38 participants reported a mild (not interfering with daily activity) or moderate (limitation of daily activity) adverse event; there were no differences in adverse events by arm, with only two reported mild adverse events (both gastrointestinal) in the highest (45\u2009g and 54\u2009g) BCAA arms. Although limited by slow enrollment, small sample size, and missing data, this study provides the first demonstration of efficacy, as well as safety and tolerability, of BCAAs in concussed adolescents and young adults; specifically, a dose-response effect in reducing concussion symptoms and a return to baseline physical activity in those treated with higher total doses of BCAAs. These findings provide important preliminary data to inform a larger trial of BCAA therapy to expedite concussion recovery.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0433","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T03:04:21Z","timestamp":1710212661000},"page":"1299-1309","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Head Injury Treatment With Healthy and Advanced Dietary Supplements: A Pilot Randomized Controlled Trial of the Tolerability, Safety, and Efficacy of Branched Chain Amino Acids in the Treatment of Concussion in Adolescents and Young Adults"],"prefix":"10.1177","volume":"41","author":[{"given":"Daniel J.","family":"Corwin","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sage R.","family":"Myers","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy B.","family":"Arbogast","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda M.","family":"Lim","sequence":"additional","affiliation":[{"name":"Oregon Alzheimer's Disease Research Center &amp; Department of Neurology, Oregon Health &amp; Science University, Portland, Oregon, USA."},{"name":"Research Service and VA RR&amp;D VISN20 Northwest Mental Illness Research Education and Clinical Center (MIRECC), VA Portland Health Care System, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Oregon Alzheimer's Disease Research Center &amp; Department of Neurology, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina B.","family":"Metzger","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"LeRoux","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center and Bassett Medical Center, Cooperstown, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclynn","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Metheny","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Suburban Community Hospital, East Norriton, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Pettijohn","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Master","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 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