A pilot trial of L-carnitine in patients with traumatic brain injury: Effects on biomarkers of injury

Objective: To investigate the effects of L-Carnitine on neuron specific enolase (NSE) as a marker of inflammation in patients with traumatic brain injury (TBI). Methods: Forty patients with severe TBI were randomized into 2 groups. The (LCA-) group received standard treatment with placebo while the (LCA+) group received L-Carnitine 2 g/day for one week. NSE was measured on days 1, 3 and 7 after the initiation of the study. Neurocognitive and neurobehavioral disorders were recorded on the first and third months. Results: Neurocognitive function and NSE significantly improved within one week in both groups. Patient mortality was similar in LCA+ and LCA- groups (P value: 0.76). Brain edema was present in 7 patients in LCA+ group and 13 patients in LCA-group (P value: 0.044). While there was no difference in NSE levels between the two groups. Neurological function was preserved in the LCA+ group with an exception of attention deficit, which was frequent in the LCA+ group. Conclusion: We concluded that despite improvements in neurobehavioral function and the degree of cerebral edema, 7-days of treatment with L-Carnitine failed to reduce serum NSE levels or improve mortality rate at 90 days in patients with TBI.