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.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 38468511 · doi:10.1089/neu.2023.0433
What was done
A pilot, double-blind, 5-arm randomized controlled trial evaluated oral branched-chain amino acid (BCAA) supplementation in 42 participants aged 11–34 years presenting with concussion to outpatient, urgent care, or emergency departments across pediatric and adult tertiary care centers. Participants were randomized to daily placebo, 15 g, 30 g, 45 g, or 54 g of BCAAs for 21 days. Analyzable data were obtained from 38 participants. The primary outcome was daily computerized processing speed; secondary outcomes included other neurocognitive domains (attention, visual learning, working memory), total symptom scores (0–54 scale), physical activity (0–5 scale), cognitive activity, sleep/wake alterations, compliance, and adverse events.
What was found
There was no difference between treatment arms for the primary outcome of processing speed. However, there was a significant reduction in total symptom score (decrease of 4.4 points on a 0–54 scale for every 500 g consumed, uncorrected trend p = 0.0036) and an increase in return to physical activity (increase of 0.503 points on a 0–5 scale for every 500 g consumed, uncorrected trend p = 0.005). No serious adverse events occurred. Eight of 38 participants reported mild or moderate adverse events with no difference across arms, including two mild gastrointestinal events in the 45 g and 54 g arms.
Why it matters
This pilot trial provides initial preliminary evidence that high-dose oral BCAA supplementation is safe, well-tolerated, and may reduce symptom burden and facilitate return to physical activity following concussion in young patients.
Limits
The study is limited by a very small sample size divided across five study arms (38 analyzed), a prolonged six-year recruitment period, and missing data. The primary neurocognitive outcome showed no effect, and positive secondary outcomes rely on uncorrected trend p-values.