Atomoxetine administration combined with intensive speech therapy for post-stroke aphasia: evaluation by a novel SPECT method

Yamada, Naoki; Kakuda, Wataru; Yamamoto, K.; Momosaki, Ryo; Abo, Masahiro

doi:10.3109/00207454.2015.1074226

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…17 In a previous study involving a small number of patients, the use of atomoxetine mainly improved oral fluency. 11,17 However, in our study, patients exhibited significant improvements only in auditory verbal comprehension and naming scores. The potential effect of atomoxetine on norepinephrine projections may help explain such improvements.…”

Section: Discussioncontrasting

confidence: 70%

“…In accordance with our findings, improvements in speech or cognition after atomoxetine treatment have been reported by smallscale studies. [10][11][12] In 55 Parkinson disease patients, atomoxetine treatment was associated with improved global cognitive performance. 12 There is only a small sample of studies on the therapeutic effects of atomoxetine in stroke patients.…”

Section: Discussionmentioning

confidence: 99%

“…Ward et al 10 reported an increased Fugl-Meyer score and improved motor function in the atomoxetine group in a study that included 12 patients. Furthermore, Yamada et al 11 reported that cerebral blood flow and language function improved after the use of atomoxetine in 4 patients with motor-dominant aphasia.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Atomoxetine (Strattera) for the Treatment of Poststroke Aphasia Combined With Cognitive Impairment

Park

Choi²,

Kim³

2022

Clinical Neuropharmacology

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ObjectiveIn this study, we aimed for the first time to evaluate the effectiveness of atomoxetine (Strattera) in the treatment of cognitive impairment and aphasia after stroke in a large sample.MethodsWe reviewed the data of 106 patients with poststroke aphasia and cognitive impairment (atomoxetine treatment group = 55 patients vs control group = 51 patients), including scores of the Korean version of the Mini-Mental State Examination (K-MMSE) and the Korean version of the Western Aphasia Battery. Wilcoxon signed-rank tests were used to compare the initial and follow-up K-MMSE and Korean version of the Western Aphasia Battery scores. Mann-Whitney U tests were used to compare the degree of improvement in K-MMSE and Aphasia Quotient (AQ) scores between the atomoxetine and control groups.ResultsBaseline characteristics including age, years of education, and scores of the initial Functional Independence Measure, Korean version of the Modified Barthel Index, Hamilton Depression Rating Scale, K-MMSE, and AQ did not differ significantly between the 2 groups. Follow-up K-MMSE and AQ scores were significantly better than the initial scores in both the treatment and control groups. However, improvements in K-MMSE scores were significantly greater in the treatment group than in the control group. In addition, the atomoxetine group had significantly higher AQ scores than the control group, especially for auditory verbal comprehension and naming.ConclusionsAtomoxetine has been shown to significantly improve cognitive function and language in patients with poststroke aphasia. It is also the first study to report improvement in auditory comprehension and naming by administration of atomoxetine.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Atomoxetine (Strattera) for the Treatment of Poststroke Aphasia Combined With Cognitive Impairment

Park

Choi²,

Kim³

2022

Clinical Neuropharmacology

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“…All participants demonstrated improved language function measured by the Western Aphasia Battery and the Token Test. Improvements were associated with increased perilesional blood flow using single photon emission computed tomography ( Yamada, Kakuda, Yamamoto, Momosaki, & Abo, 2016 ). Separate studies have evaluated off-label use of atomoxetine in subjects with Parkinson’s disease.…”

Section: Discussionmentioning

confidence: 99%

Safety and improvement of movement function after stroke with atomoxetine: A pilot randomized trial

Ward

Carrico

Powell

et al. 2017

RNN

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Background: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention.Objective: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke.Methods: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, Wolf Motor Function Test, and Action Research Arm Test at baseline, post-intervention, and 1-month follow-up.Results: No significant between-groups differences were found in mean heart rate (95% CI, –12.4–22.6; p = 0.23), mean systolic blood pressure (95% CI, –1.7–29.6; p = 0.21), or mean diastolic blood pressure (95% CI, –10.4–13.3; p = 0.08). A statistically significant between-groups difference on Fugl-Meyer at post-intervention favored the atomoxetine group (95% CI, 1.6–12.7; p = 0.016).Conclusion: Atomoxetine combined with motor training appears safe and may optimize motor training outcomes after stroke.

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“…• Intensive speech therapy [152,153] • Combined with pharmacological therapies [154][155][156][157] • Combined with noninvasive brain stimulation [158][159][160][161].…”

Section: Speechmentioning

confidence: 99%

Neuroregeneration and plasticity: a review of the physiological mechanisms for achieving functional recovery postinjury

2020

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Neuronal networks, especially those in the central nervous system (CNS), evolved to support extensive functional capabilities while ensuring stability. Several physiological “brakes” that maintain the stability of the neuronal networks in a healthy state quickly become a hinderance postinjury. These “brakes” include inhibition from the extracellular environment, intrinsic factors of neurons and the control of neuronal plasticity. There are distinct differences between the neuronal networks in the peripheral nervous system (PNS) and the CNS. Underpinning these differences is the trade-off between reduced functional capabilities with increased adaptability through the formation of new connections and new neurons. The PNS has “facilitators” that stimulate neuroregeneration and plasticity, while the CNS has “brakes” that limit them. By studying how these “facilitators” and “brakes” work and identifying the key processes and molecules involved, we can attempt to apply these theories to the neuronal networks of the CNS to increase its adaptability. The difference in adaptability between the CNS and PNS leads to a difference in neuroregenerative properties and plasticity. Plasticity ensures quick functional recovery of abilities in the short and medium term. Neuroregeneration involves synthesizing new neurons and connections, providing extra resources in the long term to replace those damaged by the injury, and achieving a lasting functional recovery. Therefore, by understanding the factors that affect neuroregeneration and plasticity, we can combine their advantages and develop rehabilitation techniques. Rehabilitation training methods, coordinated with pharmacological interventions and/or electrical stimulation, contributes to a precise, holistic treatment plan that achieves functional recovery from nervous system injuries. Furthermore, these techniques are not limited to limb movement, as other functions lost as a result of brain injury, such as speech, can also be recovered with an appropriate training program.

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Atomoxetine administration combined with intensive speech therapy for post-stroke aphasia: evaluation by a novel SPECT method

Abstract: Atomoxetine administration and intensive ST were safe and feasible for post-stroke aphasia, suggesting their potential usefulness in the treatment of this patient population.

Cited by 14 publications

References 34 publications

Effectiveness of Atomoxetine (Strattera) for the Treatment of Poststroke Aphasia Combined With Cognitive Impairment

Effectiveness of Atomoxetine (Strattera) for the Treatment of Poststroke Aphasia Combined With Cognitive Impairment

Safety and improvement of movement function after stroke with atomoxetine: A pilot randomized trial

Neuroregeneration and plasticity: a review of the physiological mechanisms for achieving functional recovery postinjury

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