Dexamphetamine Improves Upper Extremity Outcome During Rehabilitation After Stroke

Schuster, Corina; Maunz, Gerd; Lutz, Karin; Kischka, Udo; Sturzenegger, Rolf; Ettlin, Thierry

doi:10.1177/1545968311405674

Cited by 40 publications

(27 citation statements)

References 20 publications

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“…Recently, a pilot randomized clinical trial involving 16 patients showed that 10 mg amphetamine administered 2 days per week before physiotherapy augments the positive effects of physiotherapy on recovery of activities of daily living and arm function. 52 …”

Section: D-amphetaminementioning

confidence: 99%

Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation

Pekna

Pekny

Nilsson

2012

Stroke

218

154

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Section: D-amphetaminementioning

confidence: 99%

Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation

Pekna

Pekny

Nilsson

2012

Stroke

218

154

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“…(8) No documented epileptic discharge on the electroencephalogram. (9) No pathological conditions known to be contraindications for rTMS in the guidelines suggested by Wassermann [23]. In addition, patients in whom atomoxetine use was considered to be contraindicated were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported that modulation of the noradrenergic system can influence brain plasticity in human [4]. Several studies have reported that administration of amphetamine and methylphenidate improved functional outcome of stroke patients [5][6][7][8][9]. However, adverse cardiovascular events such as stroke, myocardial infarction, and sudden death and abuse potential associated with these drugs limit their use clinically in stroke rehabilitation [10,11].…”

Section: Introductionmentioning

confidence: 96%

Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

et al. 2015

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Atomoxetine, a selective noradrenaline reuptake inhibitor, has been reported to enhance brain plasticity, but has not yet been used in stroke patients. We reported the feasibility and clinical benefits on motor functional recovery of the combination of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) in stroke patients. This pilot study was designed to evaluate the additive effects of oral atomoxetine to rTMS/OT in post-stroke hemiparetic patients. The study included three post-stroke patients with upper limb hemiparesis. Treatment with 40 mg/day atomoxetine commenced 2 weeks before admission. After confirming tolerance, the dose was increased to 120 mg/day. Low-frequency rTMS/OT was provided daily for 15 days during continued atomoxetine therapy. Motor function of the affected upper limb was evaluated with the Fugl-Meyer Assessment and Wolf Motor Function test. All patients completed the protocol and showed motor improvement up to 4 weeks after the treatment. No atomoxetine-related side effects were noted. Our protocol of triple therapy of atomoxetine, low-frequency rTMS, and OT is safe and feasible intervention for upper limb hemiparesis after stroke.

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“…Other 6 studies suggested that there was an evidence of a better relative change from baseline to follow up in motor function (WMD-6.1 points, 95% CI -10.4 to -1.9). Schuster et al 2011 have recently reported increased performance in ADL and arm function in 8 patients who were administered with 10 mg of AMPH per day [45].…”

Section: Amphetamines and Motor Rehabilitationmentioning

confidence: 99%

Pharmacological Agents in Post Stroke Recovery

Moonis¹

2014

JNSK

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Pathophysiology of ischemic stroke [7]The degree and duration of impaired blood flow determines the extent and pattern of cerebrovascular damage. Ischemia causes loss of membrane potentials leading to anoxic depolarization and kills uniquely vulnerable neurons such as pyramidal neurons in the CA1 and CA4 zones of the hippocampus while sparing other neurons and glial cells. Deprivation of oxygen supply to the brain AbstractStroke is the second commonest cause of death and disability in the world. In spite of the Amazonian advances in understanding of the pathophysiology and pathogenesis of stroke, there is unfortunately limited number of agents available in the armamentarium to fight stroke. There is therefore a compelling need to develop novel therapies to target restoration of the damaged brain and not merely protect or treat in the acute phase of the disease. By developing interventions which can be administered several days or weeks after the onset of stroke, which can essentially remodel the intact brain so as to compensate for the infarction, many more patients can be treated and brought back to their previous level of integration into the society as useful members. A variety of therapeutic approaches that could be considered Neuroprotective and Neurorestorative are currently in preclinical and clinical trials after stroke. There are essentially two varieties of restorative approaches. One is cellbased and includes stem cell transplantation with and without augmentation with growth factor and other variety is the pharmacological approach. Since the current review deals only with the later, we will deliberate on the several strategies currently being explored under this banner which include statins, erythropoietin and analogs, human chorionic gonadotropin, growth factors, and agents that increase cyclic GMP. Recent published literature was searched using PubMed and Google for the article reporting on Pharmacological approaches in Post stroke recovery.

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Dexamphetamine Improves Upper Extremity Outcome During Rehabilitation After Stroke

Abstract: In this small trial that was based on prior positive trials, significant gains in ADL and arm function suggest that the dose and timing of dexamphetamine can augment physiotherapy. Effect size calculation suggests inclusion of at least 25 patients per group in future studies.

Cited by 40 publications

References 20 publications

Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation

Modulation of Neural Plasticity as a Basis for Stroke Rehabilitation

Therapeutic administration of atomoxetine combined with rTMS and occupational therapy for upper limb hemiparesis after stroke: a case series study of three patients

Pharmacological Agents in Post Stroke Recovery

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