科研之友
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摘要
Background Extensive data, primarily from animal studies, suggest that several classes of drugs may have antineuroplastic effects that could impede recovery from brain injury or reduce the efficacy of rehabilitation. Aims The Locomotor Experience Applied Post-Stroke trial, a randomized controlled study of 408 subjects that tested the relative efficacy of two rehabilitation techniques on functional walking level at one-year poststroke, provided us the opportunity to prospectively assess the potential antineuroplastic effects of several classes of drug. Methods Subjects were randomized to receive one of the two rehabilitation therapies at two-months poststroke. Drugs taken were recorded at time of randomization. Outcome was assessed at one-year poststroke. Regression models were used to determine the amount of variance in success in improving functional walking level, gains in walking speed, and declines in lower extremity, upper extremity, and cognitive impairment accounted for by alpha 1 noradrenergic blockers + alpha 2 noradrenergic agonists, benzodiazepines, voltage-sensitive sodium channel anticonvulsants, and alpha 2 delta voltage-sensitive calcium channel blockers. Results The maximum variance accounted for by any drug class was 1 center dot 66%. Drug effects were not statistically significant when using even our most lenient standard for correction for multiple comparisons. Conclusions Drugs in the classes we were able to assess do not appear to exert a clinically important effect on outcome over the period between two- and 12 months poststroke. However, the potential antineuroplastic effects of certain drugs remain an incompletely settled scientific question.
- 出版日期2014-6
- 单位UCLA
