Michelangelo Bartolo1, Chiara Zucchella2, Annarita Capone2, Giorgio Sandrini3, Francesco Pierelli4. 1. Neurorehabilitation Unit, IRCCS NEUROMED, Via Atinense, 18-86077 Pozzilli, Isernia, Italy. Electronic address: bartolomichelangelo@gmail.com. 2. Neurorehabilitation Unit, IRCCS NEUROMED, Via Atinense, 18-86077 Pozzilli, Isernia, Italy. 3. Neurorehabilitation Unit, C. Mondino National Neurological Institute, Via Mondino, 2-27100 Pavia, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Via Bassi, 21-27100 Pavia, Italy. 4. Neurorehabilitation Unit, IRCCS NEUROMED, Via Atinense, 18-86077 Pozzilli, Isernia, Italy; Department of Medical-Surgical Sciences and Biotechnology "Sapienza" University of Rome, Corso della Repubblica, 79-04100 Latina, Italy.
Abstract
INTRODUCTION:Selegiline (l-deprenyl) is a selective monoamine oxidase type B inhibitor that has been shown to have neurotrophic and anti-apoptotic properties and to protect neurons in different experimental models of cerebral ischaemia. The aim of this explorative study was to investigate whether selegiline could enhance cognitive and functional recovery in stroke survivors. METHODS: This was a randomized controlled study in which patients enrolled within two weeks of stroke underwent a clinical and functional evaluation and a neuropsychological assessment. The patients were given selegiline (10mg/day) or matched placebo once a day for six weeks in addition to standard rehabilitation care. RESULTS: Of 137 stroke survivors, 47 patients met the inclusion criteria and were randomly assigned to the Study Group (n=23) or the Control Group (n=24). The statistical analysis showed a significant improvement in most neuropsychological tests after two and six weeks in the study group; these improvements were not replicated in the control group. The between-group analysis revealed that the domains of attention and executive functions benefited most from the drug treatment. With regard to functional status, comparison of clinical scores at admission and discharge showed a statistically significant enhancement in both groups without statistically significant differences between the groups. CONCLUSIONS: These preliminary results suggest that selegiline administered in the subacute phase can promote cognitive functioning in stroke patients. Further studies will elucidate whether and how this enhancement can impact on functional recovery in the short and in the long term.
RCT Entities:
INTRODUCTION:Selegiline (l-deprenyl) is a selective monoamine oxidase type B inhibitor that has been shown to have neurotrophic and anti-apoptotic properties and to protect neurons in different experimental models of cerebral ischaemia. The aim of this explorative study was to investigate whether selegiline could enhance cognitive and functional recovery in stroke survivors. METHODS: This was a randomized controlled study in which patients enrolled within two weeks of stroke underwent a clinical and functional evaluation and a neuropsychological assessment. The patients were given selegiline (10mg/day) or matched placebo once a day for six weeks in addition to standard rehabilitation care. RESULTS: Of 137 stroke survivors, 47 patients met the inclusion criteria and were randomly assigned to the Study Group (n=23) or the Control Group (n=24). The statistical analysis showed a significant improvement in most neuropsychological tests after two and six weeks in the study group; these improvements were not replicated in the control group. The between-group analysis revealed that the domains of attention and executive functions benefited most from the drug treatment. With regard to functional status, comparison of clinical scores at admission and discharge showed a statistically significant enhancement in both groups without statistically significant differences between the groups. CONCLUSIONS: These preliminary results suggest that selegiline administered in the subacute phase can promote cognitive functioning in strokepatients. Further studies will elucidate whether and how this enhancement can impact on functional recovery in the short and in the long term.