OBJECTIVE: To determine the efficacy and safety of methylphenidate in acute stroke rehabilitation. DESIGN: A prospective, randomized, double-blind, placebo-controlled study. PATIENTS AND SETTING:Twenty-one stroke patients consecutively admitted to a community-based rehabilitation unit. INTERVENTION: Three-week treatment of methylphenidate (or placebo) in conjunction with physical therapy. Methylphenidate was started at 5mg and increased gradually to 30mg (15mg at 8:00AM and 15mg at 12:00 noon), and discontinued before discharge. MAIN OUTCOME MEASURES: Mood measures included the Hamilton Depression Rating Scale (HAM-D) and Zung Self-Rating Depression Scale (ZDS). Cognitive status was evaluated using the Mini-Mental State Exam (MMSE). Motor functioning was assessed using the Fugl-Meyer Scale (FMS) and a modified version of the Functional Independence Measure (M-FIM). All measures were administered pretreatment and weekly thereafter. Side effects were measured after each increase in dosage and weekly. RESULTS: Patients receiving methylphenidate treatment scored lower on the HAM-D (F(1,18)=5.714, p=.028), lower on the ZDS (F(1,18)=4.206, p=.055), higher on the M-FIM (F(1,18)=5.374, p=.032), and higher on the FMS (F(1,9)=4.060, p=.075) than patients receiving placebo. CONCLUSION:Methylphenidate appears to be a safe and effective intervention in early poststroke rehabilitation that may expedite recovery.
RCT Entities:
OBJECTIVE: To determine the efficacy and safety of methylphenidate in acute stroke rehabilitation. DESIGN: A prospective, randomized, double-blind, placebo-controlled study. PATIENTS AND SETTING: Twenty-one strokepatients consecutively admitted to a community-based rehabilitation unit. INTERVENTION: Three-week treatment of methylphenidate (or placebo) in conjunction with physical therapy. Methylphenidate was started at 5mg and increased gradually to 30mg (15mg at 8:00AM and 15mg at 12:00 noon), and discontinued before discharge. MAIN OUTCOME MEASURES: Mood measures included the Hamilton Depression Rating Scale (HAM-D) and Zung Self-Rating Depression Scale (ZDS). Cognitive status was evaluated using the Mini-Mental State Exam (MMSE). Motor functioning was assessed using the Fugl-Meyer Scale (FMS) and a modified version of the Functional Independence Measure (M-FIM). All measures were administered pretreatment and weekly thereafter. Side effects were measured after each increase in dosage and weekly. RESULTS:Patients receiving methylphenidate treatment scored lower on the HAM-D (F(1,18)=5.714, p=.028), lower on the ZDS (F(1,18)=4.206, p=.055), higher on the M-FIM (F(1,18)=5.374, p=.032), and higher on the FMS (F(1,9)=4.060, p=.075) than patients receiving placebo. CONCLUSION:Methylphenidate appears to be a safe and effective intervention in early poststroke rehabilitation that may expedite recovery.
Authors: Trisha M Kesar; Samir R Belagaje; Paola Pergami; Marc W Haut; Gerald Hobbs; Cathrin M Buetefisch Journal: Brain Res Date: 2017-06-17 Impact factor: 3.252
Authors: Heidi M Schambra; Isis E Martinez-Hernandez; Kevin J Slane; Amelia K Boehme; Randolph S Marshall; Ronald M Lazar Journal: Restor Neurol Neurosci Date: 2016-09-21 Impact factor: 2.406