MedicalResearch.com Interview with:
Larry B. Goldstein, MD, FAAN, FANA, FAHA
Ruth L. Works Professor and Chairman, Department of Neurology
Co-Director, Kentucky Neuroscience Institute
KY Clinic – University of Kentucky
Lexington, KY 40536
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Extensive work in laboratory models over several decades show that d-amphetamine, combined with task-relevant experience, can facilitate recovery after stroke and traumatic brain injury affecting the cerebral cortex.
Results from clinical trials have been inconsistent, in part because preclinical data indicate that the effect of amphetamines as part of a regimen for stroke recovery is biologically complex. We conducted this multicenter pilot study to explore some of that complexity.
MedicalResearch.com: What should readers take away from your report?
Response: The primary outcome was defined as a difference in the change in Fugl-Meyer Motor scores, an impairment index assessing motor function, balance, and sensation. The study also assessed changes in the NIH-Stroke Scale, Canadian Neurological Scale, Action Research Arm test, Rankin Score, Functional Independence Measure, Ambulation Speed and Endurance, Mini Mental State examination, Beck Depression Index and the Stroke Impact Scale as secondary measures. Participants were tested at baseline, the end of treatment and again at three months post-stroke.
We found no overall treatment-related difference in Fugl-Meyer Motor scores between baseline and 3-month post-stroke and no difference in any of the study’s secondary outcome measures. Certainly, at this point, amphetamines should not be used as a way of enhancing recovery after stroke.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The next step is to explore other dosing regimens, treatment intervals and times between stroke and beginning treatment which are all important based on animal studies.
Disclosures: No disclosures. The study was supported by the NIH.
Goldstein LB, Lennihan L, Rabadi MJ, et al. Effect of Dextroamphetamine on Poststroke Motor RecoveryA Randomized Clinical Trial. JAMA Neurol. Published online August 27, 2018. doi:10.1001/jamaneurol.2018.2338
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