(Stroke. 1995;26:2254-2259.)
© 1995 American Heart Association, Inc.
Articles |
Amphetamine Paired With Physical Therapy Accelerates Motor Recovery After Stroke
Further Evidence
From The Aphasia Center, Department of Communication Sciences and Disorders, Texas Woman's University (D.W.-B., S.C.), and the Departments of Neurology (D.W.-B., H.U., R.G.) and Physical Therapy (P.S.), University of Texas Southwestern Medical Center, Dallas.
Correspondence to Delaina Walker-Batson, PhD, The Aphasia Center, Department of Communication Sciences and Disorders, Texas Woman's University, 1810 Inwood Rd, Dallas, TX 75235-7299.
Background and Purpose In animal models of brain injury, administration of numerous pharmaceuticals is reported to facilitate functional recovery. However, only drugs that increase the release of norepinephrine have been shown to promote recovery when administered late (days to weeks) after injury. To determine whether these findings were applicable to humans, we administered the norepinephrine stimulant dextroamphetamine, paired with physical therapy, to hemiplegic stroke patients.
Methods Ten hemiplegic patients who suffered an acute
ischemic infarction were entered between days 16 and 30 after
onset and randomly assigned to receive either 10 mg of
dextroamphetamine or a placebo orally every fourth day for 10 sessions
paired with physical therapy. The Fugl-Meyer Motor Scale was used at
baseline, within each session, and for 12 months after onset as the
dependent measure. Confounding medications such as 
-adrenergic
antagonists or agonists were excluded in all subjects.
Results Although there were no differences between the groups at baseline (P=.599), there was a significant (P=.047) difference between the groups when the drug had been discontinued for 1 week and at the 12-month follow-up visit (P=.047).
Conclusions Administration of dextroamphetamine paired with physical therapy increased the rate and extent of motor recovery in a small group of hemiplegic stroke patients. These data support and extend previous findings of the facilitatory aspects of certain types of drugs on recovery from brain injury. The use of neuromodulation may allow the nervous system to adapt previously unused or alternative pathways to relevant external input.
Key Words: cerebrovascular disorders • hemiplegia • dextroamphetamine • stroke
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