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(Stroke. 2009;40:8.)
© 2009 American Heart Association, Inc.

Editorials

Poststroke Treatment

Lost in Translation

DeAnna L. Adkins, PhD; Timothy Schallert, PhD Larry B. Goldstein, MD

From the Psychology Department and the Institute for Neuroscience (D.L.A., T.S.), The University of Texas at Austin, Austin, Texas; and the Department of Medicine (Neurology; L.B.G.), Duke Stroke Center and Center for Clinical Health Policy Research, Duke University and Durham VA Medical Centers, Durham, NC.

Correspondence to DeAnna L. Adkins, PhD, Department of Psychology, University of Texas at Austin, 1 University Station, A8000, Austin, TX 78712. E-mail dladkins@mail.utexas.edu

Key Words: basic science • behavioral neurology • brain recovery • experimental • pharmacology • rehabilitation • stroke recovery • therapy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 294–302.

Stroke research has primarily focused on prevention and acute treatment. Yet, there is a window of opportunity to provide treatments that will increase functional recovery by capitalizing on the brain’s neural plastic responses during postacute and chronic periods.^1,2 Papadopoulos and colleagues’ study in this issue of Stroke is consistent with decades of research demonstrating that coupling of D-amphetamine administration with motor practice can enhance motor recovery after brain injury in animal models.^3,4 This study elegantly shows that short-term, postacute administration of D-amphetamine sulfate combined with focused physical activity and housing in an "enriched" environment improves motor recovery markedly. These improvements are associated with increased axonal sprouting in corticoefferent pathways to the red nucleus and cervical spinal cord from the contralesional forelimb sensorimotor cortex.

Prior animal experiments provide considerable evidence that even a single dose of D-amphetamine induces enduring motor improvements after various types of brain injury.⁵ Likewise, some clinical studies show that amphetamine administration can be beneficial^6,7 and that drugs that have pharmacological effects opposite to that of amphetamine may be harmful.⁸ Several clinical trials, however, have failed to show a benefit of poststroke amphetamine administration.^9–12 One positive⁷ and one negative¹² trial involved similar patients who were treated under similar protocols. It is therefore not surprising that a recent Cochrane report analyzing 10 studies involving 287 patients concluded that there are still no conclusive data showing that amphetamine treatment is of clinical benefit.¹³ Why is there such a discrepancy?

The fact that amphetamine effects . . . [Full Text of this Article]

Related Article:

Motor Recovery and Axonal Plasticity With Short-Term Amphetamine After Stroke

Catherine M. Papadopoulos, Shih-Yen Tsai, Veronica Guillen, Juan Ortega, Gwendolyn L. Kartje, and William A. Wolf
Stroke 2009 40: 294-302. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				L. B. Goldstein The 2009 Feinberg Lecture: The Continuum of Stroke Research and Policy Stroke, December 1, 2009; 40(12): 3879 - 3882. [Abstract] [Full Text] [PDF]