Pharmacological therapies in post stroke recovery: Recommendations for future clinical trials

F. Chollet, S. C. Cramer, C. Stinear, L. J. Kappelle, J. C. Baron, C. Weiller, P. Azouvi, M. Hommel, U. Sabatini, T. Moulin, J. Tardy, M. Valenti, S. Montgomery, H. Adams

Research output: Contribution to journalArticlepeer-review

Abstract

Stroke is a leading cause of serious long-term disability in adults and is the second leading cause of death worldwide. Early reperfusion and neuroprotection techniques have been the focus of much effort with the aim of very acute treatment of the stroke. Targeting different mechanisms, pharmacological therapies have the potential to reduce disability in a large fraction of patients who survive the acute stroke. The brain's capacity to reorganize after stroke through plasticity mechanisms can be modulated by pharmacological agents. A number of therapeutic interventions are under study, including small molecules, growth factors, and monoclonal antibodies. Recently it has been shown that the SSRI fluoxetine improved motor deficit in patients with ischaemic stroke and hemiplegia which appeared to be independent of the presence of depression. In this context, it is of major importance to support innovative research in order to promote the emergence of new pharmacological treatments targeting neurological recovery after stroke, as opposed to acute de-occlusion and neuroprotection. This paper is the work of a group of 14 scientists with aim of (1) addressing key areas of the basic and clinical aspects of human brain plasticity after stroke and potential pharmacological targets for recovery, (2) asking questions about the most appropriate characteristics of clinical trials testing drugs in post stroke recovery and (3) proposing recommendations for future clinical trials.

Original languageEnglish
Pages (from-to)1461-1468
Number of pages8
JournalJournal of Neurology
Volume261
Issue number8
DOIs
Publication statusPublished - 2014

Keywords

  • Brain plasticity
  • Clinical scales
  • Clinical trials
  • Outcome scales
  • Pharmacology
  • Statistical analysis
  • Stroke recovery

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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