Potential of Stimulants to Augment Rehabilitation i n the Acute Stroke Setting: Preliminary Support

Maybe these also? This joins marijuana, ecstasy and levodopa as possible help in stroke recovery.

https://www.researchgate.net/profile/Karen_Albright2/publication/282590626_Potential_of_Stimulants_to_Augment_Rehabilitation_in_the_Acute_Stroke_Setting_Preliminary_Support/links/56a6bedc08aeded22e3545e2.pdf
enny M. Ngo

1

, Michael Korsmo

1

, Karen C. Albright

2,3

, Mansi M. Jhaveri

4,5

,

Ramy E. l. Khoury

1

and Sheryl Martin-Schild

1*

1

Department of Neurology, Tulane University Hospital,

New Orleans, LA 70112, United States.

2

Department of Epidemiology, School of Public Health,

University of Alabama at Birmingham,

Alabama, United States.

3

Geriatric Research, Education, and Clinical Center (G

RECC), Birmingham Veteran Affairs,

Birmingham, Alabama 35233 United States.

4

Department of Physical Medicine and Rehabilitation, Un

iversity of Texas Health Sciences Center at

Houston, Houston, Texas 77030, United States.

5

Department of Neurology, University of Texas Health Scie

nces Center at Houston, Houston,

Texas 77030, United States. 

DOI: 10.9734/INDJ/2016/20621

Editor(s):

(1) Zhefeng Guo, Department of Neurology, Universit

y of California, Los Angeles, USA.

Reviewers:

(1)

Adria Arboix, University of Barcelona, Spain.

(2)

Xing Li, Mayo Clinic, USA.

Complete Peer review History:

http://sciencedomain.org/review-history/11571

Received 1

st

August 2015

Accepted 2

nd

September 2015

Published 27

th

September 2015

Case Study

Ngo et al.; INDJ, 5(1): 1-6, 2016; Article no.INDJ.

20621

2

ABSTRACT

Aims:

The objective of these case studies is to explore the possibility of using neurostimulants

during the acute stage of stroke to facilitate effective rehabilitation of patients with severe strokes.

Presentation of Cases:

In Case 1, methylphenidate was administered to a 63 year old woman with a left anterior cerebral artery infarct who was discharged to inpatient rehabilitation, rather than

original recommendation of skilled nursing facility, prior to returning home. In Case 2, modafinil was administered to a 56 year old man with a left middle cerebral artery infarct who was discharged to inpatient rehabilitation prior to returning home. In Case 3, modafinil was administered to a 66 year old man with a left middle cerebral arery infarct who was discharged to inpatient rehabilitation. In Case 4, modafinil and methylphenidate were co-administered to a patient with a hypertensive intracerebral hemorrhage who experienced an adverse event possibly related to neurostimulants resulting in discontinuation. She was discharged to

inpatient rehabilitation and subsequently to a skilled nursing facility.

Discussion: All cases initially presented to therapists with barriers to inpatient rehabilitation.

Following neurostimulant administration, therapies recommended discharge to inpatient

rehabilitation facility due to improvement in initial barriers. Three out of the four cases tolerated the neurostimulant well, while one case required discontinuation due to an adverse event.

Conclusion: Patients with severe strokes are less likely to meet criteria for inpatient rehabilitation. Depressed consciousness and limited attention are major barriers for which neurostimulants may be of benefit in the acute post-stroke setting. Administration of neurostimulants may improve participation in therapy, thus increasing qualification for inpatient rehabilitation, and ultimately accelerate recovery. Safety data in this population during the acute stage of stroke are lacking.