Roessingh Research and Development, Enschede, The Netherlands.
Eur J Phys Rehabil Med. 2009 Dec;45(4):621-30.
The objective of this review was to compare and to discuss the results of studies that investigated the ability of drugs to improve motor recovery after stroke by influencing dopamine, norepinephrine, or serotonin concentrations in the brain. A systematic literature search up to January 2009 was conducted in MEDLINE, Pubmed, EMBASE and in the database of the Cochrane Stroke Group Trial Register. In addition, the literature reference lists of the relevant publications were checked. The literature search was conducted in order to identify randomized controlled trials focusing on the effects of drugs on motor recovery after stroke. In order to structure the data, motor recovery was sub-divided into motor control and motor function. The methodological quality of the studies was also assessed. Six studies, investigating the effects of 7 different kinds of drugs were included. Methodological scores varied between 10 and 14 (max 19). Motor control was not influenced by any of the drugs. Motor function improved in patients treated with methylphenidate, trazodone, and nortriptyline. Results for fluoxetine and levodopa were contradicting. There is insufficient evidence to conclude that neuromodulating drugs targeting serotonin, norepinephrine, or dopamine influence motor recovery after stroke.
本次综述的目的是比较和讨论那些通过影响脑内多巴胺、去甲肾上腺素或 5-羟色胺浓度来改善卒中后运动功能恢复的药物的研究结果。系统检索了 MEDLINE、PubMed、EMBASE 和 Cochrane 卒中组临床试验注册库中截至 2009 年 1 月的文献。此外，还查阅了相关文献的参考文献列表。文献检索的目的是确定专注于药物对卒中后运动功能恢复影响的随机对照试验。为了对数据进行分类，运动恢复被细分为运动控制和运动功能。还对研究的方法学质量进行了评估。共纳入了 6 项研究，涉及 7 种不同药物的作用。方法学评分在 10-14 分之间（最高 19 分）。没有一种药物对运动控制有影响。在接受哌甲酯、曲唑酮和去甲替林治疗的患者中，运动功能得到了改善。氟西汀和左旋多巴的结果相互矛盾。目前尚无足够的证据表明针对 5-羟色胺、去甲肾上腺素或多巴胺的神经调节药物能影响卒中后的运动恢复。
