Acorda Therapeutics, Inc, Ardsley, NY, USA.
Stroke. 2013 Jul;44(7):1942-50. doi: 10.1161/STROKEAHA.111.000147. Epub 2013 May 7.
Stroke survivors often have permanent deficits that are only partially addressed by physical therapy. This study evaluated the effects of dalfampridine, a potassium channel blocker, on persistent sensorimotor deficits in rats with treatment initiated 4 or 8 weeks after stroke.
Rats underwent permanent middle cerebral artery occlusion. Sensorimotor function was measured using limb-placing and body-swing symmetry tests, which normally show a partial recovery from initial deficits that plateaus ≈4 weeks after permanent middle cerebral artery occlusion. Dalfampridine was administered starting at 4 or 8 weeks after permanent middle cerebral artery occlusion in 2 blinded, vehicle-controlled studies. Plasma samples were collected and brain tissue was processed for histologic assessment.
Dalfampridine treatment (0.5-2.0 mg/kg) improved forelimb- and hindlimb-placing responses and body-swing symmetry in a reversible and dose-dependent manner. Plasma dalfampridine concentrations correlated with dose. Brain infarct volumes showed no differences between treatment groups.
Dalfampridine improves sensorimotor function in the rat permanent middle cerebral artery occlusion model. Dalfampridine extended-release tablets (prolonged release fampridine outside the United States) are used to improve walking in patients with multiple sclerosis, and these preclinical data provide a strong rationale for examining the potential of dalfampridine to treat chronic stable deficits in stroke patients.
http://www.clinicaltrials.gov. Unique identifier: NCT01605825.
中风幸存者常留有永久性的功能缺损,而这些缺损仅能部分通过物理疗法来改善。本研究评估了钾通道阻断剂二甲弗林对中风后 4 或 8 周开始治疗的大鼠持续性感觉运动功能缺损的疗效。
大鼠行永久性大脑中动脉闭塞术。采用肢体放置试验和躯体摆动对称性试验评估感觉运动功能,这两项试验通常在永久性大脑中动脉闭塞后 4 周左右会出现初始缺损的部分恢复,并在该水平趋于稳定。本研究采用 2 项双盲、安慰剂对照试验,在永久性大脑中动脉闭塞后 4 或 8 周开始给予大鼠二甲弗林治疗。收集血浆样本,并对脑组织进行组织学评估。
二甲弗林(0.5-2.0mg/kg)治疗可剂量依赖性地改善大鼠永久性大脑中动脉闭塞模型的前肢和后肢放置反应以及躯体摆动对称性,且该作用具有可逆转性。血浆二甲弗林浓度与剂量呈正相关。各组大鼠的脑梗死体积无差异。
二甲弗林可改善大鼠永久性大脑中动脉闭塞模型的感觉运动功能。在国外以外延释放形式(prolonged release)使用的二甲弗林控释片(商品名:Fampyra)被用于改善多发性硬化症患者的行走能力,这些临床前数据为进一步研究二甲弗林治疗中风患者慢性稳定期缺损的潜在疗效提供了有力依据。