Senda Joe, Ito Keiichi, Kotake Tomomitsu, Kanamori Masahiko, Kishimoto Hideo, Kadono Izumi, Nakagawa-Senda Hiroko, Wakai Kenji, Katsuno Masahisa, Nishida Yoshihiro, Ishiguro Naoki, Sobue Gen
Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan.
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2019 Aug;81(3):359-373. doi: 10.18999/nagjms.81.3.359.
Cilostazol is a phosphodiesterase III-inhibiting antiplatelet agent that is often used to prevent stroke and peripheral artery disease, and its administration has shown significant improvements for cognitive impairment. We investigate the potential of cilostazol for reducing or restoring cognitive decline during convalescent rehabilitation in patients with non-cardioembolic ischemic stroke. The study sample included 371 consecutive patients with lacunar (n = 44) and atherothrombosis (n = 327) subtypes of non-cardioembolic ischemic stroke (224 men and 147 women; mean age, 72.9 ± 8.1 years) who were required for inpatient convalescent rehabilitation. Their medical records were retrospectively surveyed to identify those who had received cilostazol (n = 101). Patients were grouped based on cilostazol condition, and Functional Independence Measure (FIM) scores (total and motor or cognitive subtest scores) were assessed both at admission and discharge. The gain and efficiency in FIM cognitive scores from admission to discharge were significantly higher in patients who received cilostazol than those who did not (p = 0.047 and p = 0.035, respectively); we found no significant differences in other clinical factors or scores. Multiple linear regression analysis confirmed that cilostazol was a significant factor in FIM cognitive scores at discharge (β = 0.041, B = 0.682, p = 0.045); the two tested dosages were not significantly different (100 mg/day, n = 43; 200 mg/day, n = 58). Cilostazol can potentially improve cognitive function during convalescent rehabilitation of patients with non-cardioembolic ischemic stroke, although another research must be needed to confirm this potential.
西洛他唑是一种磷酸二酯酶III抑制性抗血小板药物,常用于预防中风和外周动脉疾病,其应用已显示出对认知障碍有显著改善。我们研究西洛他唑在非心源性缺血性中风患者康复期减少或恢复认知衰退的潜力。研究样本包括371例连续的非心源性缺血性中风的腔隙性(n = 44)和动脉粥样硬化血栓形成(n = 327)亚型患者(224例男性和147例女性;平均年龄72.9±8.1岁),这些患者需要住院康复治疗。对他们的病历进行回顾性调查以确定那些接受过西洛他唑治疗的患者(n = 101)。根据西洛他唑治疗情况对患者进行分组,并在入院和出院时评估功能独立性测量(FIM)评分(总分以及运动或认知子测试评分)。接受西洛他唑治疗的患者从入院到出院的FIM认知评分增益和效率显著高于未接受治疗的患者(分别为p = 0.047和p = 0.035);我们发现其他临床因素或评分无显著差异。多元线性回归分析证实西洛他唑是出院时FIM认知评分的一个重要因素(β = 0.041,B = 0.682,p = 0.045);两种测试剂量无显著差异(100毫克/天,n = 43;200毫克/天,n = 58)。西洛他唑可能会改善非心源性缺血性中风患者康复期的认知功能,尽管还需要另一项研究来证实这一潜力。