Stroke rehabilitation and dopamine

BACKGROUND: Functional disability is generally caused by hemiplegia after stroke. Physiotherapy used to be the only way of improving motor function in such patients. However, administration of amphetamines in addition to exercise improves motor recovery in animals, probably by increasing the concentration of norepinephrine in the central nervous system. Our aim was to ascertain whether levodopa could enhance the efficacy of physiotherapy after hemiplegia. METHODS: We did a prospective, randomised, placebo-controlled, double-blind study in which we enrolled 53 primary stroke patients...

OBJECTIVE: To evaluate the efficacy of carbidopa L-dopa (Sinemet) in reducing left spatial neglect after stroke. DESIGN: Case series. SETTING: Inpatient neurorehabilitation unit in a regional rehabilitation center. PARTICIPANTS: A convenience sample of 4 women with right brain strokes and left neglect. INTERVENTION: A trial of carbidopa L-dopa to treat left neglect, if indicated by selected subtests of the Behavioral Inattention Test (BIT)...

PURPOSE: Visuospatial inattention or sensory neglect is a common impairment following cerebrovascular accident and is thought to negatively impact on functional recovery and long-term outcome. This review examines various rehabilitative interventions available for the management of visuospatial inattention and the literature that supports their efficacy. METHOD: Medical literature review. RESULTS: Therapies geared toward improved visual scanning and 'retraining' of patients to attend to the neglected field are the mainstay of current therapy...

The mechanisms that enhance recovery from brain lesion are more and more precise. The role of neurotransmitters and post-synaptic receptors are essential. Different drugs acting at the level of synapses are potentially useful but still few used in neurorehabilitation. The aim of this article is to review the drugs that can be prescribed in selected situation. In spite of encouraging results of numerous studies, a lot of questions remain and prove the need of large randomised studies to determine the real benefit of drugs in rehabilitation...

OBJECTIVE: To study the frequency of intractable hiccups during stroke rehabilitation and the impact on rehabilitation management. DESIGN: Case series, retrospective chart review. SETTING: Inpatient stroke rehabilitation floor within a tertiary care teaching hospital. PATIENTS: Three patients admitted for stroke rehabilitation with hiccups of at least 48 hours out of 270 consecutive cases. INTERVENTIONS: None...

BACKGROUND: Communication problems are a common sequela of cerebrovascular disease and other central nervous system disorders. Behavioral treatment of these disorders aims to harness uninjured parts of the brain to improve the communicative life of the individual. While pharmacotherapy has held promise for the treatment of aphasia for over 50 years, it has not fulfilled this promise. This article reviews both the promise and the disappointment of aphasia pharmacotherapy. SUMMARY OF REVIEW: Diverse theories of the underlying neurological deficits in aphasia have led to different pharmacologic rationales for therapy...

Drugs, either self-administered or prescribed by physicians, can result in substantial neurologic disability in psychiatric patients. It is clear that the use of neuroleptic agents to treat psychiatric illness may result in a variety of tardive movement disorders. Most commonly, these take the form of orobuccal dyskinesias, but choreic movements of the trunk and extremities, dystonic postures, myoclonus, tics, parkinsonism, and akathisic syndromes also may occur. The choreic tardive syndromes are thought to occur more commonly in the elderly female population, but tardive variants may affect a different population...