Effect of ibudilast on non-specific symptoms in patients with chronic cerebral ischemia. Analysis of cerebral blood flow.

BACKGROUND AND PURPOSE: Many patients with chronic cerebrovascular disease complain that dizziness and depression negatively affect their daily lives. In these patients, ibudilast (CAS 50847-11-5) reportedly ameliorated dizziness. The efficacy of ibudilast was investigated and its effect on the cerebral blood flow (CBF) was recorded.

METHODS: The study population consisted of 11 patients (male and female) with chronic cerebrovascular disease complaining of dizziness or depression. They received 30 mg of ibudilast orally per day. The grade of vertigo and depression at entry into this study and 2 and 6 months after the start of therapy was recorded. Their depressive state was scored with the Japan Stroke Scale-Depression Scale (JSS-D) and their cerebral blood flow (CBF) was measured before and approximately 3 months after the start of ibudilast therapy.

RESULTS: At 6 months after the start of ibudilast therapy, all patients reported the resolution of dizziness; of the 6 patients with depression at entry, all experienced significant improvement. At 3 months, the CBF was significantly increased in the right frontal (p = 0.019) and occipital cortex (p = 0.004) with no significant changes in the cerebellar folia, subcortical gray matter (striatum and thalamus), and other cerebral cortices in the right cerebral hemisphere. There were no significant CBF changes in any areas of the left cerebral hemisphere.

CONCLUSION: In patients treated with ibudilast, the amelioration of dizziness and depression was accompanied by a CBF increase in the right frontal and occipital cortices. These findings suggest that the right frontal and occipital cortices may be related to their dizziness and depression.