Levodopa combined with physiotherapy enhances recovery after stroke

מתוך medicontext.co.il

By Karla Gale

LONDON (Reuters Health) – Levodopa 100 mg improves the motor recovery effects of physiotherapy in patients with hemiplegia due to stroke, according to German investigators.

Animals have shown enhanced recovery from acquired brain damage when amphetamines were administered for the purpose of increasing brain concentrations of norepinephrine, Dr. Klaus Scheidtmann and associates report in The Lancet for September 8. In this study, they hoped to see similar effectiveness with levodopa, which is metabolized and converted in the brain to norepinephrine.

The investigators enrolled patients who had experienced thromboembolic brain infarction no more than 6 months previously. They randomly assigned 22 patients to receive levodopa 100 mg in combination with carbidopa and 25 to receive placebo. Drug treatment was carried out concurrently with physical therapy for 3 weeks, after which physical therapy alone was continued.

"We found improvement in all aspects [of measured motor function] of the levodopa group compared with the placebo group," Dr. Scheidtmann, who is associated with the Neurologische Klinik in Bad Aibling, told Reuters Health.

He and his colleagues were particularly impressed with the improvements in arm function experienced by patients treated with levodopa. "In clinical experience, a lot of stroke patients finally learn how to walk, but a lot do not regain function in their arms," Dr. Scheidtmann said. "If this [improvement in arm function] holds true, it could be a tremendous change."

He noted that the research team also measured memory in the patients and observed similar benefits. He and his colleagues plan to replicate the study "on a multicenter basis in the near future," he said.

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