Stroke Rehabilitation
April 1, 2017
By Matthew E. Fink, MD, Editor
Feil Professor and Chairman, Department of Neurology, and Assistant Dean of Clinical Affairs, Weill Cornell Medical College; Neurologist-in-Chief, New York Presbyterian Hospital
Dr. Fink reports he is a consultant for Procter & Gamble.
Nimodipine for Acute Ischemic Stroke
Huaguang Zheng, from Beijing, presented the results of a prospective, randomized treatment trial with the calcium antagonist, nimodipine, in patients with acute ischemic stroke to determine if nimodipine therapy would decrease the risk of patients going on to develop vascular cognitive impairment. The authors assigned 329 participants to receive nimodipine and 325 to receive placebo in a trial that took place at 23 sites in China. A total of 476 patients were followed at six months and were involved in the final analysis. Nimodipine was administered in the treatment group (30 mg, three times a day) vs. placebo. Primary outcome measurements were change in cognitive function on the Mini-Mental State Examination from baseline to six months, or the vascular AD Assessment Scale from baseline to six months. Secondary endpoints included change in scores from baseline to six months on the Montréal Cognitive Assessment and the Frontal Assessment Battery. The primary outcome measures were similar between the two groups, and the secondary outcome measures did not differ significantly between the nimodipine and placebo groups. There were suggestions that isolated cognitive functions might have been influenced, but on balance, there were no significant differences between the two groups on any cognitive assessment scales. In conclusion, as used in this study at the dose of 30 mg three times a day, nimodipine did not prevent decline in cognitive function in acute stroke patients compared to the placebo.
These articles are based on the editor's personal interactions as a participant at the International Stroke Conference in Houston, Feb. 22-24, 2017. All interpretations and opinions are exclusively those of the editor.
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