Researchers in the neurology department at Johns Hopkins have shown that a generic selective serotonin reuptake inhibitor may help human stroke victims.
Steven Zeiler and his team administered fluoxetine, better known under the trade name Prozac, to mice and increased the time that physical therapy remains effective after an ischemic stroke--a sudden loss of blood circulation to the brain brought about by a blood clot. Zeiler is lead author of the study, which was published in the journal Stroke.
Physical therapy is part of an intense rehabilitation program given to recent stroke patients and is crucial for motor function recovery that would otherwise be lost. For some patients who are too ill to start the therapy, this pharmacotherapy may hold great value.
"For rehabilitation to be effective it needs to start as soon after a stroke as possible," says Zeiler. "But with this study, we've shown that in mice, we can extend the time period during which rehabilitative intervention has an effect on meaningful recovery."
The fact that a selective serotonin reuptake inhibitor improves patient recovery was known from a previous trial called FLAME: "Fluoxetine for motor recovery after acute ischemic stroke." The current research took this data and looked at what fluoxetine may be doing to improve recovery after stroke.
After training the mice to reach through a slit to grab a food pellet--the researchers induced a stroke in the motor area that affected the ability to perform the above task. Similar to what has been observed in human patients they found early rehab intervention, after stroke, improved motor function dramatically--i.e., the ability for the mice to successfully reach and obtain the food pellet was recovered.
They also found that by administering fluoxetine daily to the mice starting from 24 hours poststroke, they could begin rehab a week after the stroke with sufficient motor recovery.
"We believe the drug is changing plasticity," says Zeiler. "Changing the way individual neurons are responding to sensory input after the stroke."
"Time still matters; it's key," warns Zeiler. The window of opportunity for full motor recovery started fluoxetine treatment 24 hours after stroke, whereas if fluoxetine administration was delayed by a week the mice did not fully recover.
- here's the release
- get the research abstract