scholarly journals Effect of antidepressant therapy on executive function after stroke

2007 ◽  
Vol 190 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Kenji Narushima ◽  
Sergio Paradiso ◽  
David J. Moser ◽  
Ricardo Jorge ◽  
Robert G. Robinson
Keyword(s):  
Executive Function ◽  
Antidepressant Treatment ◽  
Executive Dysfunction ◽  
Active Treatment Group ◽  
Double Blind ◽  
Term Outcome ◽  
Significant Group ◽  
Long Term Outcome ◽  
End Of Treatment

BackgroundExecutive dysfunction is common after stroke and may impair long-term outcome. Remedies for this condition are limited.AimsTo examine the effect of antidepressants on executive function after stroke.MethodForty-seven patients who had had a stroke during the prior 6 months received 12 weeks of antidepressant treatment in double-blind placebo-controlled fashion, followed by assessment of executive function at the end of treatment and after 2 years.ResultsNo significant group effect was found at the end of treatment. However, 21 months after the end of treatment the placebo group showed deterioration of executive function, whereas the active treatment group showed clear and significant improvement independent of depressive symptoms (F=12.1, d.f.=1,45, P= 0.001).ConclusionsAntidepressant treatment fosters long-term improvement of executive function following stroke. This phenomenon is consistent with a reorganisation of neuronal networks associated with prefrontal functions based on modulation of monoaminergic neurotransmission and the activity of neurotrophins.

Early Aneurysm Surgery and Preventive Therapy with Intravenously Administered Nimodipine: A Multicenter, Double-Blind, Dose-Comparison Study

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Joachim M. Gilsbach ◽  
Hans J. Reulen ◽  
Bengt Ljunggren ◽  
Lennart Brandt ◽  
Hans v. Holst ◽  
...  
Keyword(s):  
Preventive Therapy ◽  
Neurological Dysfunction ◽  
Comparison Study ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dose Comparison ◽  
Significant Difference ◽  
Low Incidence

Abstract A European, multicenter. prospective, randomized. double-blind, dose-comparison study on preventive therapy with intravenously administered nimodipine was performed to evaluate the efficacy and tolerability of two different doses: 2 and 3 mg/h. Two hundred four patients fulfilled the criteria for enrollment in the study; surgery within 72 hours after the last subarachnoid hemorrhage, and age between 16 and 72 years. All patients who had Hunt and Hess grades of I to III were operated upon: patients who had poor Hunt and Hess grades (IV-V) were operated on according to the surgeon's choice. This treatment regimen was associated with a low incidence of delayed neurological dysfunction with no significant difference between the two dosage groups: three patients (1.5%) remained severely disabled and two (1%) moderately disabled due to vasospasm with or without additional complications. Among the patients with Hunt and Hess grades of IV or V. the long-term outcome was favorable (good-fair) for 40% and unfavorable for 60%. Among the patients with grades of I to III, the long-term outcome was favorable for 89% and unfavorable for 11%.

Long-Term Outcome of Panic States During Double-Blind Treatment and After Withdrawal of Alprazolam and Placebo

1992 ◽  
Vol 4 (4) ◽  
pp. 251-258 ◽  
Author(s):  
Stephen Dager ◽  
Peter Roy-Byrne ◽  
Helen Hendrickson ◽  
Deborah Cowley ◽  
David Avery ◽  
...  
Keyword(s):  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome

A Pilot Study for a Prospective, Randomized, Double-Blind Trial of the Influence of Anesthetic Depth on Long-Term Outcome

2014 ◽  
Vol 58 (5) ◽  
pp. 237-238
Author(s):  
Timothy G. Short ◽  
Kate Leslie ◽  
Douglas Campbell ◽  
Matthew T. V. Chan ◽  
Tomas Corcoran ◽  
...  
Keyword(s):  
Pilot Study ◽  
Double Blind Trial ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anesthetic Depth ◽  
Blind Trial

A Pilot Study for a Prospective, Randomized, Double-Blind Trial of the Influence of Anesthetic Depth on Long-Term Outcome

2014 ◽  
Vol 118 (5) ◽  
pp. 981-986 ◽  
Author(s):  
Timothy G. Short ◽  
Kate Leslie ◽  
Douglas Campbell ◽  
Matthew T. V. Chan ◽  
Tomas Corcoran ◽  
...  
Keyword(s):  
Pilot Study ◽  
Double Blind Trial ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anesthetic Depth ◽  
Blind Trial

scholarly journals CHInese Medicine NeuroAiD Efficacy on Stroke Recovery - Extension Study (CHIMES-E): A Multicenter Study of Long-Term Efficacy

2015 ◽  
Vol 39 (5-6) ◽  
pp. 309-318 ◽  
Author(s):  
Narayanaswamy Venketasubramanian ◽  
Sherry H. Young ◽  
San San Tay ◽  
Thirugnanam Umapathi ◽  
Annabelle Y. Lao ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Functional Independence ◽  
Stroke Recovery ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Time Points

Background: The CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) study was an international randomized double-blind placebo-controlled trial of MLC601 (NeuroAiD) in subjects with cerebral infarction of intermediate severity within 72 h. CHIMES-E (Extension) aimed at evaluating the effects of the initial 3-month treatment with MLC601 on long-term outcome for up to 2 years. Methods: All subjects randomized in CHIMES were eligible for CHIMES-E. Inclusion criteria for CHIMES were age ≥18, baseline National Institute of Health Stroke Scale of 6-14, and pre-stroke modified Rankin Scale (mRS) ≤1. Initial CHIMES treatment allocation blinding was maintained, although no further study treatment was provided in CHIMES-E. Subjects received standard care and rehabilitation as prescribed by the treating physician. mRS, Barthel Index (BI), and occurrence of medical events were ascertained at months 6, 12, 18, and 24. The primary outcome was mRS at 24 months. Secondary outcomes were mRS and BI at other time points. Results: CHIMES-E included 880 subjects (mean age 61.8 ± 11.3; 36% women). Adjusted OR for mRS ordinal analysis was 1.08 (95% CI 0.85-1.37, p = 0.543) and mRS dichotomy ≤1 was 1.29 (95% CI 0.96-1.74, p = 0.093) at 24 months. However, the treatment effect was significantly in favor of MLC601 for mRS dichotomy ≤1 at 6 months (OR 1.49, 95% CI 1.11-2.01, p = 0.008), 12 months (OR 1.41, 95% CI 1.05-1.90, p = 0.023), and 18 months (OR 1.36, 95% CI 1.01-1.83, p = 0.045), and for BI dichotomy ≥95 at 6 months (OR 1.55, 95% CI 1.14-2.10, p = 0.005) but not at other time points. Subgroup analyses showed no treatment heterogeneity. Rates of death and occurrence of vascular and other medical events were similar between groups. Conclusions: While the benefits of a 3-month treatment with MLC601 did not reach statistical significance for the primary endpoint at 2 years, the odds of functional independence defined as mRS ≤1 was significantly increased at 6 months and persisted up to 18 months after a stroke.

Controlled efficacy study of fluoxetine in dysthymia

1997 ◽  
Vol 170 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Jean-Marie Vanelle ◽  
Dominique Attar-Levy ◽  
Marie-France Poirier ◽  
Myriam Bouhassira ◽  
Patrick Blin ◽  
...  
Keyword(s):  
Additional Treatment ◽  
Group 14 ◽  
Short Term ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Randomised Study ◽  
End Point

BackgroundThere have been very few controlled studies of antidepressants in dysthymia, particularly in samples diagnosed reliably and with an adequate length of follow-up. In this investigation, we measured the long-term outcome in a large group of patients meeting DSM – III -R criteria for dysthymia. This study was designed to investigate whether fluoxetine is effective in the treatment of dysthymia.MethodThis randomised study, including 140 patients, compared fluoxetine (91 patients) and placebo (49 patients) on a double-blind basis in two distinct phases: a short-term end-point (3 months with 20 mg/day fluoxetine) and a medium-term end-point (6 months) where the initial responders continued double-blind treatment unchanged and non-responders received an additional treatment of 20 mg/day fluoxetine.ResultsAfter three months of treatment, response was seen more frequently in the fluoxetine group (42/72) than in the placebo group (14/39, P <0.0001). Improved patients at 3 months were still improved at 6 months. Furthermore, 50% of the non-responders at 3 months improved and rated as responders at 6 months, after fluoxetine was increased to 40 mg daily.ConclusionsThis study showed the significant and persistent action of fluoxetine on dysthymia. The finding that 50% of the non-responders at 3 months were improved at 6 months, after fluoxetine dosage was increased to 40 mg daily, argues in favour of treating dysthymic patients for at least 6 months, and with a higher dosage if the initial doses are ineffective.

scholarly journals Testing non-inferiority of blended versus face-to-face Cognitive Behavioural Therapy for severe fatigue in patients with Multiple Sclerosis and the effectiveness of blended booster sessions aimed at improving long term outcome following both therapies: – study protocol for two observer-blinded randomized clinical trials

2019 ◽  
Author(s):  
Marieke Houniet- de Gier ◽  
Heleen Beckerman ◽  
Kimberley van Vliet ◽  
Hans Knoop ◽  
Vincent de Groot
Keyword(s):  
Clinical Trials ◽  
Behavioural Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
Booster Sessions ◽  
Fatigue Severity

Abstract Background: Cognitive behavioural therapy (CBT) has been found effective in reducing fatigue severity in MS patients directly following treatment. However, long-term effects are inconsistent leaving room for improvement. In addition, individual face-to-face CBT draws heavily on limited treatment capacity, and the travel distance to the treatment centre can be burdensome for patients. Therefore, we developed “MS Fit”, a blended CBT for MS-related fatigue, based on a face-to-face CBT protocol found effective in a previous study, and “MS Stay Fit”, internet-based booster sessions to improve long term effectiveness of CBT for MS-related fatigue. This paper presents the protocol of two Randomised Clinical Trials (RCTs) conducted within one study investigating 1) the non-inferiority of MS Fit compared to evidence-based face-to-face CBT for MS-related fatigue, and 2) the effectiveness of MS Stay Fit on the long-term outcome of fatigue compared to no booster sessions. Methods/design: The first part of this study is an observer-blinded non-inferiority multicentre RCT, in which 166 severely fatigued MS patients will be randomized (1:1 ratio, computer-generated sequence) to either face-to-face CBT or blended CBT (MS Fit) for fatigue. The primary endpoint is at 20 weeks after baseline. After this post-treatment assessment, patients will be randomized again (1:1 ratio, computer generated sequence) to either MS Stay Fit consisting of 2 booster sessions at 2 and 4 months after end of treatment, or no booster sessions. The primary endpoint of the second study is 52 weeks after baseline. Primary outcome measure in both studies is fatigue severity assessed with the fatigue severity subscale of the Checklist Individual Strength (CIS20r). Outcomes will be assessed at baseline (T0), end of treatment (T20), after 39 and 52 weeks (T39 and T52). Discussion: If MS Fit is found to be non-inferior to face-to-face CBT it will improve the accessibility of this treatment. In addition, the study aims to test if it is possible to improve long-term effectiveness of CBT for MS-related fatigue with MS Stay Fit.

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