Atomoxetine administration combined with intensive rehabilitation therapy for post-stroke

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K16444
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Yamada Naoki 東京慈恵会医科大学, 医学部, 助教 (90756149)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: リハビリテーション / アトモキセチン / SNRI / 脳機能画像 / 経頭蓋磁気刺激 / 脳卒中後遺症 / 高次脳機能障害

Outline of Final Research Achievements

Our proposed combined protocol of atomoxetine administration and rehabilitation methods was safely tolerated, and improved cognitive function in some patients after stroke. Although further studies with a larger number of patients and healthy controls needs to be performed, atomoxetine administration combined with other therapeutic interventions.This study had certain limitations, which will have to be addressed in future studies. First, this study included a relatively small number of subjects with only about ten patients with stroke. The safety and efficacy of atomoxetine administration should be confirmed in a randomized controlled trial with a larger number of patients. Second, the long-term effects of the combined
treatment were not examined. More specifically, this study protocol lasted 4 weeks after beginning the intervention. Third, using various brain imaging analyses of the extent of brain plasticity could be useful to evaluate the effect of combined this protocol.

Free Research Field

脳卒中

Academic Significance and Societal Importance of the Research Achievements

アトモキセチン内服併用での経頭蓋磁気刺激（TMS）とリハビリテーションの安全性と有用性を確認し,脳血流画像において全脳における血流改善効果の可能性を認め,報告した.慢性期でありながら,リハビリテーションの効果を最大限に引き出すために,脳の機能変化機能を高める目的でアトモキセチンを投与し,高次脳機能障害の改善も認めた.他にも,ドーパミン系,セロトニン系に作用する薬剤でも,実験レベルでは報告が散見される.今後,こうした脳神経機能変化を促す薬剤の研究が望まれ,脳の機能変化能力を高めた状態でのリハビリテーション提供で,慢性期などの治らないと考えられていた患者に希望を与えうる結果を提供できたと考える.