Ischemic Stroke Clinical Trial
Official title:
Donepezil to Promote Functional Recovery Post-stroke
This is a 12-week, randomized, placebo controlled study to determine if donepezil (Aricept) treatment during rehabilitation after stroke improves functional recovery.
Stroke is a leading cause of disability in the US (Thom 2006). The total number of stroke
survivors (currently estimated as 5.5 million Americans) will continue to increase as the
population ages and as the medical management of acute stroke continues to improve. Given
stroke's devastating impact on activities of daily living and the large numbers of Americans
afflicted, improving acute medical rehabilitation outcomes after stroke is of great public
health importance.
Predictors of poor functional recovery post-stroke include impairments in cognition and
motivation. Recent evidence indicates that acetylcholinesterase inhibitors may improve
cognition and motivation; hence, their use post-stroke may lead to improved rehabilitation
outcomes. Our group has demonstrated that use of the acetylcholinesterase inhibitor
donepezil is associated with improved functional recovery in a pilot sample (n = 40) of
elderly, cognitively impaired stroke survivors undergoing inpatient rehabilitation.
Specifically, in this 12 week open-label study, those subjects receiving donepezil
experienced a clinically meaningful 14 point greater improvement on the Functional
Independence Measure (FIM) than an archival comparator group.
Based on these promising pilot study results, we propose a 12-week randomized, double-blind,
placebo-controlled trial (followed by a 12 week off-drug observation period) in order to
test the efficacy of donepezil to promote post-stroke functional recovery in older,
cognitively impaired stroke survivors undergoing inpatient rehabilitation. We will also use
this randomized controlled trial to examine the drug's effect on cognition post-stroke;
specifically, the drug's effect on those cognitive domains (attention/working memory,
information psychomotor speed, and episodic memory) that are relevant to functional
outcomes.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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