- 著者
- Senda Joe Ito Keiichi Kotake Tomomitsu Kanamori Masahiko Kishimoto Hideo Kadono Izumi Nakagawa-Senda Hiroko Wakai Kenji Katsuno Masahisa Nishida Yoshihiro Ishiguro Naoki
- 出版者
- Nagoya University Graduate School of Medicine, School of Medicine
- 雑誌
- Nagoya Journal of Medical Science (ISSN:00277622)
- 巻号頁・発行日
- vol.81, no.3, pp.359-373, 2019-08
Cilostazol is a phosphodiesterase III-inhibiting antiplatelet agent that is often used to prevent stroke and peripheral artery disease, and its administration has shown significant improvements for cognitive impairment. We investigate the potential of cilostazol for reducing or restoring cognitive decline during con-valescent rehabilitation in patients with non-cardioembolic ischemic stroke. The study sample included 371 consecutive patients with lacunar (n = 44) and atherothrombosis (n = 327) subtypes of non-cardioembolic ischemic stroke (224 men and 147 women; mean age, 72.9 ± 8.1 years) who were required for inpatient convalescent rehabilitation. Their medical records were retrospectively surveyed to identify those who had received cilostazol (n = 101). Patients were grouped based on cilostazol condition, and Functional Independence Measure (FIM) scores (total and motor or cognitive subtest scores) were assessed both at admission and discharge. The gain and efficiency in FIM cognitive scores from admission to discharge were significantly higher in patients who received cilostazol than those who did not (p = 0.047 and p = 0.035, respectively); we found no significant differences in other clinical factors or scores. Multiple linear regression analysis confirmed that cilostazol was a significant factor in FIM cognitive scores at discharge (β = 0.041, B = 0.682, p = 0.045); the two tested dosages were not significantly different (100 mg/day, n = 43; 200 mg/day, n = 58). Cilostazol can potentially improve cognitive function during convalescent rehabilitation of patients with non-cardioembolic ischemic stroke, although another research must be needed to confirm this potential.
- 著者
- Senda Joe Watanabe Hirohisa Endo Kuniyuki Yasui Keizo Hawsegawa Yasuhiro Yoneyama Noritaka Tsuboi Takashi Hara Kazuhiro Ito Mizuki Atsuta Naoki Epifanio Bagarinao Jr. Katsuno Masahisa Naganawa Shinji Sobue Gen
- 出版者
- Nagoya University Graduate School of Medicine, School of Medicine
- 雑誌
- Nagoya Journal of Medical Science (ISSN:00277622)
- 巻号頁・発行日
- vol.78, no.4, pp.455-463, 2016-11
Voxel-based analysis (VBA) of diffusion tensor images (DTI) and voxel-based morphometry (VBM) in patients with multiple sclerosis (MS) can sensitively detect occult tissue damage that underlies pathological changes in the brain. In the present study, both at the start of fingolimod and post-four months clinical remission, we assessed four patients with MS who were evaluated with VBA of DTI, VBM, and fluid-attenuated inversion recovery (FLAIR). DTI images for all four patients showed widespread areas of increased mean diffusivity (MD) and decreased fractional anisotropy (FA) that were beyond the highintensity signal areas across images. After four months of continuous fingolimod therapy, DTI abnormalities progressed; in particular, MD was significantly increased, while brain volume and high-intensity signals were unchanged. These findings suggest that VBA of DTI (e.g., MD) may help assess MS demyelination as neuroinflammatory conditions, even though clinical manifestations of MS appear to be in complete remission during fingolimod.