Saturday, April 24, 2010
The Buck Institute for Age Research has been studying the possibility that antidepressants and mood stabilizers, like lithium for example, could have positive effects on stroke victims. The growth of new neurons has been known to diminish the effects of a stroke as well as dramatically improve impaired functions after a stroke, while those types of medications have been found to encourage neurogenesis in rodents. "What this study shows more convincingly than in the past is that the production of new neurons after stroke is beneficial in rodents," said Buck faculty member and senior author David Greenberg, MD, PhD. "Assuming that neurogenesis is also beneficial in humans, drugs approved by the FDA for other purposes and already shown to promote new neuron growth in rodents might be worth studying as a potential treatment for stroke in humans. For example, antidepressants are often used to treat post-stroke depression, but their potential for improving outcome from stroke itself is less certain."Researchers compared the size of a stroke and the recovery from stroke in genetically altered mice that either had the ability to grow new neurons or not. It was discovered that mice without the ability to grow new neurons suffered strokes 30% larger; whereas the mice with the ability to grow new neurons showed dramatic improvement of motor functions following a stroke.
Although this new research sounds very exciting, Greenberg cautions that people should not attempt to treat themselves until clear evidence is made official as testing has not been rigorous enough to determine if negative effects exist or whether these positive effects can be seen in humans. Testing these medications that stimulate the growth of neurons could lead to other exciting discoveries for many other age-related disorders, such as Alzheimer’s, Parkinson’s and Huntington’s disease.
“Stroke is the third leading cause of death in the U.S. and is the leading cause of serious long-term disability in this country. Treatments for stroke are limited. Clot busting drugs, which have to be given within hours of the stroke, have been of great benefit to a small number of patients, but stroke is not usually diagnosed in time for them to be used.”What is a stroke?
A stroke (sometimes called a cerebrovascular accident (CVA)) is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain, caused by a blocked or burst blood vessel. This can be due to ischemia (lack of glucose and oxygen supply) caused by thrombosis or embolism or due to a hemorrhage. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.
What factors lead to a higher risk of stroke?
- advanced age
- hypertension
- a previous stroke or transient ischemic attack (TIA)
- diabetes
- high cholesterol
- cigarette smoking
- atrial fibrillation
Symptoms of a stroke that affects the central nervous system include:
- hemiplegia and muscle weakness of the face
- numbness
- reduction in sensory or vibratory sensation
Symptoms of a stroke that affects the brain stem include:
- altered smell, taste, hearing, or vision
- drooping of eyelid and weakness of ocular muscles
- decreased reflexes (gag, swallow, pupil reactivity to light)
- decreased sensation and muscle weakness in the face
- balance problems and nystagmus (involuntary eye movement)
- altered breathing and heart rate
- weakness in sternocleidomastoid muscle with an inability to turn the head to one side
- weakness in tongue (inability to protrude and/or move from side to side)
- aphasia (inability to speak or understand language from involvement of Broca's or Wernicke's area)
- apraxia (altered voluntary movements)
- visual field defect
- memory deficits (with damage to the temporal lobe)
- hemineglect (a deficit in attention to and awareness of one side of space is observed when there is damage to the parietal lobe)
- disorganized thinking, confusion, hypersexual gestures (with damage to the frontal lobe)
- anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)
- trouble walking
- altered movement coordination
- vertigo and or disequilibrium
Disability affects 75% of stroke survivors enough to decrease their employability. Stroke can affect patients physically, mentally, emotionally, or a combination of the three. The results of stroke vary widely depending on size and location of the lesion. Dysfunctions correspond to areas in the brain that have been damaged.
Some of the physical disabilities that can result from stroke include:
- paralysis
- numbness
- pressure sores
- pneumonia
- incontinence
- apraxia (inability to perform learned movements)
- difficulties carrying out daily activities
- appetite loss
- speech loss
- vision loss
- pain
- coma
- death
- anxiety
- panic attacks
- flat affect (failure to express emotions)
- mania
- apathy
- psychosis
- depression (characterized by lethargy, irritability, sleep disturbances, lowered self esteem, and withdrawal)
- emotional lability (a rapid switch between emotional highs and lows and an inappropriate expression of emotions
- speech problems
- dementia
- attention and memory problems
- anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)
- hemispatial neglect (inability to attend to anything on the side of space opposite to the damaged hemisphere)
- seizures
Antidepressants as Treatment Immediately Following a Stroke?
Stroke
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Anti-Depressants, Blood Clot, Brain Stem, Central Nervous System, Cerebellum, Cerebral Cortex, Depression, Diabetes, Disability, Lithium, Neurogenesis, Neuron, Speech, Stroke, Thrombosis
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