Effect of cilostazol administration on cerebral hemodynamics and rehabilitation outcomes in poststroke patients.

摘要

PRIMARY OBJECTIVE: Cilostazol is an antiplatelet agent that inhibits phosphodiesterase III in platelets and the vascular endothelium. We assessed the effects of cilostazol on human cerebral hemodynamics and rehabilitation outcomes. RESEARCH DESIGN: Prospective, consecutive, observational trial with pretreatment and posttreatment evaluations. EXPERIMENTAL INTERVENTIONS: Cilostazol (200 mg/day) administered for 8 weeks. METHODS AND PROCEDURES: Cerebral blood flow at rest, cerebrovascular reserve capacity, and rehabilitation outcomes (Brunnstrom stage, Barthel index score, modified Rankin Scale score, and Mini-Mental State Examination score) were measured in 104 poststroke patients with an average age +/- standard deviation of 60.8 +/- 9.2 years. MAIN OUTCOMES AND RESULTS: The cerebral blood flow increased by 23.8% on the affected side of the brain and by 16.9% on the nonaffected side. The cerebrovascular reserve capacity increased by 19.0% on the affected side of the brain and by 13.3% on the nonaffected side. Improvements were observed in the Brunnstrom stage, Barthel index score, modified Rankin Scale score, and Mini-Mental State Examination score. CONCLUSIONS: Cilostazol appeared to have beneficial effects in poststroke patients with cerebral ischemia and might improve cerebral circulation and rehabilitation outcome.