Abstract
Objective
To investigate the effects of single doses of a selective serotonin reuptake inhibitor
(SSRI) on lower limb voluntary and reflex function in individuals with chronic stroke.
Design
Double-blind, randomized, placebo-controlled crossover trial.
Setting
Outpatient research setting.
Participants
Individuals (N=10; 7 men; mean age ± SD, 57±10y) with poststroke hemiplegia of >1
year duration who completed all assessments.
Interventions
Patients were assessed before and 5 hours after single-dose, overencapsulated 10-mg
doses of escitalopram (SSRI) or placebo, with 1 week between conditions.
Main Outcome Measures
Primary assessments included maximal ankle and knee isometric strength, and velocity-dependent
(30°/s–120°/s) plantarflexor stretch reflexes under passive conditions, and separately
during and after 3 superimposed maximal volitional drive to simulate conditions of
increased serotonin release. Secondary measures included clinical measures of lower
limb coordination and locomotion.
Results
SSRI administration significantly increased stretch reflex torques at higher stretch
velocities (eg, 90°/s; P=.03), with reflexes at lower velocities enhanced by superimposed voluntary drive
(P=.02). No significant improvements were seen in volitional peak torques or in clinical
measures of lower limb function (lowest P=.10).
Conclusions
Increases in spasticity but not strength or lower limb function were observed with
single-dose SSRI administration in individuals with chronic stroke. Further studies
should evaluate whether repeated dosing of SSRIs, or as combined with specific interventions,
is required to elicit significant benefit of these agents on lower limb function poststroke.
Keywords
List of abbreviations:
5-HT (5-hydroxytryptamine (serotonin)), MG (medial gastrocnemius), MVC (maximum volitional contraction), SCI (spinal cord injury), 6MWD (6-minute walking distance), SSRI (selective serotonin reuptake inhibitor), TA (tibialis anterior), UMN (upper motor neuron)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 13, 2015
Footnotes
Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133G060124).
Clinical Trial Registration No.: NCT01751854.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
