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PubMed2004

Ischemic cardiomyopathy: value of different MRI techniques for prediction of functional recovery after revascularization.

OBJECTIVE: The purpose of this study was to compare the value of different MRI techniques for the assessment of myocardial viability. SUBJECTS AND METHODS. Eighteen infarct patients (mean age +/- SD, 62 +/- 8 years) with myocardial ischemia were examined using MRI before and after revascularization. The MRI study before treatment consisted of an evaluation of first-pass perfusion, contractile function at rest and during dobutamine stress, and delayed hyperenhancement. Findings were correlated with segmental and global cardiac function after revascularization. RESULTS: In initially dysfunctional segments, the likelihood of functional recovery after revascularization was 91% for segments without delayed hyperenhancement, 43% for segments with delayed hyperenhancement with transmural extent of 75% or less, and 8% for segments with delayed hyperenhancement with transmural extent of more than 75% (p < 0.05). Improved function at dobutamine stress MRI indicated functional recovery in 87%, whereas functional recovery was observed in only 30% of segments not responding at dobutamine stress MRI (p < 0.05). No significant correlation was found between the results of first-pass perfusion MRI and functional recovery. The ejection fraction after revascularization was best predicted by the MRI-derived infarct volume (p < 0.001, R(2) = 0.63). CONCLUSION: A simple protocol consisting of baseline contractility and delayed enhancement MRI studies is adequate to differentiate dysfunctional but viable from nonviable myocardium. Dobutamine stress and perfusion MRI studies offer little or no additional information.

Aged↗
PubMed2003

Higher Hb level is associated with better early functional recovery after hip fracture repair.

BACKGROUND: The benefits and indications for blood transfusion are controversial. One possible reason to transfuse is to improve functional recovery after major surgery. However, the data linking improved function with higher Hb concentration are limited. STUDY DESIGN AND METHODS: A: retrospective cohort study was performed in 5793 patients at least 60 years old undergoing hip fracture repair at 20 academic and community hospitals. The primary outcome was distance walked at the time of discharge from the hospital. The mean postoperative Hb concentration was the main exposure variable and was defined as the average value from Day 1 after surgery to discharge. We used robust regression to assess the association between postoperative Hb level with distance walked, controlling for other preoperative variables that could influence functional recovery. RESULTS: On bivariate analysis, the predicted distance walked at discharge in feet (95% CI) increased with higher Hb levels (7 g/dL, 56 feet [42-70]; 8 g/dL, 61 feet [54-68]; 9 g/dL, 67 feet [64-70]; 10 g/dL, 74 feet [72-77]; 11 g/dL, 83 feet [80-85]; 12 g/dL, 92 feet [87-96]). After adjustment for other factors associated with ability to walk, higher average postoperative Hb level was independently associated with walking greater distance (p < 0.001). CONCLUSIONS: Higher postoperative Hb level may improve functional recovery after hip fracture repair. If confirmed with clinical trials, this finding would provide a rationale to maintain higher Hb concentrations in elderly patients recovering from surgery.

Aged↗
PubMed2002

Prediction of left ventricular functional recovery by dobutamine echocardiography, F-18 deoxyglucose or 99mTc sestamibi nuclear imaging in patients with chronic myocardial infarction.

BACKGROUND: Currently, several modalities are available to predict viability, however, studies comparing various modalities validated by functional recovery after revascularization are scarce. This study analyzed the relative merits of low-dose dobutamine echocardiography, F-18 deoxyglucose (FDG) positron emission tomography (PET) and (99m)Tc sestamibi single-photon emission computed tomography to predict functional recovery after revascularization in patients with chronic myocardial infarction. METHODS: Patients with chronic coronary occlusion (duration: 3.1 +/- 4.8 years) and impaired left ventricular function (ejection fraction: 42 +/- 13%) underwent low-dose dobutamine echocardiography (20 microg/kg/min), FDG-PET and (99m)Tc sestamibi imaging before revascularization. Revascularization was performed irrespective of any viability data. Follow-up angiography was obtained 4.8 +/- 2.5 months after revascularization. RESULTS: Viability analysis was performed in 34 patients with patent target vessel at follow-up, of whom 9 (27%) exhibited functional recovery on left ventricular angiography. For dobutamine echocardiography, improvement of >/=2 adjacent akinetic segments resulted in improved sensitivity of 89% and specificity of 80% to predict functional recovery. For glucose metabolism, FDG uptake >55% was an optimal threshold yielding a sensitivity of 89% and a specificity of 68%. With respect to perfusion, (99m)Tc sestamibi uptake >60% was the best cutoff resulting in a sensitivity and a specificity of 56 and 88%, respectively. A concordant match of FDG >55% and of (99m)Tc sestamibi >50% resulted in optimized sensitivity (78%) and specificity (80%) with dual imaging. CONCLUSIONS: Recovery of chronically dysfunctional myocardium can be predicted with high accuracy by stimulation of contractile reserve or by concordant match of preserved glucose metabolism and residual perfusion.

Aged↗
PubMed2005

[Usefulness of parametric imaging-based quantitative myocardial contrast echocardiography in predicting the functional recovery of akinetic segments following primary angioplasty in acute myocardial infarction patients].

INTRODUCTION AND OBJECTIVES: Myocardial contrast echocardiography (MCE) is useful for predicting the functional recovery of akinetic segments in patients undergoing primary angioplasty after acute myocardial infraction (AMI). Recently, parametric imaging-based quantitative MCE has been developed for measuring perfusion. Our aims were: a) to measure perfusion in akinetic myocardial segments in patients undergoing primary angioplasty using parametric imaging-based quantitative MCE; and b) to assess the usefulness of these measurements in predicting functional recovery of these segments. PATIENTS AND METHOD: The study group comprised 49 consecutive patients undergoing primary angioplasty. Both MCE and standard echocardiography were performed between 2 and 5 days after AMI. Six months later, additional standard echocardiography and coronary angiography were performed. Perfusion was quantified independently off-line from parametric images. RESULTS: The patients' mean age was 62.3+/-14.5 years (39 men; 79.2%). Some 170 akinetic segments were detected. Of these, 105 (62.1%) recovered function. The quantitative MCE parameter that best predicted functional recovery was myocardial blood flow velocity (beta): the area under the receiver operating characteristic (ROC) curve was 0.96 (95% CI, 0.92-0.99). For a cut-off point of 31 dB/s, the sensitivity was 87.62%, the specificity was 95.31%, the positive predictive value was 96.8%, and the negative predictive value was 82.43%. These results were better than those obtained using qualitative methods for assessing myocardial perfusion. CONCLUSIONS: Perfusion measurement by parametric imaging-based quantitative MCE is useful for predicting the functional recovery of akinetic segments in patients undergoing primary angioplasty after AMI. The technique provides superior information to older qualitative methods.

Aged↗
PubMed2006

Variables explaining functional recovery following motor stroke.

Few well-designed descriptive studies focus exclusively on patients after motor stroke. This study describes a cohort of participants after motor stroke and assesses the extent to which five key variables explain the variation in functional recovery 3 months after stroke. Prospective data were collected (N=100) on age, lesion volume, motor strength, cognition, and poststroke function during the acute care hospital admission. Instruments included magnetic resonance imaging (MRI) to provide a measure of lesion volume, the Mini-Mental State Examination (MMSE) and the Neurobehavioral Cognitive Status Examination (NCSE) to measure cognitive status, and the National Institutes of Health Stroke Scale (NIHSS) to measure motor strength. The Functional Independence Measure (FIM) was used to measure baseline function and functional recovery 3 months after stroke. Descriptive and hierarchical multiple regression analyses were used to describe the cohort and predict functional recovery. The means for key variables during acute care were 65 (+/-15) years of age, lesion volume 21.5 (+/-44.7) cm3, NIHSS 6.34 (+/-3.55), MMSE 24.38 (+/-4.82), NCSE 64.33 (+/-13), and FIMTM 94.05 (+/-19.31). Age, cognitive status, and initial function accounted for 42% of the variance in functional recovery 3 months after stroke. Results indicate that neuroscience nurses need to add cognition to their focus during the fast-paced acute phase of care following motor stroke.

Aged↗
PubMed2005

Geriatric depression, medical diagnosis, and functional recovery during acute rehabilitation.

OBJECTIVE: To examine and compare the prevalence and functional impact of depressive symptoms for older adult stroke and nonstroke rehabilitation inpatients. DESIGN: Case-control study examining functional outcome using a 2 (stroke, nonstroke) by 2 (depression, no depression) design. SETTING: Urban hospital rehabilitation unit. PARTICIPANTS: A total of 509 rehabilitation inpatients (age, > or = 60 y) were included and grouped by diagnosis of stroke (n=207) and nonstroke (n=302). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Geriatric Depression Scale and FIM instrument. Analysis of covariance procedures examined the impact of depressive symptoms on discharge functional ability controlling for age, sex, admission functional ability, and hospital length of stay. RESULTS: Prevalence of depressive symptoms was similar for stroke (31.8%) and nonstroke (31.5%) and negatively associated with functional ability at discharge for both groups. Overall, the stroke and nonstroke groups did not differ significantly with respect to functional recovery. CONCLUSIONS: Depression, and its impact on acute rehabilitation, is significantly related to functional recovery but does not differ in its frequency or impact for stroke patients. Because depressive symptoms do not appear to discriminate across diagnostic groups, routine screening for depression is recommended for all rehabilitation inpatients.

Aged↗
PubMed2004

Relation between wall thickening on gated perfusion SPECT and functional recovery after coronary revascularization in patients with previous myocardial infarction.

PURPOSE: This study aimed to evaluate whether wall thickening analysis by gated perfusion single-photon emission computed tomography (SPECT) is useful in predicting functional recovery after revascularization. METHODS: Forty-one patients with previous myocardial infarction and left ventricular (LV) dysfunction (ejection fraction, EF, 36+/-6%) who were scheduled for revascularization underwent rest 99mTc-sestamibi gated SPECT. RESULTS: Of 131 akinetic or dyskinetic segments at baseline echocardiography, 82 (63%) recovered after revascularization. Compared with wall thickening analysis, perfusion imaging provided higher sensitivity (78% vs 50%, P<0.0001) and specificity (80% vs 71%, P<0.0005). Among segments with > or =55% sestamibi uptake (viable), those with detectable wall thickening had a higher likelihood of functional recovery than those with absent wall thickening (95% vs 77%, P<0.05). In segments with improved function, the absence of wall thickening was associated with lower sestamibi activity than was observed when detectable wall thickening was present (58+/-14% vs 71+/-13%, P<0.0005). An increase in EF of > or =5% was detectable in 22 (54%) patients. For the prediction of EF improvement, perfusion imaging provided a higher sensitivity than wall thickening analysis (68% vs 41%, P<0.05), while specificity was not significantly different (68% vs 74%). The prevalence of patients with functional recovery did not change when wall thickening analysis was considered in addition to perfusion status (73% in patients with detectable wall thickening and 70% in those without; P=NS). CONCLUSION: In patients with coronary artery disease, wall thickening analysis by gated perfusion SPECT provides additional information compared with perfusion data for the prediction of segmental functional recovery. However, on a patient basis, wall thickening assessment seems to be of more limited value than perfusion status.

Adult↗
PubMed1999

Early low-dose dobutamine echocardiography predicts late functional recovery after thrombolyzed acute myocardial infarction.

BACKGROUND: This study was undertaken to evaluate the ability of predischarge low-dose dobutamine echocardiography to predict late left ventricular functional recovery after thrombolyzed acute myocardial infarction. METHODS AND RESULTS: Low-dose dobutamine echocardiography was performed in 54 patients 4 +/- 2 days after acute myocardial infarction treated with thrombolysis. Follow-up resting echocardiography was carried out in 49 of these patients at a mean of 18 +/- 6 months later. Viability was defined as recovery of myocardial function at follow-up, expressed as an improvement of wall motion of at least 1 grade or more in at least 2 contiguous infarct zone segments. In 24 of the 49 patients (group I), wall motion at follow-up improved in comparison with the early resting echocardiographic study (1.72 +/- 0.29 vs 1.37 +/- 0.34, P <.001). In the remaining 25 patients (group II), no wall motion enhancement was seen at follow-up (1.57 +/- 0.38 vs 1.58 +/- 0.36, NS). In 22 of the 24 patients in group I, early low-dose dobutamine echocardiography showed improvement in the wall motion score index compared with baseline resting measurements (1.72 +/- 0.29 vs 1.44 +/- 0.24, P <.001). The positive and negative predictive value of early low-dose dobutamine echocardiography to predict functional recovery was 76% and 92%, respectively. CONCLUSION: Predischarge low-dose dobutamine echocardiography is an accurate tool for detecting viable myocardium and predicting late left ventricular recovery after acute myocardial infarction treated with thrombolysis.

Adrenergic beta-Agonists↗
PubMed2006

Profound differences in spontaneous long-term functional recovery after defined spinal tract lesions in the rat.

The purpose of this study was to compare spontaneous functional recovery after different spinal motor tract lesions in the rat spinal cord using three methods of analysis, the BBB, the rope test, and the CatWalk. We transected the dorsal corticospinal tract (CSTx) or the rubrospinal tract (RSTx) or the complete dorsal half of the spinal cord (Hx) at thoracic level T8. Functional recovery was monitored for 31 weeks. We found no recovery of consistent inter limb coordination in any experimental group over time using the BBB locomotor rating scale. Quantitative CatWalk analysis revealed significant differences between experimental groups for inter limb coordination (RI). RSTx and Hx animals showed a significant decrease in the RI, and only in the RSTx group did the RI improve from 6 weeks post-lesion onward. Significant differences between experimental groups in step sequence patterns and base of support were also observed. In the rope test all experimental groups had significantly higher error percentages compared to control animals. Tracing of the CST revealed enhanced collateral formation rostral to the lesion in the CSTx group, not in other groups. The results presented here show that locomotor function in all, but CSTx groups gradually improved over time. This is important for studies that employ pharmacological, cell-, and/or gene therapy- based interventions to improve axonal regeneration and functional recovery after spinal cord injury.

Animals↗
PubMed1997

Brain lactate is an obligatory aerobic energy substrate for functional recovery after hypoxia: further in vitro validation.

This study used the rat hippocampal slice preparation and the monocarboxylate transporter inhibitor, alpha-cyano-4-hydroxycinnamate (4-CIN), to assess the obligatory role that lactate plays in fueling the recovery of synaptic function after hypoxia upon reoxygenation. At a concentration of 500 microM, 4-CIN blocked lactate-supported synaptic function in hippocampal slices under normoxic conditions in 15 min. The inhibitor had no effect on glucose-supported synaptic function. Of control hippocampal slices exposed to 10-min hypoxia, 77.8 +/- 6.8% recovered synaptic function after 30-min reoxygenation. Of slices supplemented with 500 microM 4-CIN, only 15 +/- 10.9% recovered synaptic function despite the large amount of lactate formed during the hypoxic period and the abundance of glucose present before, during, and after hypoxia. These results indicate that 4-CIN, when present during hypoxia and reoxygenation, blocks lactate transport from astrocytes, where the bulk of anaerobic lactate is formed, to neurons, where lactate is being utilized aerobically to support recovery of function after hypoxia. These results unequivocally validate that brain lactate is an obligatory aerobic energy substrate for posthypoxia recovery of function.

Animals↗
PubMed1990

Age effect on prognosis for functional recovery in acute, traumatic central cord syndrome.

The purpose of this study was to determine if age is significant in functional recovery in acute, traumatic central cord syndrome (CCS). Recovery of ambulation, ADL status, and bowel and bladder function were evaluated. A retrospective study tested the hypothesis that functional recovery in 51 consecutive CCS patients was better in younger patients than in older patients. Four patients, all more than 50 years, died. Ability to ambulate independently at discharge was compared in 30 patients younger than 50 years with 21 patients 50 years or older. Results showed that 29 of 30 (97%) of the younger patients were ambulatory compared to seven of 17 (41%) of the older patients (p less than .002). The younger patients were also able to achieve independence in self-care and bowel and bladder function in a significantly greater proportion. The prognosis for functional recovery in acute traumatic CCS should consider the patient's age. The prognosis is less optimistic in older patients, but it is considerably more favorable in younger patients than previously reported.

Activities of Daily Living↗
PubMed1990

A method for real-time processing to study recovery functions of evoked potentials.

A new method for evaluating the recovery function of evoked potential (EP) in real time was reported. To record the test response of paired stimulation, the responses to alternate presentation of unpaired stimulus and several kinds of paired stimuli with various interstimulus intervals were averaged respectively and subtraction was made in real time. The EP's to the test stimulus obtained by the proposed method were proved to be accurate even under the changing recording conditions. A formula for computing the recovery correlation factor was derived as a measure of the recovery function of the recorded EP, and the recovery curves for three subjects were obtained.

Adult↗
PubMed2000

A functional recovery score for elderly hip fracture patients: I. Development.

OBJECTIVE: To develop a Functional Recovery Score for ambulatory elderly hip fracture patients related to independent functioning to assess restoration of function to prefracture status. STUDY DESIGN/METHODS: The phases of this effort consisted of: (a) identification of five relevant components represented by sixteen specific functional capacities; (b) assessment of the importance independent community-dwelling elderly gave to the sixteen functional capacities; (c) pilot testing of a sixteen-item preliminary questionnaire in recovering elderly hip fracture patients; and (d) modification of the questionnaire to an eleven-item score. RESULTS: The resulting eleven-item Functional Recovery Score is comprised of three main components: basic activities of daily living (BADL) assessed by four items, instrumental activities of daily living (IADL) assessed by six items, and mobility assessed by one item. Basic activities of daily living comprise 44 percent of the score; instrumental activities of daily living comprise 23 percent, and mobility comprises 33 percent. Complete independence in basic and instrumental activities of daily living and mobility results in a score of 100 percent.

Activities of Daily Living↗
PubMed2006

Comparative assessment of 18F-fluorodeoxyglucose PET and 99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction.

PURPOSE: Although preserved glucose metabolism is considered to be a marker of myocardial viability in the chronic stage, it has not been fully elucidated whether this is also true with regard to reperfused acute myocardial infarction (AMI). The aim of this study was to compare the diagnostic performance of(99m)Tc-tetrofosmin SPECT and(18)F-fluorodeoxyglucose (FDG) PET for the prediction of functional recovery in reperfused AMI. METHODS: The study population comprised 28 patients. Both tetrofosmin SPECT and FDG PET were performed in all 28 patients at ca. 2 weeks and in 23 at 6 months. The tetrofosmin and FDG findings in infarct-related segments were compared with the regional wall motion score assessed by left ventriculography over 6 months to determine the predictive value for functional recovery. RESULTS: Of 120 infarct-related segments, 83 had preserved flow (tetrofosmin uptake >/=50%) and 81 had preserved glucose metabolism (FDG uptake >/=40%). The sensitivity and specificity of tetrofosmin SPECT for the prediction of functional recovery tended to be superior to those of FDG PET (90.0% and 72.5% vs 85.0% and 67.5%, respectively). Thirteen segments with preserved flow and decreased glucose metabolism demonstrated marked recovery of contractile function from 2.5+/-1.0 to 1.4+/-1.4 (p<0.01), with restoration of glucose metabolism at 6 months. In contrast, 11 segments with decreased flow and preserved glucose metabolism demonstrated incomplete functional improvement from 3.0+/-0.8 to 2.2+/-1.2. CONCLUSION: In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium.

Aged↗
PubMed2000

Head to head comparison of dobutamine-transoesophageal echocardiography and dobutamine-magnetic resonance imaging for the prediction of left ventricular functional recovery in patients with chronic coronary artery disease.

AIMS: A substantial number of patients with dysfunctional but potentially viable myocardium cannot be accurately evaluated by transthoracic echocardiography due to a poor acoustic window. This study compares the diagnostic value of alternative functional imaging techniques, such as dobutamine-transoesophageal echocardiography (dobutamine-TEE) and dobutamine magnetic resonance imaging (dobutamine-MRI) for the detection of viable myocardium and the prediction of left ventricular functional recovery in patients with chronic coronary artery disease following successful revascularization procedures. METHODS AND RESULTS: Rest and low-dose (5, 10 microg dobutamine x min(-1) x kg(-1)) multiplane dobutamine-TEE and ultrafast cine-MRI studies were performed in 103 patients. Contractile recovery of an infarct region was predicted if a dobutamine contraction reserve could be assessed visually by TEE or MRI in > or =50% of infarct-related a- or dyskinetic segments. Revascularization of the infarct-related vessel was successful in 88 patients, and 4.9 +/- 0.7 months later 52 patients still had an angiographically controlled open target vessel. These patients underwent another rest MRI study to assess left ventricular functional recovery. A dobutamine contraction reserve was observed in 27/52 (52%) patients by TEE and in 26/52 (50%) patients by MRI. Functional improvement of the infarct region was diagnosed in 28/52 (54%) patients. The positive and negative predictive accuracy of dobutamine-TEE and dobutamine-MRI for the prediction of left ventricular functional recovery was not significantly different (85% vs 92%, ns and 80% vs 85%, ns). Diagnosis of a predominantly viable infarct region by TEE and MRI predicted a significant increase in left ventricular ejection fraction (TEE: 12 +/- 8% vs 2 +/- 7% P<0.001, MRI: 13 +/- 7% vs 2 +/- 7%, P<0.001) compared to infarct regions graded as scar. CONCLUSION: A qualitative visual analysis of TEE and MRI viability studies is highly accurate for the prediction of left ventricular functional recovery in patients with dysfunctional myocardium and proved to be a clinically valuable alternative if transthoracic dobutamine-echocardiography is unsuitable. To date, TEE is cardiologists' preferred choice for the assessment of myocardial viability but MRI may become significantly more attractive with increasing local availability and experience.

Aged↗
PubMed1997

Sprouting and functional recovery in co-cultures between old and young hippocampal organotypic slices.

We developed a model of lesion of Schaffer collaterals in hippocampal organotypic slice cultures to analyse the capacity for sprouting and functional recovery expressed in young (one week old) and old (four week old) slice cultures. Slice cultures were sectioned at different ages of maturation in two separate half-slices and maintained in co-culture. Functional recovery was assessed by measuring synaptic responses elicited across the lesion seven days after the lesion and sprouting was evaluated by biocytin labeling of the regenerating fibers seen under the same conditions. Sprouting and functional recovery were found to be markedly reduced and delayed in old vs young cultures. Preparation of co-cultures between young CA3 and old CA1 half-slices resulted in a significant reduction in the capacity for sprouting and regeneration of the young CA3 neurons. Conversely, co-cultures prepared between old CA3 and young CA1 half-slices showed a markedly enhanced capacity for sprouting and functional recovery of old CA3 neurons. These results indicate that the age-dependent impairment in sprouting and regeneration expressed in cortical regions can be improved by and depends upon the presence of a favourable environment.

Animals↗
PubMed2003

Minocycline reduces cell death and improves functional recovery after traumatic spinal cord injury in the rat.

We examined the effects of minocycline, an anti-inflammatory drug, on functional recovery following spinal cord injury (SCI). Rats received a mild, weight-drop contusion injury to the spinal cord and were treated with the vehicle or minocycline at a dose of 90 mg/kg immediately after SCI and then twice at a dose of 45 mg/kg every 12 h. Injecting minocycline after SCI improved hind limb motor function as determined by the Basso-Beattie-Bresnahan (BBB) locomotor open field behavioral rating test. Twenty four to 38 days after SCI, BBB scores were significantly higher in minocycline-treated rats as compared with those in vehicle-treated rats. Morphological analysis showed that lesion size increased progressively in both vehicle-treated and minocycline-treated spinal cords. However, in response to treatment with minocycline, the lesion size was significantly reduced at 21-38 days after SCI when compared to the vehicle control. Minocycline treatment significantly reduced the number of terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL)-positive cells 24 h after SCI as compared to that of the vehicle control. DNA gel electrophoresis also revealed a marked decrease in DNA laddering in response to treatment with minocycline. In addition, minocycline treatment significantly reduced the specific caspase-3 activity after SCI as compared to that of vehicle control. Furthermore, RT-PCR analyses revealed that minocycline treatment increased expression of interleukin-10 mRNA but decreased tumor necrosis factor-alpha expression. These data suggest that, after SCI, minocycline treatment modulated expression of cytokines, attenuated cell death and the size of lesions, and improved functional recovery in the injured rat. This approach may provide a therapeutic intervention enabling us to reduce cell death and improve functional recovery after SCI.

Animals↗
PubMed2005

Dimeric fibroblast growth factor-2 enhances functional recovery after focal cerebral ischemia.

PURPOSE: The purpose of this study was to examine the effects of dimerized basic fibroblast growth factor (dFGF), a novel engineered growth factor, in a model of functional recovery following focal cerebral infarction (stroke) in rats. METHODS: A focal stroke was made in mature male rats by occlusion of the middle cerebral artery (MCA). dFGF was administered by intracisternal injection at one and three days after stroke. Tests to evaluate sensorimotor recovery of the contralateral limbs were done during the next three weeks after stroke. RESULTS: dFGF significantly enhanced recovery of sensorimotor function in limb placing and body swing tests compared to vehicle treatment. There were no differences in body weight or infarct volume in dFGF- vs. vehicle-treated animals. CONCLUSIONS: dFGF represents a potential treatment to enhance functional recovery after stroke and offers several advantages over bFGF, including stability and independence from extracellular heparan sulfates.

Animals↗