Randomized, Placebo-Controlled, Double-Blind Pilot Study of D-Cycloserine in Chronic Stroke.

• Type of Material: Article
• Authors: Andrew Butler, Emory University; Justiss Kallos, Georgia State University; Stephen N. Housley, Georgia State University; Michelle Camille LaPlaca, Emory University; Stephen Traynelis, Emory University; Steven L Wolf, Emory University
• Language: English
• Date: 2015
• Publisher: Hindawi Publishing Corporation
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Andrew J. Butler et al.
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1155/2015/534239
• Title of Journal or Parent Work: Rehabilitation Research and Practice
• ISSN: 2090-2867
• Volume: 2015
• Start Page: 534239
• End Page: 534239
• Grant/Funding Information: This work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award no. UL1TR000454.
• Research Categories: Health Sciences, Pharmacology; Health Sciences, Rehabilitation and Therapy; Engineering, Biomedical

Abstract

Stroke is a leading cause of death and disability in the USA. Up to 60% of patients do not fully recover despite intensive physical therapy treatment. N-Methyl-D-aspartate receptors (NMDA-R) have been shown to play a role in synaptic plasticity when activated. D-Cycloserine promotes NMDA receptor function by binding to receptors with unoccupied glycine sites. These receptors are involved in learning and memory. We hypothesized that D-cycloserine, when combined with robotic-assisted physiotherapy (RAP), would result in greater gains compared with placebo + RAP in stroke survivors. Participants (n = 14) were randomized to D-cycloserine plus RAP or placebo plus RAP. Functional, cognitive, and quality-of-life measures were used to assess recovery. There was significant improvement in grip strength of the affected hand within both groups from baseline to 3 weeks (95% confidence interval for mean change, 3.95 ± 2.96 to 4.90 ± 3.56 N for D-cycloserine and 5.72 ± 3.98 to 8.44 ± 4.90 N for control). SIS mood domain showed improvement for both groups (95% confidence interval for mean change, 72.6 ± 16.3 to 82.9 ± 10.9 for D-cycloserine and 82.9 ± 13.5 to 90.3 ± 9.9 for control). This preliminary study does not provide evidence that D-cycloserine can provide greater gains in learning compared with placebo for stroke survivors.