Document Detail


Time course and outcome of recovery from stroke: relevance to stem cell treatment.
MedLine Citation:
PMID:  16427047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stroke is the third leading cause of death in the United States after heart disease and cancer; it has an incidence of approximately 750,000 cases per year, and it is a leading cause of disability in adults. The factors predicting a poor outcome from stroke include severe initial neurological dysfunction, hypertension, cardiac arrhythmias, myocardial infarction, hypercholesterolemia, and diabetes mellitus. The armamentarium available for improvement of neurological function after stroke is currently limited to placement in specialized stroke units, optimal therapy for medical complications, and intense physical, occupational and speech rehabilitation. Despite many trials, no pharmacological intervention has been shown convincingly to improve neurological outcome. This review was undertaken to determine the appropriate time for new approaches to the therapy of stroke such as the infusion of stem cells into the central nervous system. The literature shows in large case series that functional recovery from stroke reaches a maximum level by 3-6 months after onset, and no further recovery occurs beyond this time. Nevertheless, about 80% of these patients reach their maximum function for activities of daily living within 6 weeks from onset. Initiation of a clinical trial of stem cell therapy would require demonstration of optimal clinical improvement by neurological evaluations, with no change over at least 4 weeks of observation. Accordingly, in subjects with first-ever ischemic stroke who remained neurologically unchanged from the second until the third month after the acute event, implementation of stem cell therapy would be appropriate at approximately 3 months after the stroke.
Authors:
Sid Gilman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2006-01-19
Journal Detail:
Title:  Experimental neurology     Volume:  199     ISSN:  0014-4886     ISO Abbreviation:  Exp. Neurol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-06-26     Completed Date:  2006-08-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370712     Medline TA:  Exp Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-41     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Michigan, 300 North Ingalls St., Ann Arbor, MI 48109, USA. sgilman@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Recovery of Function*
Stem Cell Transplantation / methods*
Stroke / epidemiology,  mortality,  surgery*
Time Factors

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