title: Methylphenidate modulates cerebral post-stroke reorganization.
abstract: OBJECTIVE
  We hypothesized that a single dose of methylphenidate (MP) would modulate cerebral motor activation and behavior in patients having suffered a subcortical stroke.
  
  
  METHODS
  Eight men with a single stroke on the corticospinal tract resulting in a pure motor hemiparesia were included in a randomized, cross-over, double-blind, placebo-controlled study. Patients were first evaluated 17 days after stroke onset by validated neurological scales, motor tests and fMRI (flexion/extension of the digits) after 20 mg MP or placebo. Seven days later, the patients underwent the same protocol and received the drug they had not taken at the first evaluation. Each patient was his own control.
  
  
  RESULTS
  Placebo intake did not change performance. MP compared to placebo elicited a significant improvement in motor performance of the affected hand at the finger tapping test. MP induced: (1) a hyperactivation of the ipsilesional primary sensorimotor cortex including the motor hand and face areas and of the contralesional premotor cortex; (2) a hypoactivation of the ipsilesional anterior cingulum. Hyperactivation in the face motor area correlated positively with the improvement in performance.
  
  
  CONCLUSIONS
  We demonstrated that the reorganized network may efficiently be targeted by the drug and that the effect of MP might partly rely on an improvement in attention/effort through cingulum modulation.
authors.affiliation: INSERM U455, Pavillon Riser, Purpan Hospital, Toulouse, France. tardyjean@yahoo.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Tardy
authors.forename: Jérémie
authors.initials: J
authors.lastname: Pariente
authors.forename: Anne
authors.initials: A
authors.lastname: Leger
authors.forename: Sophie
authors.initials: S
authors.lastname: Dechaumont-Palacin
authors.forename: Angélique
authors.initials: A
authors.lastname: Gerdelat
authors.forename: Vincent
authors.initials: V
authors.lastname: Guiraud
authors.forename: Fabrice
authors.initials: F
authors.lastname: Conchou
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Albucher
authors.forename: Philippe
authors.initials: P
authors.lastname: Marque
authors.forename: Xavier
authors.initials: X
authors.lastname: Franceries
authors.forename: Christophe
authors.initials: C
authors.lastname: Cognard
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
authors.forename: François
authors.initials: F
authors.lastname: Chollet
authors.forename: Isabelle
authors.initials: I
authors.lastname: Loubinoux
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology; D001288:Attention / Q000187:drug effects; D001519:Behavior / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000473:pathology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009044:Motor Cortex / Q000187:drug effects; D009473:Neuronal Plasticity / Q000187:drug effects; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects / Q000502:physiology; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology* / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate