title: Randomized, Placebo-Controlled, Double-Blind Pilot Study of D-Cycloserine in Chronic Stroke.
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.
authors.affiliation: Department of Physical Therapy, School of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA ; Atlanta Veterans Affairs Medical Center, Rehabilitation Research and Development Center of Excellence for Visual and Neurocognitive Rehabilitation, Decatur, GA 30033, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Butler
authors.affiliation: Department of Physical Therapy, School of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA.
authors.forename: Justiss
authors.initials: J
authors.lastname: Kallos
authors.affiliation: Department of Physical Therapy, School of Nursing and Health Professions, Georgia State University, Atlanta, GA 30303, USA.
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Housley
authors.affiliation: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: LaPlaca
authors.affiliation: Department of Pharmacology, Emory University, Atlanta, GA 30332, USA.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Traynelis
authors.affiliation: Atlanta Veterans Affairs Medical Center, Rehabilitation Research and Development Center of Excellence for Visual and Neurocognitive Rehabilitation, Decatur, GA 30033, USA ; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wolf