title: Safety and improvement of movement function after stroke with atomoxetine: A pilot randomized trial.
abstract: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention.
  
  
  
  Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke.
  
  
  
  In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, Wolf Motor Function Test, and Action Research Arm Test at baseline, post-intervention, and 1-month follow-up.
  
  
  
  No significant between-groups differences were found in mean heart rate (95% CI, -12.4-22.6; p = 0.23), mean systolic blood pressure (95% CI, -1.7-29.6; p = 0.21), or mean diastolic blood pressure (95% CI, -10.4-13.3; p = 0.08). A statistically significant between-groups difference on Fugl-Meyer at post-intervention favored the atomoxetine group (95% CI, 1.6-12.7; p = 0.016).
  
  
  
  Atomoxetine combined with motor training appears safe and may optimize motor training outcomes after stroke.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ward
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Carrico
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Powell
authors.affiliation: Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Westgate
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.|HealthSouth Cardinal Hill Rehabilitation Hospital, Lexington, KY, USA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Nichols
authors.affiliation: Eastern Kentucky University, Richmond, KY, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Fleischer
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA.|HealthSouth Cardinal Hill Rehabilitation Hospital, Lexington, KY, USA.|Wake Forest University, Department of Neurology, Winston-Salem, NC, USA.
authors.forename: Lumy
authors.initials: L
authors.lastname: Sawaki
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects*; D009069:Movement Disorders / Q000188:drug therapy* / Q000209:etiology*; D010865:Pilot Projects; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000069445:Atomoxetine Hydrochloride
keywords: Upper extremity; motor training; neurorehabilitation; occupational therapy; safety; vital signs