Dl-3-n-butylphthalide can improve the cognitive function of patients with acute ischemic stroke: a prospective intervention study.
OBJECTIVE
The present study investigated the effects of dl-3-n-butylphthalide on cognitive function of patients with acute ischemic stroke (AIS).


METHODS
A total of 104 patients with AIS admitted between October 2012 and June 2013 were assigned to either the Treatment (standardized treatment plus dl-3-n-butylphthalide) or Control (standardized treatment alone) groups. Cognitive function was assessed by the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) and Mini-Mental State Examination (MMSE) before and 1 month after treatment, when high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) were also detected. A multivariate logistic regression analysis was done for explore the independent risk factors for vascular dementia (VD).


RESULTS
The proportion of cognitive impairment was significantly lower after treatment than before in both the Treatment (88% vs. 64%, P = 0.023) and Control (87% vs. 70%, P = 0.047) groups. Vascular dementia dropped from 30 to 10% in the Treatment (P = 0.035) and from 25.9 to 16.7% in the Control (P = 0.027) groups. Total cognitive improvement was more significant in the Treatment Group (P = 0.018); naming, memory, attention, and linguistic abilities were significantly improved (all P < 0.05). Serum Hcy and hs-CRP levels were significantly lower in the Treatment Group than in the Control Group 1 month after treatment (P < 0.05).


CONCLUSIONS
Dl-3-n-butylphthalide could significantly improve the cognitive function of AIS patients 1 month after stroke. Hcy was involved in the incidence of VD 1 month after AIS. However, further studies are necessary because of differences between groups at baseline.
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Haiqing
H
Yan
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Zhixin
Z
Yan
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Xiaolu
X
Niu
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Jianling
J
Wang
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Yongkun
Y
Gui
a Department of Neurology , First Affiliated Hospital of Xinxiang Medical University , Weihui , China.
Ping
P
Zhang
D001572:Benzofurans / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002097:C-Reactive Protein / Q000378:metabolism; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D015140:Dementia, Vascular / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D016015:Logistic Models; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D015999:Multivariate Analysis; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
D001572:Benzofurans; D015415:Biomarkers; D018696:Neuroprotective Agents; D018697:Nootropic Agents; D006710:Homocysteine; C027125:3-n-butylphthalide; D002097:C-Reactive Protein
AIS: acute ischemic stroke; C-reactive protein; DWI: diffusion weighted imaging; Hcy: homocysteine; MMSE: Mini-Mental State Examination; MoCA-BJ: Beijing version of the Montreal Cognitive Assessment; NIHSS: National Institutes of Health Stroke Scale; Stroke; VCIND: vascular cognitive impairment with no dementia; VD: Vascular dementia; dl-3-n-butylphthalide; homocysteine; hs-CRP: high-sensitivity C-reactive protein; risk factors; vascular dementia