GABAergic drug use and global, cognitive, and motor functional outcomes after stroke.

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State: Public
Version: Final published version
License: All rights reserved
Serval ID
serval:BIB_5169E9C1CC68
Type
Article: article from journal or magazin.
Collection
Publications
Title
GABAergic drug use and global, cognitive, and motor functional outcomes after stroke.
Journal
Annals of physical and rehabilitation medicine
Author(s)
Schwitzguébel A.J., Benaïm C., Carda S., Torea Filgueira A.M., Frischknecht R., Rapin P.A.
ISSN
1877-0665 (Electronic)
ISSN-L
1877-0657
Publication state
Published
Issued date
03/2016
Volume
59
Number
5-6
Pages
320-325
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Abstract
In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear.
We aimed to evaluate the association between GABA-AG use and functional recovery after stroke.
We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement.
Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31-0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08-0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM.
GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery.

Keywords
Adult, Aged, Aged, 80 and over, Cognition/drug effects, Disability Evaluation, Female, GABA-A Receptor Agonists/adverse effects, GABA-A Receptor Agonists/pharmacology, Humans, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Recovery of Function/drug effects, Regression Analysis, Retrospective Studies, Stroke/drug therapy, Stroke/psychology, Stroke Rehabilitation/methods, Survivors/psychology, Treatment Outcome
Pubmed
Open Access
Yes
Create date
12/10/2016 11:04
Last modification date
20/08/2019 14:07
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