Enhancing Rehabilitation After Stroke (Enhance)
This is a 12-week, randomized, placebo controlled study to determine if donepezil (Aricept) treatment during rehabilitation after stroke improves functional recovery.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Donepezil to Promote Functional Recovery Post-stroke|
- Functional Independence Measure (FIM) [ Time Frame: Weekly/12 weeks ] [ Designated as safety issue: No ]
- Cognitive Function (ImPACT battery used to assess attention - working memory continuum, information processing speed, and verbal and visual episodic memory.) [ Time Frame: Multiple time points over 12 weeks ] [ Designated as safety issue: No ]
|Study Start Date:||March 2009|
|Estimated Study Completion Date:||November 2013|
|Estimated Primary Completion Date:||August 2013 (Final data collection date for primary outcome measure)|
Experimental: 1: donepezil
Participants will receive treatment for 12 weeks on donepezil 10 mg (or 5 mg if unable to tolerate 10 mg). Treatment will be then be terminated and participants followed for another 12 weeks naturalistically.
5 mg or 10 mg, titrated per drug insert. Participants may remain in the study at 5 mg if unable to tolerate 10 mg.
Other Name: Aricept
Placebo Comparator: 2. placebo
Participants will receive treatment for 12 weeks with placebo pill. Treatment will be then be terminated and participants followed for another 12 weeks naturalistically.
Participants will receive a placebo pill for 12 weeks if randomized to this treatment.
Stroke is a leading cause of disability in the US (Thom 2006). The total number of stroke survivors (currently estimated as 5.5 million Americans) will continue to increase as the population ages and as the medical management of acute stroke continues to improve. Given stroke's devastating impact on activities of daily living and the large numbers of Americans afflicted, improving acute medical rehabilitation outcomes after stroke is of great public health importance.
Predictors of poor functional recovery post-stroke include impairments in cognition and motivation. Recent evidence indicates that acetylcholinesterase inhibitors may improve cognition and motivation; hence, their use post-stroke may lead to improved rehabilitation outcomes. Our group has demonstrated that use of the acetylcholinesterase inhibitor donepezil is associated with improved functional recovery in a pilot sample (n = 40) of elderly, cognitively impaired stroke survivors undergoing inpatient rehabilitation. Specifically, in this 12 week open-label study, those subjects receiving donepezil experienced a clinically meaningful 14 point greater improvement on the Functional Independence Measure (FIM) than an archival comparator group.
Based on these promising pilot study results, we propose a 12-week randomized, double-blind, placebo-controlled trial (followed by a 12 week off-drug observation period) in order to test the efficacy of donepezil to promote post-stroke functional recovery in older, cognitively impaired stroke survivors undergoing inpatient rehabilitation. We will also use this randomized controlled trial to examine the drug's effect on cognition post-stroke; specifically, the drug's effect on those cognitive domains (attention/working memory, information psychomotor speed, and episodic memory) that are relevant to functional outcomes.
|Contact: Kara Kentonfirstname.lastname@example.org|
|United States, Ohio|
|Hillside Rehabilitation Hospital||Not yet recruiting|
|Warren, Ohio, United States, 44484|
|Contact: Nancy Landgraff, PhD 330-941-2703 email@example.com|
|Principal Investigator: Nancy Landgraff, PhD|
|United States, Pennsylvania|
|University of Pittsburgh Medical Center||Recruiting|
|Pittsburgh, Pennsylvania, United States, 15213|
|Contact: Kara Kenton 412-246-5815 firstname.lastname@example.org|
|Sub-Investigator: Howard Aizenstein, MD, PhD|
|Principal Investigator: Ellen M Whyte, MD|
|Sub-Investigator: Meryl Butters, PhD|
|Sub-Investigator: Ariel Gildengers, MD|
|Sub-Investigator: Jordan Karp, MD|
|Sub-Investigator: Oscar Lopez, MD|
|Sub-Investigator: Sati Mazumdar, MD|
|Sub-Investigator: Michael Munin, MD|
|Sub-Investigator: Charles Reynolds, MD|
|Sub-Investigator: Elizabeth Skidmore, PhD|
|Principal Investigator:||Ellen M Whyte, MD||University of Pittsburgh|