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J Nippon Med Sch. 2013;80(1):50-6.

Administration of cilostazol, an antiplatelet, to patients with acute-stage cerebral infarction and its effects on plasma substance P level and latent time of swallowing reflex.

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  • 1Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. abe@nms.ac.jp

Abstract

BACKGROUND AND OBJECTIVE:

It has been reported that medical treatment with cilostazol (cilo) as an antiplatelet may increase a substance P level in the striatum to shorten the latent time of swallowing reflex (LTSR). We undertook a pilot study to confirm whether cilo administration to patients with cerebral infarction is effective in increasing their plasma substance P level and then in ameliorating the status of LTSR.

METHODS AND SUBJECTS:

Eligible subjects were recruited, after informed consents, from 20 hospitalized patients with acute-phase cerebral infarction within 72 hours from the onset. At the start of treatment, the subjects were assigned at random to those given aspirin alone (non-cilo group) and those given aspirin plus cilo (cilo group). Plasma substance P levels and LTSR values were measured at the starting point (baseline), 28 days after, and 180 days after.

RESULTS AND DISCUSSION:

No significant time-dependent change in plasma substance P level was found probably because of large individual differences but, 28 days after the start of treatment, this value tended to become higher in cilo group than in non-cilo group (P<0.10). Whereas, in terms of fold changes of LTSR in cilo group, there was a significant between-term difference at P<0.05, indicating that this medication is effective in ameliorating the swallowing function is improved in the long run.

CONCLUSION:

The LTSR values was significantly shortened within 180 days after the start of cilo treatment, but the result was not well explained by substance P levels as far as these were measured using the plasma, probably because this substance had diluted during blood circulation. However, it will become clinically usable as a single swallowing index, if in the future some ingeneus method of its measurement is developed. A larger-scale study would also be needed to confirm our conclusion from this pilot study.

PMID:
23470806
[PubMed - indexed for MEDLINE]
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