PMID- 27132886
OWN - NLM
STAT- MEDLINE
DCOM- 20170322
LR  - 20191210
IS  - 1877-0665 (Electronic)
IS  - 1877-0657 (Linking)
VI  - 59
IP  - 5-6
DP  - 2016 Dec
TI  - GABAergic drug use and global, cognitive, and motor functional outcomes after 
      stroke.
PG  - 320-325
LID - S1877-0657(16)30028-8 [pii]
LID - 10.1016/j.rehab.2016.03.007 [doi]
AB  - BACKGROUND: 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. OBJECTIVES: We aimed to evaluate the association between GABA-AG use and 
      functional recovery after stroke. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
CI  - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.
FAU - Schwitzguebel, A J-P
AU  - Schwitzguebel AJ
AD  - Department of Physical Medicine and Rehabilitation, Nestle Hospital, Lausanne 
      University Hospital, Lausanne, Switzerland. Electronic address: 
      adrien.schwitzguebel@gmail.com.
FAU - Benaim, C
AU  - Benaim C
AD  - Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, 
      Lausanne University Hospital, Lausanne, Switzerland; Institute for Research in 
      Rehabilitation, Clinique Romande de Readaptation, Sion, Switzerland.
FAU - Carda, S
AU  - Carda S
AD  - Department of Physical Medicine and Rehabilitation, Nestle Hospital, Lausanne 
      University Hospital, Lausanne, Switzerland.
FAU - Torea Filgueira, A M
AU  - Torea Filgueira AM
AD  - Service of Neurologic Rehabilitation, Institution de Lavigny, Lavigny, 
      Switzerland.
FAU - Frischknecht, R
AU  - Frischknecht R
AD  - Department of Physical Medicine and Rehabilitation, Nestle Hospital, Lausanne 
      University Hospital, Lausanne, Switzerland.
FAU - Rapin, P-A
AU  - Rapin PA
AD  - Service of Neurologic Rehabilitation, Institution de Lavigny, Lavigny, 
      Switzerland.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20160426
PL  - Netherlands
TA  - Ann Phys Rehabil Med
JT  - Annals of physical and rehabilitation medicine
JID - 101502773
RN  - 0 (GABA-A Receptor Agonists)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cognition/drug effects
MH  - Disability Evaluation
MH  - Female
MH  - GABA-A Receptor Agonists/adverse effects/*pharmacology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Recovery of Function/*drug effects
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Stroke/*drug therapy/psychology
MH  - Stroke Rehabilitation/*methods
MH  - Survivors/*psychology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Benzodiazepines
OT  - Functional independence measure
OT  - GABA-A receptor agonists
OT  - Minimal clinically important difference
OT  - Recovery
OT  - Rehabilitation
OT  - Stroke
EDAT- 2016/05/03 06:00
MHDA- 2017/03/23 06:00
CRDT- 2016/05/03 06:00
PHST- 2015/11/23 00:00 [received]
PHST- 2016/03/22 00:00 [revised]
PHST- 2016/03/25 00:00 [accepted]
PHST- 2016/05/03 06:00 [pubmed]
PHST- 2017/03/23 06:00 [medline]
PHST- 2016/05/03 06:00 [entrez]
AID - S1877-0657(16)30028-8 [pii]
AID - 10.1016/j.rehab.2016.03.007 [doi]
PST - ppublish
SO  - Ann Phys Rehabil Med. 2016 Dec;59(5-6):320-325. doi: 10.1016/j.rehab.2016.03.007. 
      Epub 2016 Apr 26.