The Effect of Levodopa on Motor Function Outcome in Patients with Ischemic Stroke: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial
Gholamreza Shamsaei1, Shahram Rafie1, Nastaran Majdinasab1, Sepideh Zandifar1*, Alireza Hassanzadeh1, Ali Nakhostin-Mortazavi1 and Neda Safapour2

1Department of Neurology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ²Department of Internal Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran .

Abstract: Levodopa enhances neuronal plasticity and functional recovery and modulates anatomical and functional variations in central nervous system. The present study was aimed to evaluate the effect of levodopa-C on motor function recovery of patients experienced a stroke. This was a randomized, placebo-controlled, double-blind clinical trial conducted on 114 patients with ischemic middle cerebral artery stroke. The patients after the first day of stroke were randomly divided into two groups: the levodopa-C group and placebo group. In addition to the intervention, the patients received the stroke routine medications during the study. The patients received 100 mg daily medication for 3 weeks. A significant improvement was observed in motor function criteria of Rivermead mobility index (RMI) (p = 0.006) and Barthel index (BI) (p = 0.009) after 21 days in the levodopa-C group (79.1 %), compared to the placebo group (49 %). A review was carried in the subgroups, which indicate that patients with cortical stroke in the levodopa group had a significant improvement, compared with the placebo group (p = 0.005). The basic motor functions of about 79 % of the levodopa-C patients (n = 35), compared with the 44% in the placebo group, were enhanced by 25% according to the BI and RMI criteria (p = 0.008). Most of these patients had cortical stroke. Our findings showed significant therapeutic effect of levodopa-C in the patients with cortical stroke. Larger clinical trials containing larger sample size with cortical ischemic stroke are needed to better assess the impact.

Keywords: Ischemic stroke; levodopa–C; Motor Function Improvement; Middle Cerebral Artery; Rivermead Mobility Index; Barthel Index Clinical Trials; Placebo

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