Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke

Authors

  • Jérémie Pariente MD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
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  • Isabelle Loubinoux PhD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
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  • Christophe Carel MD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
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  • Jean-François Albucher MD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
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  • Anne Leger MD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
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  • Claude Manelfe MD, PhD,

    1. Department of Neuroradiology, Toulouse, France
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  • Olivier Rascol MD, PhD,

    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
    3. Centre d'Investigation Clinique, Hôpital Purpan, Toulouse, France
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  • François Chollet MD

    Corresponding author
    1. Institut national de la santé et de la recherche médicale, unit U455, Pavillon Riser, Toulouse, France
    2. Department of Neurology, Pavillon Riser, Toulouse, France
    • INSERM U455, Pavillon Riser, Hôpital Purpan, 31059 Toulouse, France
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Abstract

In order to determine the influence of a single dose of fluoxetine on the cerebral motor activation of lacunar stroke patients in the early phase of recovery, we conducted a prospective, double-blind, crossover, placebo-controlled study on 8 patients with pure motor hemiparesia. Each patient underwent two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after stroke onset and the second a week later. During the two fMRI examinations, patients performed an active controlled motor task with the affected hand and a passive one conducted by the examiner with the same hand. Motor performance was evaluated by motor tests under placebo and under fluoxetine immediately before the examinations to investigate the effect of fluoxetine on motor function. Under fluoxetine, during the active motor task, hyperactivation in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor activation in patients. This redistribution of activation toward the motor cortex output activation was associated with an enhancement of motor performance.

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