Article

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.

Langue : ANGLAIS