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Pharmacological interventions for unilateral spatial neglect after stroke
Gustavo José Luvizutto1, Rodrigo Bazan, Gabriel Pereira Braga
1Department of Neurology, Botucatu Medical School, Universidade Estadual Paulista (UNESP), District of Rubiao Junior, Botucatu, São Paulo, Brazil.
The Cochrane Database of Systematic Reviews
|November 7, 2015
Summary
Pharmacological interventions for unilateral spatial neglect (USN) after stroke show uncertain effectiveness and safety due to very low-quality evidence from limited trials. More large randomized controlled trials (RCTs) are needed to clarify treatment benefits.
Area of Science:
- Neuroscience
- Pharmacology
- Rehabilitation Medicine
Background:
- Unilateral spatial neglect (USN) significantly impairs stroke survivors' functional outcomes.
- Pharmacological interventions are explored to improve USN, offering potential insights for healthcare professionals.
Purpose of the Study:
- To systematically evaluate the effectiveness and safety of pharmacological interventions for USN in stroke patients.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to April 2015.
- Included randomized controlled trials (RCTs) and quasi-RCTs.
- Two reviewers independently assessed risk of bias and extracted data.
Main Results:
- Two small trials (30 participants) with very low-quality evidence were included.
- Rivastigmine showed no significant effect on USN outcomes at discharge or follow-up.
- Transdermal nicotine significantly reduced omissions in cancellation tasks, but one major adverse event occurred.
Conclusions:
- The effectiveness and safety of pharmacological treatments for post-stroke USN remain uncertain due to very low-quality evidence.
- Further large-scale RCTs are essential to establish the efficacy and safety of these interventions.
