Cilostazol versus aspirin therapy in patients with chronic dizziness after ischemic stroke
Clinical Neurology and Neurosurgery, 07/26/2012
Johkura K et al. – Cilostazol improves the chronic dizziness that follows ischemic stroke and increases supratentorial cerebral blood flow (CBF) and cerebral function for adaptation of the brainstem reflex related to the sense of balance.Methods
- The authors performed a prospective, randomized, open–label, blinded endpoint trial.
- One hundred six patients who suffered supratentorial ischemic stroke within the previous 1–6 months and subsequently complained of persistent dizziness without other obvious sequelae were enrolled.
- Patients were randomly given cilostazol (200mg/day) or aspirin (100mg/day) for 6 months.
- Rates of improvement in the dizziness were then evaluated.
- Changes in fixation suppression of the vestibulo–ocular reflex (an indicator of cerebral control over the brainstem reflex related to balance), regional cerebral blood flow (CBF) in the cerebrum, cerebellum, and brainstem; and the Zung Self–Rating Depression Scale (SDS) were also evaluated.
- Dizziness was significantly improved in the cilostazol group versus the aspirin group (P<0.0001) after the 6–month therapy.
- The capacity for fixation suppression of the vestibulo–ocular reflex was improved (P<0.0001), and regional CBF in the cerebrum (relative to that in the brainstem [P=0.003] and to that in the cerebello–brainstem [P=0.012]) was increased only in the cilostazol group.
- There was no statistical difference in the change in SDS scores between the two groups.