How A Stroke Affects The Brain
Scientists at the University of Iowa have published results of a fascinating study showing that antidepressants can improve the cognitive functioning of stroke victims.
Prior studies had indicated that antidepressants provided cognitive benefits for depressed stroke victims. The authors of this study set out to find whether the same would be true for those not suffering from depression.
“We knew that a patient with depression had poorer outcomes. We knew also that antidepressants improved outcomes among depressed patients,” professor Ricardo Jorge explained. “But we really didn’t have (although we had a hint) evidence that antidepressants given in small doses — relatively small doses — would be able to modify the outcome of these patients, particularly the cognitive outcome.”
The team compared the benefits of antidepressant treatment to the improvements on cognitive tests in two control groups, who received training in problem-solving skills or a placebo.
“The change in memory scores in this neuropsychological test for those patients who received the escitalopram was 11.3 points, against 2.5 points of positive change in patients who did not receive escitalopram,” says Dr. Jorge.
While pointing out that increased neurogenesis isn’t the only possible explanation for the cognitive benefits of antidepressants to the stroke patients he indicated that it was a distinct possibility:
“This is a complex issue, because there are several alternatives,” he explains. “One, and probably one that is quite appealing because this is related to the mechanism of antidepressants for treatment of depression, is that antidepressants have an effect called a neurotrophic effect. In a sense, that increases the expression of neurotrophic factors.”
“There is evidence that it will increase the neurogenesis and the proliferation of primordial neurons in the hippocampus,” Dr. Jorge theorized. “There are several trophic effects that help the brain reorganize itself. This is also important because the period immediately after a stroke is a period of greater plasticity in the brain, where the brain tries to compensate for its deficits. In not only a functional way but also in a structural way, there are changes in structure and changes in function that try to override the deficits brought by the stroke.”