The Neurotrophic Effects of Lithium Carbonate Following Stroke: A Feasibility Study
Status:
Completed
Trial end date:
2017-07-25
Target enrollment:
Participant gender:
Summary
Stroke is the leading cause of adult disability and the third leading cause of death in
Canada. Most stroke survivors live with residual impairments that diminish independence and
quality of life. This may include vascular cognitive impairment (loss of ability to plan,
think and reason) which can lead to dementia and loss of mental and functional independence.
The current treatment to reduce stroke induced brain tissue injury is limited to
thrombolytics (clot busters), a therapy useful only if given in the first hours following
stroke. One major new approach aims to reduce cell death after stroke by targeting the
ongoing tissue loss initiated by the stroke. The tissue can be maintained by interfering with
later neurochemical processes that are activated by stroke, potentially through activating
natural substances in the brain that help survival and growth of nerve cells ("neurotrophic"
factors).
The recent recognition of lithium as a neurotrophic agent has generated the first studies of
lithium treatment for managing brain diseases. Clinically, lithium has now been shown to
increase brain gray matter volume in bipolar patients. This effect is potentially important
in stroke because gray matter loss has been implicated in the development of cognitive
impairment after stroke, a result of the series of brain processes that are activated by lack
of oxygen due to stroke. Our primary objective is to examine the effects of lithium on total
brain gray matter volume in the post-stroke population, as measured by volumetric magnetic
resonance imaging (MRI) with the hope that lithium may increase gray matter volume in
post-stroke patients and lead to greater cognitive and functional rehabilitation. This study
will provide valuable information on the tolerability of lithium, and its effects on clinical
outcomes relevant to stroke, providing the information needed for designing a large-scale
clinical trial.