Lithium Carbonate in a Poststroke Population: Exploratory Analyses of Neuroanatomical and Cognitive Outcomes

Yue Ran Sun, Nathan Herrmann, Christopher J M Scott, Sandra E Black, Richard H Swartz, Julia Hopyan, Krista L Lanctôt, Yue Ran Sun, Nathan Herrmann, Christopher J M Scott, Sandra E Black, Richard H Swartz, Julia Hopyan, Krista L Lanctôt

Abstract

Purpose/background: Loss of gray matter after stroke has been associated with cognitive impairment. This pilot study aimed to investigate the therapeutic potential of lithium, a putative neurotrophic agent, in the stroke recovery process within a year of stroke occurrence.

Methods: Twelve stroke patients (mean ± SD age, 71.1 ± 11.9 years) were recruited to the study, and eligible participants were prescribed open-label lithium for 60 days. Magnetic resonance imaging was used to assess global gray matter at baseline and end of treatment; global cognition was assessed using the standardized Mini-Mental State Examination and Montreal Cognitive Assessment, and verbal memory was evaluated using the Hopkins Verbal Learning Test-Revised.

Findings/results: There was no difference in global gray matter volume between baseline and follow-up (t = 1.977, P = 0.074). There was a significant interaction between higher lithium dose and increased global gray matter volume (F = 14.25, P = 0.004) and a correlation between higher lithium dose and improved verbal memory (r = 0.576, P = 0.05).

Implications/conclusions: Lithium pharmacotherapy may be associated with gray matter volume change and verbal memory improvement in stroke patients, providing a rationale for future trials assessing therapeutic potential of lithium in a poststroke population.

Figures

FIGURE 1
FIGURE 1
Percent change in global gray matter volume was significantly different between the 2 dose groups: at least 300 mg/d and less than 300 mg/d group (t = −3.80, P = 0.003).
FIGURE 2
FIGURE 2
Greater cumulative lithium dose was positively correlated with a more positive change in delayed recall score (r = 0.576, P = 0.05).

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