Letter to the Editor
Accepted August 27, 2008 Published online: September 9, 2008
Neuroaid in Stroke Recovery
Mount Alvernia Hospital, Singapore , Singapore
Stroke is a leading cause of death and disability condition dictated ( table 2 ). The Neuroaid dose received
worldwide  . Many patients only make a partial or poor
was 4 tablets, 3 times per day. Treatment was initiat-
recovery after stroke, and the major burden of stroke is ed between 1 week and 6 months after stroke, and given chronic disability  . To date, no effective treatment has to each patient for 2–3 months. been found for reducing stroke-induced disabilities.
Cases presented with neurological impairments af-
Neuroaid originates from Traditional Chinese Medi-
fecting motor, balance, speech and visual functions.
cine. It has been developed to aid post-stroke recovery, These were assessed during initial examination and and has recently been approved in 7 countries, includ-
The patients showed a good tolerability to the treat-
Early trials of Neuroaid, performed in China on 605 ment. Only 1 mild adverse event was reported, with pa-
patients in 2000, established its safety and demonstrated
tient No. 4 reporting diarrhea after starting Neuroaid.
a positive effect on the recovery of independence and Treatment was reduced, and then progressively in-motor functions. Patients receiving Neuroaid were creased to full dosage within a week. found to be 2.4 times more likely to achieve indepen-
On follow-up, all cases reported improvements over
dence at 1 month after stroke than the control group [3, the period in which they received Neuroaid. There were 4] . More recently, safety trials showed that Neuroaid, 6 cases of patients showing full recovery, 3 cases of good taken either alone or in combination with aspirin, does or moderate recovery and 1 case of poor recovery. Sig-not modify hemostasis, hematology and biochemistry nificant improvements were recorded in motor, visual, in normal subjects and stroke patients  . Additional
speech and cognitive functions ( table 1 ). Motor skills:
double-blind randomized placebo-controlled trials are the 8 patients with motor deficits improved in the ongoing in Asia  .
strength of their upper and lower extremities, and their
This is a case description of 10 patients who took ability to walk; motor disabilities fully resolved in 6 pa-
Neuroaid after ischemic stroke onset. All patients were tients. Balance: the 3 patients showing difficulties in seen in a private clinic at Mount Alvernia Hospital in their balance recovered. Vision: the diplopia and hemi- Singapore and in the Neurology Outpatient Clinic for anopia in 5 patients resolved. Speech: 4 patients report- subsequent follow-up.
ed improvements in speech disabilities, including ex-
Neuroaid was given as an add-on to other medica-
pressive aphasia and anomia; after 3 months, 2 had ful-
tions, including antiplatelet, anticoagulant (warfarin), ly recovered from their speech impairments. lipid-lowering, antihypertensive, diabetic and antide-
The impact of Neuroaid treatment cannot be differ-
pressant medications, which were used as the patient’s entiated from the contribution of natural recovery, med-
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Table 1. Patient recovery
blurred vision, right hemianopia; right-sided headache
left hemianopia;short-term memory loss, mild headache
ness, strength 4+/5 LLE, left dysmetria;acute vertigo;diplopia
speech difficulties: mild anomia,expressive aphasia
RUE = Right upper extremities; RLE = right lower extremities; LLE = left lower extremities; LUE = left upper extremities.
ication and physiotherapy effects. However, all cases re-
It is consistent with late-stage recovery data shown in
early clinical trials. Although the exact mechanism is
Interestingly, 3 patients started Neuroaid treatment not well understood, initial laboratory studies suggest
at a later stage of stroke recovery. In particular, patient improvements in brain neuroplasticity and neuropro-No. 8 started Neuroaid 6 months after reaching a pla-
tection. Larger double-blind placebo-controlled studies
teau in his recovery, and after this continued to experi-
will provide more comprehensive data on Neuroaid in
ence improvements in his speech and cognitive abilities.
Another 2 patients (No. 6 and 7) started Neuroaid 1 month after their strokes, and both recovered signifi-cantly.
These findings support the safety of Neuroaid and its
positive effect on the recovery of the post-stroke patient.
Table 2. Concomitant medications
M = Morning; N = night; D = once a day; B = twice a day; T = thrice a day. a Intake for patient No. 2 was D. b Intake for patient No. 10 was B. References
1 Mathers CD, Loncar D: Projections of global
4 Chen C, Venketasubramanian N, Gan R, et
mortality and burden of disease from 2002
al: Danqi jiaonang (DJ): a Traditional Chi-
2 Wolfe CD: The impact of stroke. Br Med Bull
5 CHIMES: Chinese medicine Neuroaid effi-
3 Tang Q: Clinical study report on efficiency
cacy on stroke recovery. http://clinicaltrials.
of danqi piantan capsule in the treatment of
apoplexy due to deficiency of qi and stasis of
6 Gan R, Lambert C, Lianting J, et al: Danqi
Piantan Jiaonang does not modify hemosta-
sis, hematology and biochemistry in normal
subjects and stroke patients. Cerebrovas Dis 2008; 25: 450–456.
Lymphoma is considered to be the most chemo-responsive cancer in cats and treatment with multi-agent chemotherapy is associated with the longest survival times. Common protocols include ACOPA and Madison Wisconsin, but both utilize the same chemotherapy agents. The induction part of the treatment protocol ranges from 21-25 weeks. The goal of induction chemotherapy is to induce a remission whi
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