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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 [1] . 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 [2] . 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 [6] . 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 [5] .
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- Tel. +65 6254 5289, Fax +65 6254 1089, E-Mail siowneurology@singnet.com.sg 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.

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