Conclusions Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials .
Its effect on overall linguistic level and written language tends to emerge within a short period and declines thereafter
Background Aphasia is a common symptom in post-stroke patients .
Piracetam is a commonly used nootropic agent that promises various benefits to brain function , including language improvement .
Objective We performed a systematic review and meta- analysis to assess whether piracetam facilitates the rehabilitation of language performance in post-stroke patients .
Treatment of acute ischemic stroke with piracetam. Members of the Piracetam in Acute Stroke Study (PASS) Group.
BACKGROUND AND PURPOSE Piracetam , a nootropic agent with neuroprotective properties , has been reported in pilot studies to increase compromised regional cerebral blood flow in patients with acute stroke and , given soon after onset , to improve clinical outcome . We performed a multicenter , r and omized , double-blind trial to test whether piracetam conferred benefit when given within 12 hours of the onset of acute ischemic stroke to a large group of patients . METHODS Patients received placebo or 12 g piracetam as an initial intravenous bolus , 12 g daily for 4 weeks and 4.8 g daily for 8 weeks . The primary end point was neurologic outcome after 4 weeks as assessed by the Orgogozo scale . Functional status at 12 weeks as measured by the Barthel Index was the major secondary outcome . CT scan was performed within 24 hours of the onset of stroke but not necessarily before treatment . Analyses based on the intention to treat were performed in all r and omized patients ( n = 927 ) and in an " early treatment " population specified in the protocol as treatment within 6 hours of the onset of stroke but subsequently redefined as less than 7 hours after onset ( n = 452 ) . RESULTS In the total population , outcome was similar with both treatments ( the mean Orgogozo scale after 4 weeks : piracetam 57.7 , placebo 57.6 ; the mean Barthel Index after 12 weeks : piracetam 55.8 , placebo 53.1 ) . Mortality at 12 weeks was 23.9 % ( 111/464 ) in the piracetam group and 19.2 % ( 89/463 ) in the placebo group ( relative risk 1.24 , 95 % confidence interval , 0.97 to 1.59 ; P = .15 ) . Deaths were fewer in the piracetam group in those patients in the intention-to-treat population admitted with primary hemorrhagic stroke . Post hoc analyses in the early treatment subgroup showed differences favoring piracetam relative to placebo in mean Orgogozo scale scores after 4 weeks ( piracetam 60.4 , placebo 54.9 ; P = .07 ) and Barthel Index scores at 12 weeks ( piracetam 58.6 , placebo 49.4 ; P = .02 ) . Additional analyses within this subgroup , confined to 360 patients with moderate and severe stroke ( initial Orgogozo scale score < 55 ) , showed significant improvement on piracetam in both outcomes ( P < .02 ) . CONCLUSIONS Piracetam did not influence outcome when given within 12 hours of the onset of acute ischemic stroke . Post hoc analyses suggest that piracetam may confer benefit when given within 7 hours of onset , particularly in patients with stroke of moderate and severe degree . A r and omized , placebo-controlled , multicenter study , the Piracetam Acute Stroke Study II ( PASS II ) will soon begin
Conclusions Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials .
Its effect on overall linguistic level and written language tends to emerge within a short period and declines thereafter
Background Aphasia is a common symptom in post-stroke patients .
Piracetam is a commonly used nootropic agent that promises various benefits to brain function , including language improvement .
Objective We performed a systematic review and meta- analysis to assess whether piracetam facilitates the rehabilitation of language performance in post-stroke patients .