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Effect of Cilostazol Administration on Cerebral Hemodynamics and Rehabilitation Outcomes in Poststroke Patients

ABSTRACT Primary objective: Cilostazol is an antiplatelet agent that inhibits phosphodiesterase III in platelets and the vascular endothelium. We assessed the effects of cilostazol on human cerebral hemodynamics and rehabilitation outcomes. Research design: Prospective, consecutive, observational trial with pretreatment and posttreatment evaluations. Experimental interventions: Cilostazol (200 mg/day) administered for 8 weeks. Methods and procedures: Cerebral blood flow at rest, cerebrovascular reserve capacity, and rehabilitation outcomes (Brunnstrom stage, Barthel index score, modified Rankin Scale score, and Mini-Mental State Examination score) were measured in 104 poststroke patients with an average age ± standard deviation of 60.8 ± 9.2 years. Main outcomes and results: The cerebral blood flow increased by 23.8% on the affected side of the brain and by 16.9% on the nonaffected side. The cerebrovascular reserve capacity increased by 19.0% on the affected side of the brain and by 13.3% on the nonaffected side. Improvements were observed in the Brunnstrom stage, Barthel index score, modified Rankin Scale score, and Mini-Mental State Examination score. Conclusions: Cilostazol appeared to have beneficial effects in poststroke patients with cerebral ischemia and might improve cerebral circulation and rehabilitation outcome.