The Effect of Levodopa on Motor Function Outcome in Patients with Ischemic Stroke: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Levodopa enhances neuronal plasticity and functional recovery and modulates anatomical and functional variations in central nervous system. The present study was aimed to evaluate the effect of levodopa-C on motor function recovery of patients experienced a stroke. This was a randomized, placebo-controlled, double-blind clinical trial conducted on 114 patients with ischemic middle cerebral artery stroke. The patients after the first day of stroke were randomly divided into two groups: the levodopa-C group and placebo group. In addition to the intervention, the patients received the stroke routine medications during the study. The patients received 100 mg daily medication for 3 weeks. A significant improvement was observed in motor function criteria of Rivermead mobility index (RMI) (p = 0.006) and Barthel index (BI) (p = 0.009) after 21 days in the levodopa-C group (79.1 %), compared to the placebo group (49 %). A review was carried in the subgroups, which indicate that patients with cortical stroke in the levodopa group had a significant improvement, compared with the placebo group (p = 0.005). The basic motor functions of about 79 % of the levodopa-C patients (n = 35), compared with the 44% in the placebo group, were enhanced by 25% according to the BI and RMI criteria (p = 0.008). Most of these patients had cortical stroke. Our findings showed significant therapeutic effect of levodopa-C in the patients with cortical stroke. Larger clinical trials containing larger sample size with cortical ischemic stroke are needed to better assess the impact.