Fluoxetine modulates motor performance and cerebral activation of patientsrecovering from stroke

In order to determine the influence of a single dose of fluoxetine on the c erebral motor activation of lacunar stroke patients in the early phase of r ecovery, we conducted a prospective, double-blind, crossover, placebo-contr olled study on 8 patients with pure motor hemiparesia. Each patient underwe nt two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after st roke onset and the second a week later. During the two fMRI examinations, p atients performed an active controlled motor task with the affected hand an d a passive one conducted by the examiner with the same hand. Motor perform ance was evaluated by motor tests under placebo and under fluoxetine immedi ately before the examinations to investigate the effect of fluoxetine on mo tor function. Under fluoxetine, during the active motor task, hyperactivati on in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor act ivation in patients. This redistribution of activation toward the motor cor tex output activation was associated with an enhancement of motor performan ce.