Efficacy of the free radical scavenger, edaravone, for motor palsy of acute lacunar infarction

Objective: Free radicals are important in causing neural cell injury during cerebral infarction. Although there was a randomized, placebo-controlled, double-blind study at multiple centers in Japan showing the efficacy of the free radical scavenger, edaravone, in acute cerebral infarction, to date the clinical studies are few. This study investigated the effect of edaravone on the outcome of patients with acute lacunar infarction. Methods: We retrospectively evaluated 124 consecutive patients with first-ever acute lacunar infarctions who were admitted to our hospital within 24 hours after the onset between January 2004 and June 2007. Of these, 59 patients received both edaravone and conventional therapy (edaravone group), and the other 65 underwent conventional therapy only (non-edaravone group). There was no significant difference in patients' baseline characteristics in the two groups. The clinical outcome was assessed by the National Institutes of Health Stroke Scale (NIHSS). Results: The reduction of NIHSS scale during hospitalization (1.5±1.0 vs. 1.0±1.1; p = 0.007), especially that of the motor palsy scale (1.0±1.0 vs. 0.5±1.0; p = 0.006) was significantly larger, and the percentage of patients with a favorable outcome (NIHSS at discharge ≤1) (91.5% vs. 78.5%; p = 0.044) was significantly better in the edaravone group. Conclusion: Edaravone improves the outcomes of patients with acute lacunar infarction, especially motor palsy, without regard to the conventional therapy performed concomitantly.