Abstract Details

Title Metformin Effects on Functional Recovery Following Stroke

Topic Neural Repair/Rehabilitation

Presentation(s) P04 - (-)

Poster/Presentation
Number 035

Objective

Background BACKGROUND: Metformin inhibits gluconeogenesis and facilitates fatty acid metabolism via its effect on adenosine monophosphate kinase (AMPK), a critical molecular switch which senses low blood glucose and oxygen levels. AMPK plays a role in cellular energy homeostasis and may enhance neuronal survival in an ischemic environment.

Design/Methods DESIGN/METHODS: Diabetic patients admitted to our inpatient stroke rehabilitation unit 3 to 30 days following ischemic stroke were included. Metformin (M) and Control (C) subjects were matched for gender, age +/- 5 years, interval post stroke +/-7 days, Admission Functional Independence Measure Total (AFIMT) scores, and presence of urinary protein (scored from 0 to 3) +/- 1 unit as a measure of diabetic glomerulosclerosis severity. 60 case matched pairs were calculated to detect a 5 point change in FIMT from admission to discharge with a Power of 84.6%. A two-tailed probability statistic

Results RESULTS: Means +/- SEM for M vs C for the 60 matched pairs were as follows: Age, 62.8 (0.90) vs. 63.5 (0.96) p=0.61; IPS, 8.8 (0.54) vs. 9.5 (0.68) p=0.64; AFIMT, 58.2 (2.6) vs. 58.8 (2.6) p=0.88; Urine Protein mean rank, 61.5 vs. 59.5 p=0.69. The mean change +/- SD in FIM scores for M v C matched pairs were: 28.0 +/- 11.9 vs. 27.9 +/- 10.4, p=0.98.

Conclusions CONCLUSIONS: This case-matched controlled study does not support the value of metformin as a neuroprotective agent for enhancing functional recovery following ischemic stroke. Secondary analyses will be performed to see if there are other clinical benefits of metformin use. If identified, they will be validated by replication in an independently matched M v C pair group.

Authors/Disclosures
Carolin Dohle, MD PRESENTER	Dr. Dohle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion TPharmaceuticals. Dr. Dohle has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics.
Rolf Martin (Burke-Cornell Medical Research Institute)	No disclosure on file
Rajiv R. Ratan, MD, PhD (Neurology Labs Beth Israel Deaconess Med Ctr)	No disclosure on file
	No disclosure on file
Michael J. Reding, MD	No disclosure on file
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic)	Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.

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