Animal experiments have indicated that noradrenergic agents can improve the recovery from stroke. In this double-blind placebo-controlled crossover study, hemiparetic chronic stroke patients (n = 10) received a single dose of the noradrenaline reuptake inhibitor reboxetine or placebo. Then the patients participated in one hour of physiotherapy focused on function of the paretic hand. Three different motor assessments (tapping speed, grip strength, dexterity evaluation) were performed before drug intake, 1.5 hours later and after the physiotherapy session. Transcranial magnetic stimulation (TMS) was used to investigate motor excitability by measuring motor thresholds and amplitudes of motor evoked potentials. Both hands were studied. Compared with placebo, reboxetine ingestion was followed by an increase of tapping speed and grip strength in the paretic but not in the unaffected hand. No further improvement was noticed after physiotherapy. TMS results and dexterity measurements remained unchanged. We conclude that reboxetine improved simple hand functions in chronic stroke patients. Reboxetine should be considered as an additional tool in neurorehabilitation.
