Dl-3-n-butylphthalide can improve the cognitive function of patients with acute ischemic stroke: a prospective intervention study

Objectives: The present study investigated the effects of dl-3-n-butylphthalide on cognitive function of patients with acute ischemic stroke (AIS).Methods: A total of 104 patients with AIS admitted between October 2012 and June 2013 were assigned to either the Treatment (standardized treatment plus dl-3-n-butylphthalide) or Control (standardized treatment alone) groups. Cognitive function was assessed by the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) and Mini-Mental State Examination (MMSE) before and 1month after treatment, when high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) were also detected. A multivariate logistic regression analysis was done for explore the independent risk factors for vascular dementia (VD).Results: The proportion of cognitive impairment was significantly lower after treatment than before in both the Treatment (88% vs. 64%, P=0.023) and Control (87% vs. 70%, P=0.047) groups. Vascular dementia dropped from 30 to 10% in the Treatment (P=0.035) and from 25.9 to 16.7% in the Control (P=0.027) groups. Total cognitive improvement was more significant in the Treatment Group (P=0.018); naming, memory, attention, and linguistic abilities were significantly improved (all P<0.05). Serum Hcy and hs-CRP levels were significantly lower in the Treatment Group than in the Control Group 1month after treatment (P<0.05).Discussion: Dl-3-n-butylphthalide could significantly improve the cognitive function of AIS patients 1month after stroke. Hcy was involved in the incidence of VD 1month after AIS. However, further studies are necessary because of differences between groups at baseline.