Donepezil Improves Gait Performance in Patients with an Acute Cerebral Infarction: A Prospective Observational Cohort Study

Abstract

Background: Hemiplegia is a common symptom after acute cerebral infarction. Objective: This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction. Methods: A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent 3-month assessment. At the study's conclusion, patients were divided into 2 groups-those received daily donepezil (observation Group) and those not (Control Group). Results: There was significant difference (t=3.269, p=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference of WGS scores between subgroups (p>0.05), respectively. Patient's admission National Institute of Health Stroke Scale(NIHSS) score had strongly positive correlation with WGS score (r=0.850, p<0.001). Besides, age (r=0.218, p=0.024), glycosylated hemoglobin (r=0.274, p=0.004), MMSE (r=-0.261, p=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, p=0.005) had weakly correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.042~0.188, p=0.002), admission NIHSS score (95% CI: 2.405~3.137, p<0.001) and multiple sites infarction (95% CI: 0.044~2.983, p=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (p<0.001). At 3 months after admission, WGS score of observation group was significantly lower than control group (t=2.468, p=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (p>0.05). And WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (p<0.001), while there were no significant difference between two groups (p>0.05). Conclusion: Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with an acute cerebral infarction.