The effects of
cilostazol (Pletaal, Otsuka
Pharmaceutical Co., Tokyo, Japan) on cerebral blood flow, P300 event-related potentials, and serum
lipid levels were examined in patients in the chronic stage of
cerebral infarction. This study included 20 patients (13 men and 7 women, mean age 67 +/- 11 years) with
cerebral infarction who had taken
ticlopidine (100 mg orally, twice a day). Quantitative cerebral blood flow measurements by Patlak plot analysis, ultrasound examinations of the common carotid arteries, and measurements of P300 event-related potentials and serum
lipid levels were performed.
Ticlopidine was then replaced with
cilostazol (100 mg orally, twice a day) while other medications remained unchanged. The same examinations were performed again 3 months later. After replacement of
ticlopidine with
cilostazol, cerebral blood flow significantly increased in the frontal white matter, temporal cortex, and occipital cortex compared with cerebral blood flow before replacement with
cilostazol. Ultrasonograms of the common carotid arteries showed no significant differences in intima-media thickness before and after replacement. However, peak systolic velocity, time-averaged peak velocity, and volume flow all significantly increased after replacement. Blood flow in the frontal white matter showed a significant negative correlation with P300 latency before and after replacement of
ticlopidine with
cilostazol. And P300 latency improved significantly after replacement with
cilostazol. Regarding
lipid levels, total
cholesterol,
triglycerides, and remnant-like particles-
cholesterol all decreased significantly after replacement with
cilostazol.
Cilostazol, an inhibitor of platelet aggregation, was thus concluded to be effective in improving cerebral blood flow, cerebral function, and serum
lipid levels in patients in the chronic stage of
cerebral infarction.