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Letter to the Editor regarding “Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes diagnosed after metformin-triggered stroke-like episodes”
We read with interest the article by Murakami et al. about a 40 years-old male with mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome due to the variant m.3243A>G with a heteroplasmy rate of 27%, in whom metformin was suspected to have triggered a stroke-like episode (SLE), the phenotypic hallmark of MELAS.1 Metformin was replaced by sitagliptin and the patient was discharged in a stable condition after three weeks.1 The study is excellent, but has limitations that are objectionable and should be discussed.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2023 Category: Neurology Authors: Josef Finsterer Tags: Letter to the Editor Source Type: research

In reply to the letter to the editor reading: Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes diagnosed after metformin-triggered stroke-like episodes
We are grateful to Josef Finsterer for his comments on our recent report regarding mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) diagnosed after metformin-triggered stroke-like episodes (SLEs).1 In his letter to the editor, several limitations regarding our study were raised.
Source: Journal of Stroke and Cerebrovascular Diseases - April 19, 2023 Category: Neurology Authors: Keishu Murakami, Ken Sakamoto, Hiroshi Ishiguchi, Hidefumi Ito Tags: Letter to the Editor Source Type: research

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes diagnosed after metformin-triggered stroke-like episodes
A 40-year-old man with sensorineural hearing loss and diabetes mellitus was hospitalized with acute-onset impaired consciousness and clumsiness in his left hand. He had been taking metformin (750 mg/day) for 4 months. He had no febrile illness, energy failure, or use of mitochondria-toxic drugs other than metformin. The patient had a family history of diabetes mellitus (maternal uncle and aunt). His weight and height were 35 kg and 1.58 m, respectively. A neurological examination revealed confusion and weakness in the left upper limb.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2023 Category: Neurology Authors: Keishu Murakami, Ken Sakamoto, Hiroshi Ishiguchi, Hidefumi Ito Tags: Case Report Source Type: research

Effect of metformin on outcome after acute ischemic stroke in patients with type 2 diabetes mellitus
Diabetes mellitus is a well-known risk factor for ischemic stroke and is associated with unfavorable outcome after stroke. Metformin is recommended as first-line treatment in these patients. Pre-stroke metformin use might have neuroprotective properties resulting in reduced stroke severity. However, results of the effects of pre-stroke metformin use on functional outcome are conflicting and has not been previously described in patients with type 2 diabetes mellitus regardless of stroke severity or revascularization treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - August 1, 2022 Category: Neurology Authors: C.J.B.A. Kersten, I.L.H. Knottnerus, E. Heijmans, M. Haalboom, A.A.M. Zandbergen, H.M. den Hertog Source Type: research

Impact of Metformin on the Severity and Outcomes of Acute Ischemic Stroke in Patients with Type 2 Diabetes Mellitus
This study evaluated the effects of metformin on stroke severity and outcomes in acute ischemic stroke patients with type 2 DM.
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2015 Category: Neurology Authors: Yohei Mima, Takahiro Kuwashiro, Masahiro Yasaka, Yuichiro Tsurusaki, Asako Nakamura, Yoshiyuki Wakugawa, Yasushi Okada Source Type: research

Metformin-inclusive Therapy Reduces the Risk of Stroke in Patients with Diabetes: A 4-Year Follow-up Study
Metformin is a kind of oral hypoglycemic agents commonly prescribed to patients with diabetes mellitus. Although past studies had proven its protective effect on cardiovascular risk and related mortality, the evidence of metformin on stroke prevention was still insufficient and conflicting. Our study randomly selected 14,856 patients with diabetes from the database provided by the Taiwan National Health Research Institute, and 2 cohorts were formulated according to whether metformin was in the prescription record. All cases were followed up for 4 years to track their stroke incidence. As a result, 701 (17.5%) of 3999 diabe...
Source: Journal of Stroke and Cerebrovascular Diseases - October 11, 2013 Category: Neurology Authors: Yuan-Yang Cheng, Hsin-Bang Leu, Tzeng-Ji Chen, Chen-Ling Chen, Chia-Hua Kuo, Shin-Da Lee, Chung-Lan Kao Tags: Original Articles Source Type: research