{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:23:29Z","timestamp":1789579409997,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,21]],"date-time":"2021-03-21T00:00:00Z","timestamp":1616284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002345","name":"Eberhard Karls Universit\u00e4t T\u00fcbingen","doi-asserted-by":"publisher","award":["2459\u20100\u20100"],"award-info":[{"award-number":["2459\u20100\u20100"]}],"id":[{"id":"10.13039\/501100002345","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Poststroke delirium (PSD) comprises a common and severe complication after stroke. However, treatment options for PSD remain insufficient. We investigated whether prophylactic melatonin supplementation may be associated with reduced risk for PSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients admitted to the T\u00fcbingen University Stroke Unit, T\u00fcbingen, Germany, with acute ischemic stroke (AIS), who underwent standard care between August 2017 and December 2017, and patients who additionally received prophylactic melatonin (2\u00a0mg per day at night) within 24\u00a0h of symptom onset between August 2018 and December 2018 were included. Primary outcomes were (i) PSD prevalence in AIS patients and (ii) PSD risk and PSD\u2010free survival in patients with cerebral infarction who underwent melatonin supplementation compared to propensity score\u2013matched (PSM) controls. Secondary outcomes included time of PSD onset and PSD duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 465 (81.2%) patients with cerebral infarction and 108 (18.8%) transient ischemic attack (TIA) patients, 152 (26.5%) developed PSD (median time to onset [IQR]: 16 [8\u201332] h;\u00a0duration 24 [8\u201340] h). Higher age, cerebral infarction rather than TIA, and higher National Institutes of Health Stroke Scale score and aphasia on admission were significant predictors of PSD. After PSM (164 melatonin\u2010treated patients with cerebral infarction versus 164 matched controls), 42 (25.6%) melatonin\u2010treated patients developed PSD versus 60 (36.6%) controls (odds ratio, 0.597; 95% confidence interval, 0.372\u20130.958; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.032). PSD\u2010free survival differed significantly between groups (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.027), favoring melatonin\u2010treated patients. In patients with PSD, no between\u2010group differences in the time of PSD onset and PSD duration were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients prophylactically treated with melatonin within 24\u00a0h of AIS onset had lower risk for PSD than patients undergoing standard care. Prospective randomized trials are warranted to corroborate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14792","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:44:16Z","timestamp":1614818656000},"page":"1958-1966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Delirium REduction after administration of melatonin in acute ischemic stroke (DREAMS): A propensity score\u2013matched analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2399-3020","authenticated-orcid":false,"given":"Annerose","family":"Mengel","sequence":"first","affiliation":[{"name":"Department of Neurology &amp; Stroke Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Hertie Institute for Clinical Brain Research Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen 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Applied Biometry of the University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Department of Psychiatry and Psychotherapy University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Stadler","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Stroke Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Hertie Institute for Clinical Brain Research Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Sartor\u2010Pfeiffer","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Stroke Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Hertie Institute for Clinical Brain Research Eberhard\u2010Karls University of T\u00fcbingen T\u00fcbingen 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