scholarly journals Non‐invasive spinal direct current simulation for spasticity therapy following spinal cord injury: mechanistic insights contributing to long‐term treatment effects

2019 ◽  
Vol 597 (8) ◽  
pp. 2121-2122 ◽  
Author(s):  
Julio Gómez‐Soriano ◽  
Alvaro Megía‐García ◽  
Diego Serrano‐Muñoz ◽  
Bethel Osuagwu ◽  
Julian Taylor
2014 ◽  
Vol 9 (24) ◽  
pp. 2164 ◽  
Author(s):  
JorgeD Miranda ◽  
OdrickR Rosas ◽  
AranzaI Torrado ◽  
JoseM Santiago ◽  
AnaE Rodriguez ◽  
...  

Author(s):  
Stephen P. Burns ◽  
Mohammad Yavari Rad ◽  
Stacey Bryant ◽  
Vishesh Kapur

1993 ◽  
Vol 78 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Robert J. Coffey ◽  
David Cahill ◽  
William Steers ◽  
T. S. Park ◽  
Joe Ordia ◽  
...  

✓ A total of 93 patients with intractable spasticity due to either spinal cord injury (59 cases), multiple sclerosis (31 cases), or other spinal pathology (three cases) were entered into a randomized double-blind placebocontrolled screening protocol of intrathecal baclofen test injections. Of the 88 patients who responded to an intrathecal bolus of 50, 75, or 100 µg of baclofen, 75 underwent implantation of a programmable pump system for chronic therapy. Patients were followed for 5 to 41 months after surgery (mean 19 months). No deaths or new permanent neurological deficits occurred as a result of surgery or chronic intrathecal baclofen administration. Rigidity was reduced from a mean preoperative Ashworth scale score of 3.9 to a mean postoperative score of 1.7. Muscle spasms were reduced from a mean preoperative score of 3.1 (on a fourpoint scale) to a mean postoperative score of 1.0. Although the dose of intrathecal baclofen required to control spasticity increased with time, drug tolerance was not a limiting factor in this study. Only one patient withdrew from the study because of a late surgical complication (pump pocket infection). Another patient received an intrathecal baclofen overdose because of a human error in programming the pump. The results of this study indicate that intrathecal baclofen infusion can be safe and effective for the long-term treatment of intractable spasticity in patients with spinal cord injury or multiple sclerosis.


2021 ◽  
Vol 12 ◽  
Author(s):  
Fangliang Guo ◽  
Xiaolong Zheng ◽  
Ziyu He ◽  
Ruoying Zhang ◽  
Song Zhang ◽  
...  

Spinal cord injury (SCI) is a devastating condition that results in severe motor, sensory, and autonomic dysfunction. The L-/T-type calcium channel blocker nimodipine (NMD) exerts a protective effect on neuronal injury; however, the protective effects of long-term administration of NMD in subjects with SCI remain unknown. Thus, the aim of this study was to evaluate the role of long-term treatment with NMD on a clinically relevant SCI model. Female rats with SCI induced by 25 mm contusion were subcutaneously injected with vehicle or 10 mg/kg NMD daily for six consecutive weeks. We monitored the motor score, hind limb grip strength, pain-related behaviors, and bladder function in this study to assess the efficacy of NMD in rats with SCI. Rats treated with NMD showed improvements in locomotion, pain-related behaviors, and spasticity-like symptoms, but not in open-field spontaneous activity, hind limb grip strength or bladder function. SCI lesion areas and perilesional neuronal numbers, gliosis and calcitonin gene-related peptide (CGRP+) fiber sprouting in the lumbar spinal cord and the expression of K+–Cl− cotransporter 2 (KCC2) on lumbar motor neurons were also observed to further explore the possible protective mechanisms of NMD. NMD-treated rats showed greater tissue preservation with reduced lesion areas and increased perilesional neuronal sparing. NMD-treated rats also showed improvements in gliosis, CGRP+ fiber sprouting in the lumbar spinal cord, and KCC2 expression in lumbar motor neurons. Together, these results indicate that long-term treatment with NMD improves functional recovery after SCI, which may provide a potential therapeutic strategy for the treatment of SCI.


2019 ◽  
Vol 597 (8) ◽  
pp. 2201-2223 ◽  
Author(s):  
Wagdy Mekhael ◽  
Sultana Begum ◽  
Sreyashi Samaddar ◽  
Mazen Hassan ◽  
Pedro Toruno ◽  
...  

2021 ◽  
Vol 11 (12) ◽  
pp. 1643
Author(s):  
Gaëtan Poulen ◽  
Sylvain Bartolami ◽  
Harun N. Noristani ◽  
Florence E. Perrin ◽  
Yannick N. Gerber

Microglia are major players in scar formation after an injury to the spinal cord. Microglia proliferation, differentiation, and survival are regulated by the colony-stimulating factor 1 (CSF1). Complete microglia elimination using CSF1 receptor (CSF1R) inhibitors worsens motor function recovery after spinal injury (SCI). Conversely, a 1-week oral treatment with GW2580, a CSF1R inhibitor that only inhibits microglia proliferation, promotes motor recovery. Here, we investigate whether prolonged GW2580 treatment further increases beneficial effects on locomotion after SCI. We thus assessed the effect of a 6-week GW2580 oral treatment after lateral hemisection of the spinal cord on functional recovery and its outcome on tissue and cellular responses in adult mice. Long-term depletion of microglia proliferation after SCI failed to improve motor recovery and had no effect on tissue reorganization, as revealed by ex vivo diffusion-weighted magnetic resonance imaging. Six weeks after SCI, GW2580 treatment decreased microglial reactivity and increased astrocytic reactivity. We thus demonstrate that increasing the duration of GW2580 treatment is not beneficial for motor recovery after SCI.


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