Early Administration of Gabapentinoids Improves Motor Recovery after Human Spinal Cord Injury

Freda M Warner; Jacquelyn J Cragg; Catherine R Jutzeler; Frank Röhrich; Norbert Weidner; Marion Saur; Doris D Maier; Christian Schuld; EMSCI Sites; Armin Curt; John K Kramer

doi:10.1016/j.celrep.2017.01.048

Early Administration of Gabapentinoids Improves Motor Recovery after Human Spinal Cord Injury

Cell Rep. 2017 Feb 14;18(7):1614-1618. doi: 10.1016/j.celrep.2017.01.048.

Authors

Affiliations

¹ School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
² International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada; Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland.
³ School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada; Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland.
⁴ Berufsgenossenschaftliche Klinik Bergmanstrost of Halle, Halle 06112, Germany.
⁵ Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg 69120, Germany.
⁶ Orthopädische Klinik, Hessisch Lichtenau 37235, Germany.
⁷ Berufsgenossenschaftliche Unfallklinik Murnau, Murnau 82418, Germany.
⁸ European Multi-centre Study about Spinal Cord Injury (EMSCI) Study Group, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland.
⁹ Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland; European Multi-centre Study about Spinal Cord Injury (EMSCI) Study Group, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland.
¹⁰ School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada. Electronic address: kramer@icord.org.

PMID: 28199834
DOI: 10.1016/j.celrep.2017.01.048

Abstract

The anticonvulsant pregabalin promotes neural regeneration in a mouse model of spinal cord injury (SCI). We have also previously observed that anticonvulsants improve motor outcomes following human SCI. The present study examined the optimal timing and type of anticonvulsants administered in a large, prospective, multi-center, cohort study in acute SCI. Mixed-effects regression techniques were used to model total motor scores at 1, 3, 6, and 12 months post injury. We found that early (not late) administration of anticonvulsants significantly improved motor recovery (6.25 points over 1 year). The beneficial effect of anticonvulsants remained significant after adjustment for differences in 1-month motor scores and injury characteristics. A review of a subset of patients revealed that gabapentinoids were the most frequently administrated anticonvulsant. Together with preclinical findings, intervention with anticonvulsants represents a potential pharmacological strategy to improve motor function after SCI.

Keywords: anticonvulsants; gabapentin; gabapentinoids; pregabalin; spinal cord injury.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Anticonvulsants / therapeutic use*
Female
Humans
Male
Middle Aged
Motor Activity / drug effects*
Nerve Regeneration / drug effects
Neuroprotective Agents / therapeutic use
Prospective Studies
Spinal Cord / drug effects
Spinal Cord Injuries / drug therapy*

Substances

Anticonvulsants
Neuroprotective Agents