title: Effects of progesterone and vitamin D on outcome of patients with acute traumatic spinal cord injury; a randomized, double-blind, placebo controlled study.
abstract: Steroid hormones offer promising therapeutic perspectives during the acute phase of spinal cord injury (SCI) while the role of progesterone and vitamin D remain controversial. The aim of the current study was to investigate the effects of progesterone and vitamin D on functional outcome of patients with acute traumatic SCI.
  
  
  
  This was a randomized clinical trial including 64 adult patients with acute traumatic SCI admitted within 8 hours of injury. All the patients received methylprednisolone on admission according to standard protocol (30 mg/kg as bolus dose and 15 mg/kg each 3 hours up to 24 hours). Patients were randomly assigned to receive intramuscular injection of 0.5 mg/kg progesterone twice daily and 5µg/kg oral vitamin D3 twice daily up to 5 days (n = 32) or placebo (n = 32). Patients were visited 6 days, 3 and 6 months after injury and motor and sensory function was assessed according to American Spinal Injury Association (ASIA) score.
  
  
  
  There was no significant difference between two study groups regarding age (P = 0.341), sex (P = 0.802) and therapy lag (P = 0.609). The motor powers and sensory function increased significantly after 6 months in both study groups. Those who received progesterone and vitamin D had significantly higher motor powers and sensory function after 6 months of therapy. Those who received the therapy within 4 hours of injury, had significantly higher motor powers and sensory function 6 months after treatment in progesterone and vitamin D group. Therapy lag was negatively associated with 6-month motor powers and sensory function in progesterone and vitamin D group.
  
  
  
  Administration of progesterone and vitamin D in acute phase of traumatic SCI is associated with better functional recovery and outcome.
authors.affiliation: a Department of Neurosurgery , Isfahan University of Medical Sciences , Isfahan , Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Aminmansour
authors.affiliation: a Department of Neurosurgery , Isfahan University of Medical Sciences , Isfahan , Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Asnaashari
authors.affiliation: a Department of Neurosurgery , Isfahan University of Medical Sciences , Isfahan , Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Rezvani
authors.affiliation: b Neurosciences Research Center , Shiraz University of Medical Sciences , Shiraz , Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.affiliation: c Student Research Committee , Isfahan University of Medical Sciences , Isfahan , Iran.
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Amin Noorian
authors.affiliation: a Department of Neurosurgery , Isfahan University of Medical Sciences , Isfahan , Iran.
authors.forename: Masih
authors.initials: M
authors.lastname: Saboori
authors.affiliation: d Department of Psychiatry , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Abdollahzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009043:Motor Activity; D011374:Progesterone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012677:Sensation; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000188:drug therapy*; D014807:Vitamin D / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014807:Vitamin D; D011374:Progesterone; D008775:Methylprednisolone
keywords: Functional recovery; Outcomes; Progesterone; Spinal cord injury; Vitamin D
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