title: Early Administration of Gabapentinoids Improves Motor Recovery after Human Spinal Cord Injury.
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.
authors.affiliation: 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.
authors.forename: Freda M
authors.initials: FM
authors.lastname: Warner
authors.affiliation: 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.
authors.forename: Jacquelyn J
authors.initials: JJ
authors.lastname: Cragg
authors.affiliation: 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.
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Jutzeler
authors.affiliation: Berufsgenossenschaftliche Klinik Bergmanstrost of Halle, Halle 06112, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Röhrich
authors.affiliation: Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg 69120, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Weidner
authors.affiliation: Orthopädische Klinik, Hessisch Lichtenau 37235, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Saur
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Murnau, Murnau 82418, Germany.
authors.forename: Doris D
authors.initials: DD
authors.lastname: Maier
authors.affiliation: Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg 69120, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schuld
authors.affiliation: European Multi-centre Study about Spinal Cord Injury (EMSCI) Study Group, University Hospital Balgrist, University of Zurich, Zurich 8008, Switzerland.
authors.affiliation: 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.
authors.forename: Armin
authors.initials: A
authors.lastname: Curt
authors.affiliation: 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.
authors.forename: John K
authors.initials: JK
authors.lastname: Kramer
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects*; D009416:Nerve Regeneration / Q000187:drug effects; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011446:Prospective Studies; D013116:Spinal Cord / Q000187:drug effects; D013119:Spinal Cord Injuries / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D018696:Neuroprotective Agents
keywords: anticonvulsants; gabapentin; gabapentinoids; pregabalin; spinal cord injury