Warner Freda M, Cragg Jacquelyn J, Jutzeler Catherine R, Röhrich Frank, Weidner Norbert, Saur Marion, Maier Doris D, Schuld Christian, Curt Armin, Kramer John K
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.
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.
Cell Rep. 2017 Feb 14;18(7):1614-1618. doi: 10.1016/j.celrep.2017.01.048.
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.
抗惊厥药物普瑞巴林可促进脊髓损伤（SCI）小鼠模型的神经再生。我们之前还观察到，抗惊厥药物可改善人类脊髓损伤后的运动结局。本研究在一项大型、前瞻性、多中心队列研究中，对急性脊髓损伤患者使用抗惊厥药物的最佳时机和类型进行了研究。采用混合效应回归技术对损伤后1、3、6和12个月时的总运动评分进行建模。我们发现，早期（而非晚期）使用抗惊厥药物可显著改善运动恢复情况（1年内提高6.25分）。在对1个月时的运动评分和损伤特征差异进行调整后，抗惊厥药物的有益效果仍然显著。对一部分患者的回顾显示，加巴喷丁类药物是最常用的抗惊厥药物。结合临床前研究结果，抗惊厥药物干预是改善脊髓损伤后运动功能的一种潜在药理学策略。
