Department of Neurology, Third Faculty of Medicine, Královské Vinohrady University Hospital, Prague, Czech Republic.
Department of Clinical Psychology, Na Homolce Hospital, Prague, Czech Republic.
Neuromodulation. 2021 Oct;24(7):1199-1203. doi: 10.1111/ner.13340. Epub 2021 Feb 2.
Intrathecal baclofen (ITB) pump delivery systems are safe and effective in the treatment of generalized spasticity in chronic spinal cord injury (SCI). Despite its widespread use, few and discrepant data are available in animal studies on the effects of ITB on cognitive functions, such as memory. The effects of chronic administration of baclofen on humans have not been investigated to date. The aim of this study is to find out, whether a long-term administration of ITB has any effects on cognitive functions in SCI subjects.
In 11 out of 22 subjects with chronic SCI, we performed comprehensive neuropsychological assessment carried out using specialized tests focused on memory and other higher cognitive domains and emotional state.
All patients receiving ITB treatment for spasticity relief improved significantly in RAVLT Trials 1-5 (p = 0.049), Logical memory-immediate recall (p = 0.019) and Logical memory-delayed recall (p = 0.008). Visual memory, long-term semantic memory, attention, executive, perceptual and spatial functions, and mood status remained stable.
No significant decline in memory functions were detected following one year of ITB delivery, creating an opportunity for careful prescription of this treatment in chronic SCI. Moreover, we have detected a significant increase in short-term auditory-verbal memory and logical memory performance.
鞘内注射巴氯芬（ITB）泵输送系统在治疗慢性脊髓损伤（SCI）的全身性痉挛方面是安全有效的。尽管它被广泛应用，但在动物研究中，关于 ITB 对认知功能（如记忆）的影响的数据很少且存在差异。迄今为止，尚未研究慢性给予巴氯芬对人类的影响。本研究旨在确定长期给予 ITB 是否会对 SCI 患者的认知功能产生任何影响。
在 22 名慢性 SCI 患者中，我们对 11 名患者进行了全面的神经心理学评估，使用专门的测试进行，这些测试侧重于记忆和其他高级认知领域以及情绪状态。
所有接受 ITB 治疗以缓解痉挛的患者在 RAVLT 试验 1-5 中均有显著改善（p=0.049），逻辑记忆即时回忆（p=0.019）和逻辑记忆延迟回忆（p=0.008）。视觉记忆、长期语义记忆、注意力、执行、感知和空间功能以及情绪状态保持稳定。
在接受 ITB 治疗一年后，未发现记忆功能明显下降，为慢性 SCI 患者谨慎处方这种治疗方法创造了机会。此外，我们还发现短期听觉言语记忆和逻辑记忆表现有显著提高。
