Cominacini Mattia, Valenti Maria Teresa, Braggio Michele, Caramori Alberto, Vedovi Ermes, Dalle Carbonare Luca
Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy.
Department of Neurosciences, Biomedicines and Movement Medicine, University of Verona, Verona, Italy.
Eur J Neurol. 2025 Aug;32(8):e70334. doi: 10.1111/ene.70334.
Peripheral neuropathies encompass a diverse group of disorders involving peripheral nerve damage, often leading to pain, sensory disturbances, and motor impairments. The etiology is multifactorial, with trauma as a key contributor. The treatment of peripheral neuropathies includes medications targeting the nociceptive component, whereas the neuropathic component is managed with agents such as gabapentinoids or antidepressants, though their prolonged use is limited by significant side effects. Some neuroprotective compounds, such as acetyl-L-carnitine (ALC), palmitoylethanolamide (PEA), and alpha-lipoic acid (ALA), have emerged as potential alternatives due to their anti-inflammatory and analgesic properties.
This monocentric, observational, single-arm longitudinal study evaluated the efficacy of a fixed combination containing ALC, PEA, and ALA (as an adjuvant to the previous two) and Boswellia serrata, Vitamin E, and Vitamin B6 in patients with acute low back trauma. Over 8 weeks, 48 participants received the supplement alongside conventional therapy. The primary end point was improvement in neuropathic pain assessed via the Neuropathic Pain Scale (NPS) and Visual Analogue Scale (VAS). Secondary endpoints included quality of life (SF-36) changes, reduced NSAID consumption, and adverse events.
The study showed significant reductions in NPS and VAS scores and improvements in physical health-related SF-36 domains, with reduced NSAID consumption. Participants with more severe baseline symptoms demonstrated the greatest benefits. No significant changes were observed in emotional parameters. Adverse events were mild and in a very limited number of patients.
Results suggest the combination's potential to improve pain and reduce reliance on conventional therapies; however, further controlled randomized trials are needed to validate these findings.
周围神经病变包括多种涉及周围神经损伤的疾病,常导致疼痛、感觉障碍和运动功能受损。其病因是多因素的,创伤是关键因素。周围神经病变的治疗包括针对伤害性感受成分的药物,而神经病变成分则用加巴喷丁类药物或抗抑郁药等药物治疗,但其长期使用受到明显副作用的限制。一些神经保护化合物,如乙酰-L-肉碱(ALC)、棕榈酰乙醇胺(PEA)和α-硫辛酸(ALA),因其抗炎和镇痛特性而成为潜在的替代药物。
这项单中心、观察性、单臂纵向研究评估了一种固定组合(包含ALC、PEA和ALA(作为前两者的佐剂)以及乳香、维生素E和维生素B6)对急性下背部创伤患者的疗效。在8周内,48名参与者在接受常规治疗的同时服用该补充剂。主要终点是通过神经病理性疼痛量表(NPS)和视觉模拟量表(VAS)评估的神经病理性疼痛的改善情况。次要终点包括生活质量(SF-36)变化、非甾体抗炎药消耗量减少以及不良事件。
研究表明,NPS和VAS评分显著降低,与身体健康相关的SF-36领域有所改善,非甾体抗炎药消耗量减少。基线症状较严重的参与者受益最大。情绪参数未观察到显著变化。不良事件轻微,且仅在极少数患者中出现。
结果表明该组合有可能改善疼痛并减少对传统疗法的依赖;然而,需要进一步的对照随机试验来验证这些发现。