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Gene therapy is a technique where a gene is inserted into a person’s cells to prevent or treat a serious disease. The added gene may be a healthy version of the gene that is mutated in the patient, or it could be a different gene that inactivates or compensates for the patient’s disease-causing gene. For example, in patients with severe combined immunodeficiency (SCID) due to a mutation in the gene for the enzyme adenosine deaminase, a functioning version of the gene can be...
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Intrathecal Therapies.

Michael Saulino1

  • 1MossRehab, 60 Township Line Road, Elkins Park, PA 19027, USA; Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA.

Physical Medicine and Rehabilitation Clinics of North America
|January 11, 2019
PubMed
Summary
This summary is machine-generated.

Intrathecal baclofen therapy effectively manages spasticity. This review explores its pharmacology, delivery, and novel applications for broader patient access.

Keywords:
Intrathecal baclofenIntrathecal therapyIntraventricular baclofenSpasticity

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Area of Science:

  • Neurology
  • Pharmacology
  • Neurosurgery

Background:

  • Intrathecal baclofen therapy (ITB) is a primary treatment for severe spasticity.
  • ITB involves delivering baclofen directly into the cerebrospinal fluid via an implanted pump.
  • Understanding ITB's pharmacology and delivery is crucial for effective patient management.

Observation:

  • This review examines the established use of ITB for spasticity.
  • Four unique clinical scenarios are presented to illustrate expanded ITB applications.
  • These include ITB trial necessity, patient-controlled boluses, alternative intrathecal medications, and intraventricular delivery.

Findings:

  • Baclofen's mechanism of action involves GABA-B receptor agonism.
  • Standard ITB protocols focus on continuous infusion for spasticity.
  • Unconventional uses demonstrate ITB's adaptability beyond typical indications.

Implications:

  • Exploring novel ITB applications can benefit a wider spastic patient population.
  • Patient-directed dosing and alternative intrathecal agents may enhance treatment efficacy.
  • Intraventricular delivery offers a potential alternative for specific neurological conditions.