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Related Experiment Videos

Effectiveness of gabapentin in controlling spasticity: a quantitative study

M M Priebe1, A M Sherwood, D E Graves

  • 1Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.

Spinal Cord
|March 1, 1997
PubMed
Summary

Gabapentin may help control some spasticity in spinal cord injury (SCI) patients. Higher doses showed greater effectiveness in clinical trials and quantitative assessments, warranting further study.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Pharmacology

Background:

  • Spasticity is a common and often debilitating symptom following spinal cord injury (SCI).
  • Current pharmacological treatments for SCI-induced spasticity have limitations, necessitating exploration of alternative therapies.
  • Quantitative assessment methods are crucial for objectively evaluating treatment efficacy in SCI spasticity.

Purpose of the Study:

  • To investigate the effectiveness of gabapentin in managing spasticity in individuals with spinal cord injury (SCI).
  • To utilize the brain motor control assessment (BMCA), a surface EMG-based quantitative technique, for evaluating spasticity.
  • To compare the efficacy of gabapentin against a placebo in a controlled, cross-over clinical trial setting.

Main Methods:

Related Experiment Videos

  • A multi-center, placebo-controlled, cross-over trial involving six male participants with traumatic SCI and spasticity.
  • Administration of oral gabapentin (400 mg three times daily) or placebo for 48 hours, followed by a 10-day washout and cross-over.
  • Multi-channel surface EMG recordings of lower extremities, abdomen, and low back muscles were used for assessment before and during treatment, alongside clinical evaluation.
  • An open-label extension phase was conducted to explore higher gabapentin dosages (up to 3600 mg/day).

Main Results:

  • Group results from the initial controlled trial at 400 mg T.I.D. did not achieve statistical significance.
  • One participant showed significant clinical and BMCA-documented improvement in spasticity.
  • Modest improvements were detected by BMCA in other participants, though not always clinically apparent at the lower dose.
  • During the open-label extension, four participants experienced notable clinical improvements at higher doses (up to 3600 mg/day).
  • BMCA detected subclinical changes that correlated with clinical improvements at higher doses.
  • A seventh participant demonstrated a dose-related effect of gabapentin (800-1200 mg T.I.D.) that aligned with clinical observations.

Conclusions:

  • Gabapentin at 400 mg T.I.D. may offer benefits for specific spasticity features in SCI patients, though not statistically significant in group analysis at this dose.
  • Higher doses of gabapentin appear to provide more substantial control over spasticity, as evidenced in the open-label extension and individual case studies.
  • Further controlled studies employing higher gabapentin dosages are necessary to definitively establish its efficacy for managing SCI-related spasticity.