Spinal cord injury treatment

Hashimoto T, Fukuda N (1991) Effect of thyrotropin-releasing hormone on the neurologic impairment in rats with spinal cord injury treatment starting 24 h and 7 days after injury. Eur J Pharmacol 203 25-32... 

Tso and Lam suggested that astaxanthin could be useful for prevention and treatment of neuronal damage associated with age-related macular degeneration and may also be effective in treating ischemic reperfusion injury, Alzheimer s disease, Parkinson s disease, spinal cord injuries, and other types of central nervous system injuries. Astaxanthin was found to easily cross the blood-brain barrier and did not form crystals in the eye. 

Nogo-A. Treatment with IN-1 promoted axonal regeneration and behavioral recovery in rats after thoracic spinal cord injury. These exciting results have since been confirmed using local intrathecal pump infusions of recombinant IN-1 Fab fragments or novel anti-Nogo-A antibodies [9]. 

Another important aspect of this study was that the time window for starting the treatment was extended to 1 week after stroke, demonstrating that anti-Nogo therapy is effective even beyond the time of acute brain damage. These findings open the possibility of treatment options for those suffering from chronic brain or spinal cord injuries. 

Even in the case of spinal cord injury where application of anti-Nogo antibodies results in regeneration of the cut axons, an additional important element for functional recovery is enhanced fiber growth from the unlesioned fibers, i.e. compensatory plasticity, as discussed above. After high corticospinal tract injury in the rat at the level of the medullary pyramid and treatment with anti-Nogo antibodies, rubrospinal pathways were shown to sprout into deafferented areas of the spinal cord, resulting in high levels of functional recovery, i.e. a functional switch in the remodeled pathway [42]. 

Koc RK, Akdemir H, Kurtsoy A, Pasaoglu H, Kavuncu I, Pasaoglu A, Karakucuk I. (1995). Lipid peroxidation in experimental spinal cord injury. Comparison of treatment with Ginkgo biloba, TRH, and methylprednisolone. Res Exp Med. 195(2) 117-123. 

Baclofen is a GABA agonist at GABA B receptors and it has a presynaptic inhibitory function by reducing calcium influx. Its indication is increased extensor tone and clonus. Intrathecal administration may control severe spasticity pain. It is used for the treatment of spastic movement, especially in instances of spinal cord injury, spastic diplegia, multiple sclerosis and amyotrophic lateral sclerosis. Its central nervous system effects include drowsiness, somnolence and seizure activity in epileptic patients. 

Currently stem cells are the focus of a broad and burgeoning area of science aimed at marshaling their generative powers into new treatments, especially for degenerative disorders such as stroke, Parkinson s disease, and spinal-cord injury. These disorders are so destructive that the affected tissue generally cannot be repaired by the body s normal healing mechanisms. 

StemCells Inc receives grant to continue development of human neural stem cells as treatment for spinal cord injuries. StemCells, Inc. PRESS RELEASE 2003 September 08. 

Finally, gastrointestinal distress in the form of nausea and vomiting is quite common with many of the narcotic analgesics. Because of their antiperistaltic action, these drugs can also cause constipation.48 Because this constipating effect can be quite severe, laxatives and stool softeners (see Chapter 27) can be used to prevent opioid-induced constipation in certain people, such as with patients who are at risk for fecal impaction (e.g., people with spinal cord injuries), or with people who are taking opioids for an extended period of time (e.g., patients receiving opioids for treatment of cancer-related pain).36,70... 

Evans CT, Lavela SL, Smith B, et al. Influenza diagnosis and treatment in veterans with spinal cord injury. Arch PhysMed Rehabil. 2006 87 291-293. 

At present, there is no approved medical use for cannabis in patients with neurological disorders. However, it is illegally used for spasticity and ataxia in patients with multiple sclerosis and spinal cord injury, and for the treatment of trigeminal nerve pain and, to a lesser extent, attention deficit hyperactivity disorder. Individuals with spinal cord injury have reported a reduction in spasticity after cannabis use. 

Intracavernosal injection or urethral suppository therapy with alprostadil (PGE1) is useful in the treatment of erectile dysfunction, especially in spinal cord injury. Doses of 2.5-25 ug are used. Penile pain is a frequent side effect that may be related to the algesic effects of PGE derivatives however, only a few patients discontinue the use due to pain. Prolonged erection and priapism are less frequent side effects that occur in fewer than 4% of patients and are minimized by careful titration to the minimal effective dose. When given by injection, alprostadil may be used as monotherapy or in combination with either papaverine or phentolamine. 

Today, with the exception of bone marrow for hematopoietic reconstitution, therapeutic cellular transplantation is an emerging technology. In recent years novel approaches in the potential restoration of function through cellular transplantation have included the use of fetal human or xenogeneic neural tissue for Parkinson s disease, ectopically implanted pancreatic islets for diabetes, Schwann cells and olfactory ensheathing glia for spinal cord injury, encapsulated chromaffin cells for pain, and various types of stem cells for the treatment of diabetes, cardiac disease, and central nervous system injuries or disease [2], There have also been trials of encapsulated cells to provide enzymes that either remove toxic products or provide activation of prodrugs to therapeutics, usually anticancer derivatives. 

Recent studies suggest that U-74006F retains its efficacy in promoting post-traumatic recovery after experimental spinal-cord injury even when initiation of treatment is delayed to 4 hours post-injury. However, after a treatment delay... 

Anderson, D.K., Braughler, J.M., Hall, E.D., Waters, T.R., McCall, J.M. and Means, E.D. (1988) Effects of treatment with U-74006F on neurological recovery following experimental spinal cord injury, J. Neurosurg. 69, 562-567. 

The effects of zf9-THC (5 mg) on the neurological symptoms of spinal cord injury have been studied in one patient [142], Numerous treatments over several months resulted in reduction in subjectively-rated spasticity for periods over 12 h, in improvement of bladder control and pain as well as in the quality of mood and sleep. In contrast to the above reports, Greenberg et al. found no improvement in 10 MS patients who smoked marijuana on a single occasion [143]. Actually, an impairement of balance was noted. 

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