levetiracetam and Spinal-Cord-Injuries

A randomized, double-blind, placebo-controlled, crossover, multicenter trial. A 1-week baseline period was followed by two treatment periods of 5 weeks duration with levetiracetam increased from 500 mg b.i.d. to a maximum of 1500 mg b.i.d. separated by a 1-week washout period.. The objective of the study was primarily to evaluate the efficacy of the anticonvulsant levetiracetam in patients with spinal cord injury (SCI) at- and below-level pain and secondarily to evaluate the effect on spasm severity.. Outpatients at two spinal cord units and a pain center.. Patients were allowed to continue their usual pain treatment at a constant dose. The primary outcome measure was the change in median daily pain score (on a 0-10 point numeric rating scale) from 1-week baseline period to the last week of each treatment period. Secondary outcome measures included pain relief of at- and below-level pain, allodynia, spasms and spasticity.. A total of 36 patients with SCI at- and or below-level pain were enrolled. Of these, 24 patients completed the trial. We found no effect of levetiracetam on the primary (P=0.46) or any of the secondary outcome measures. Only two patients continued levetiracetam treatment following the trial, and one patient was still in levetiracetam treatment at the 6-month follow-up. Levetiracetam was generally well tolerated with no serious adverse events.. Levetiracetam does not relieve neuropathic pain or spasm severity following spinal cord injury.

Topics: Adult; Afferent Pathways; Aged; Analgesics; Anticonvulsants; Cross-Over Studies; Double-Blind Method; Female; Humans; Levetiracetam; Male; Middle Aged; Outcome Assessment, Health Care; Pain Measurement; Pain, Intractable; Parasympatholytics; Piracetam; Spasm; Spinal Cord; Spinal Cord Injuries; Treatment Failure

The spinal cord injury (SCI) is one of the major reasons causing the motor dysfunctions of the patients. At present, few therapeutic strategies can effectively improve the symptom of SCI. Levetiracetam has been confirmed to alleviate the injury of nerve cells, while its functions in SCI remains unclear. In this study, C57BL/6J mice were used to establish SCI models to observe the effect of levetiracetam on SCI. The mice were fed with 180 mg/kg levetiracetam when suffering from SCI, and Basso mouse score (BMS) and CatWalk-assisted gait analysis were used to observe the motor functions of the mice. Nissl staining and TUNEL staining were used to observe the injury of nerve cells. The abundance of inflammatory factors was measured by ELISA. The permeability of blood-spinal cord barrier (BSCB) in mice was detected with macrophage infiltration analysis. Moreover, the abundance of perforin in the tissues was detected by western blot. The results showed that the SCI mice treated with levetiracetam exhibited lighter motor dysfunction compared with the mice treated with saline. Levetiracetam can effectively reduce the inflammatory reactions and alleviate apoptosis of the nerve cells. Moreover, levetiracetam remarkably decreased the BSCB permeability of SCI mice. Besides, it was also found that levetiracetam can significantly inhibit the expression of perforin. In conclusion, this study suggests that levetiracetam can attenuate the injury of BSCB to block the progression of SCI via suppressing the expression of perforin.

Topics: Animals; Humans; Levetiracetam; Mice; Mice, Inbred C57BL; Perforin; Spinal Cord Injuries

Topics: Animals; Levetiracetam; Male; Methylprednisolone; Neuroprotective Agents; Rats; Rats, Wistar; Spinal Cord; Spinal Cord Injuries