Association of timing of gabapentinoid use with motor recovery after spinal cord injury

Neurology, 2020 · DOI: 10.1212/WNL.0000000000010950 · Published: December 15, 2020

Spinal Cord Injury Pharmacology Neurology

Simple Explanation

Gabapentinoids are commonly used to manage neuropathic pain after spinal cord injury. This study investigates whether the timing of gabapentinoid administration affects motor recovery. The study found that administering gabapentinoids within 30 days of the injury was associated with improved motor recovery compared to those who did not receive them during this time. The benefit was even greater when the medication was given within the first 5 days after the injury, suggesting that early intervention may lead to better outcomes.

Study Duration

1 year

Participants

201 participants with spinal cord injury

Evidence Level

Class IV evidence, observational study

Key Findings

1
Early administration (within 30 days) of gabapentinoids after spinal cord injury is associated with improved motor recovery.
2
The greatest improvement in motor score was observed when gabapentinoids were administered within the first 5 days of injury.
3
Early gabapentinoid administration was also significantly associated with greater recovery of light touch scores.

Research Summary

This observational study examined the association between the timing of gabapentinoid administration and motor recovery after spinal cord injury. The study found that early administration of gabapentinoids (within 30 days of injury) was associated with improved motor recovery, with the greatest benefit observed when administered within 5 days. The findings suggest a potential time dependence for the beneficial effects of gabapentinoids on neurologic recovery after spinal cord injury.

Practical Implications

Potential for Drug Repurposing

Gabapentinoids, already used for pain management in spinal cord injury patients, may offer a readily available option to improve motor recovery.

Importance of Early Intervention

The study suggests that administering gabapentinoids as early as possible after spinal cord injury, ideally within the first 5 days, may maximize benefits.

Future Clinical Trials

The findings support the need for randomized controlled trials to confirm the benefits of early gabapentinoid administration and to determine optimal dosage and duration.

Study Limitations

1
The observational nature of the study prevents establishing causality.
2
Specific dosages of gabapentinoids were not collected.
3
The effect of very early administration (within 5 days) is based on a small sample size.

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