Functional improvement in chronic human spinal cord injury: Four years after acidic fibroblast growth factor

Scientific Reports, 2018 · DOI: 10.1038/s41598-018-31083-4 · Published: August 10, 2018

Spinal Cord Injury Genetics Neurorehabilitation

Simple Explanation

This study investigates the long-term effects of acidic fibroblast growth factor (aFGF) on patients with chronic spinal cord injury (SCI). The treatment involved applying aFGF directly to the injured spinal cord during surgery and follow-up lumbar punctures. The study tracked neurological functions over four years to assess the treatment's safety and effectiveness. The results showed improvements in several neurological functions, including motor skills, sensory perception, and functional independence. Patients experienced a decrease in dependence on others for daily activities. No major adverse events or oncological problems were reported during the follow-up period. The study suggests that aFGF is a safe and feasible treatment that can lead to modest functional improvements in patients with chronic SCI. However, the authors emphasize the need for further randomized controlled trials to validate the optimal dosage and effectiveness of aFGF.

Study Duration

48 months

Participants

46 patients (21 cervical- and 25 thoracolumbar-SCI)

Evidence Level

Level III, Open-label prospective clinical trial

Key Findings

1
Significant improvements were observed in ASIA impairment scales, motor scores, pin prick, light touch, and FIM motor subtotal scores in both cervical and thoracolumbar SCI groups.
2
Patients in both groups experienced a decrease in dependence on helpers for daily activities, as indicated by improvements in FIM scores.
3
No major adverse events or oncological problems were reported throughout the 48-month follow-up period, indicating the safety of aFGF treatment.

Research Summary

This study evaluated the long-term efficacy and safety of aFGF in treating chronic SCI patients over a 48-month period. The aFGF was administered directly to the injured spinal cord during surgery and via lumbar punctures. The results demonstrated significant improvements in neurological functions, including motor and sensory scores, as well as functional independence. The improvements were sustained from the 24-month mark to the 48-month follow-up, with no additional aFGF boosters administered. The study concludes that aFGF is a safe and feasible treatment option for chronic SCI, leading to improved quality of life for patients. However, the authors emphasize the need for further randomized controlled trials to validate these findings and determine optimal dosage.

Practical Implications

Potential Therapeutic Strategy

aFGF can be considered as a potential therapeutic strategy to improve functional outcomes in patients with chronic SCI.

Improved Patient Independence

The improvements in FIM scores suggest that aFGF treatment can help reduce dependence on caregivers and enhance the quality of life for SCI patients.

Further Research Needed

Large-scale, randomized, controlled trials are needed to validate the efficacy and safety of aFGF and to optimize its dosage and administration protocols.

Study Limitations

1
The study lacked a control group due to ethical issues and strict inclusion/exclusion criteria.
2
Neurological improvements may be attributed to the effects of aFGF, surgical procedures (neurolysis), or the rehabilitation program.
3
The intrinsic capacity of individuals to repair the injured nervous system cannot be neglected.

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