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Effect of intrathecal baclofen on sleep and respiratory function in patients with spasticity.
Neurology 2006; 67(8):1432-6Neur

Abstract

OBJECTIVE

To prospectively evaluate the effect of pump-infused intrathecal baclofen infusion (ITB) in therapeutic doses on sleep quality and on daytime and nighttime respiratory function in patients with severe spasticity.

METHODS

We prospectively evaluated 20 consecutive patients (mean +/- SD age 45 +/- 13 years). We assessed spasticity and obtained polysomnography, pulmonary function tests, and resting energy expenditure measurements 1 week before and at least 8 days after pump implantation. Patients stopped oral baclofen upon pump implantation but continued other medications unchanged. We report descriptive statistics as means +/- SD.

RESULTS

Most of the patients had multiple sclerosis (n = 9) or spinal cord injury (n = 8); there was one case each of cerebral palsy, hereditary spastic paraplegia, and Friedreich ataxia. Before and after ITB initiation, mean Ashworth scores were 2.75 +/- 0.85 and 1.15 +/- 0.36, and mean spasm scores were 3.75 +/- 0.55 and 1.00 +/- 0.56. ITB improved total sleep time (p = 0.05) and sleep efficiency (p = 0.01) and reduced periodic leg movements (p = 0.02). ITB did not modify sleep-related respiratory events, lung function tests, CO2 rebreathing response, or resting energy expenditure.

CONCLUSION

Compared with oral baclofen, intrathecal baclofen infusion did not affect respiratory function and improved sleep continuity. Intrathecal baclofen infusion in therapeutic doses may act at the spinal level rather than at the supraspinal level.

Authors+Show Affiliations

Physical Medicine and Rehabilitation Department, AP-HP, Hôpital Raymond Poincaré, Université Versailles-Saint-Quentin, Garches, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17060570

Citation

Bensmail, D, et al. "Effect of Intrathecal Baclofen On Sleep and Respiratory Function in Patients With Spasticity." Neurology, vol. 67, no. 8, 2006, pp. 1432-6.
Bensmail D, Quera Salva MA, Roche N, et al. Effect of intrathecal baclofen on sleep and respiratory function in patients with spasticity. Neurology. 2006;67(8):1432-6.
Bensmail, D., Quera Salva, M. A., Roche, N., Benyahia, S., Bohic, M., Denys, P., ... Lofaso, F. (2006). Effect of intrathecal baclofen on sleep and respiratory function in patients with spasticity. Neurology, 67(8), pp. 1432-6.
Bensmail D, et al. Effect of Intrathecal Baclofen On Sleep and Respiratory Function in Patients With Spasticity. Neurology. 2006 Oct 24;67(8):1432-6. PubMed PMID: 17060570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of intrathecal baclofen on sleep and respiratory function in patients with spasticity. AU - Bensmail,D, AU - Quera Salva,M A, AU - Roche,N, AU - Benyahia,S, AU - Bohic,M, AU - Denys,P, AU - Bussel,B, AU - Lofaso,F, PY - 2006/10/25/pubmed PY - 2006/11/11/medline PY - 2006/10/25/entrez SP - 1432 EP - 6 JF - Neurology JO - Neurology VL - 67 IS - 8 N2 - OBJECTIVE: To prospectively evaluate the effect of pump-infused intrathecal baclofen infusion (ITB) in therapeutic doses on sleep quality and on daytime and nighttime respiratory function in patients with severe spasticity. METHODS: We prospectively evaluated 20 consecutive patients (mean +/- SD age 45 +/- 13 years). We assessed spasticity and obtained polysomnography, pulmonary function tests, and resting energy expenditure measurements 1 week before and at least 8 days after pump implantation. Patients stopped oral baclofen upon pump implantation but continued other medications unchanged. We report descriptive statistics as means +/- SD. RESULTS: Most of the patients had multiple sclerosis (n = 9) or spinal cord injury (n = 8); there was one case each of cerebral palsy, hereditary spastic paraplegia, and Friedreich ataxia. Before and after ITB initiation, mean Ashworth scores were 2.75 +/- 0.85 and 1.15 +/- 0.36, and mean spasm scores were 3.75 +/- 0.55 and 1.00 +/- 0.56. ITB improved total sleep time (p = 0.05) and sleep efficiency (p = 0.01) and reduced periodic leg movements (p = 0.02). ITB did not modify sleep-related respiratory events, lung function tests, CO2 rebreathing response, or resting energy expenditure. CONCLUSION: Compared with oral baclofen, intrathecal baclofen infusion did not affect respiratory function and improved sleep continuity. Intrathecal baclofen infusion in therapeutic doses may act at the spinal level rather than at the supraspinal level. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17060570/Effect_of_intrathecal_baclofen_on_sleep_and_respiratory_function_in_patients_with_spasticity_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=17060570 DB - PRIME DP - Unbound Medicine ER -