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Use of intrathecal baclofen for treatment of severe spasticity in selected patients with motor neuron disease.
Neurorehabil Neural Repair. 2013 Nov-Dec; 27(9):828-33.NN

Abstract

OBJECTIVE

To assess the safety and efficacy of intrathecal baclofen (ITB) therapy for severe spasticity in patients with upper-motor neuron predominant motor neuron disease (U-MND).

METHODS

A total of 44 patients with U-MND were referred for discussion of ITB therapy. Baseline and outcomes data were extracted on 35 patients from a clinical spasticity registry at a tertiary referral center. Patients choosing to initiate ITB (n = 20) were compared with those choosing conservative therapy (n = 15).

RESULTS

At baseline, lower average pain score in the non-ITB group was the only significant difference between the 2 groups. A significant reduction in pain scores, Modified Ashworth Scale (MAS), Spasm Frequency Scale, and requirement for oral spasticity medications was observed within the ITB group at early and late follow-up. Within the non-ITB group, there was a significant increase in MAS scores between baseline and late follow-up. A statistically significant difference favoring the ITB group was observed for change in MAS score (P < .0001), Numerical Rating Scale pain score (P = .04), dose of oral baclofen (P = .002) and tizanidine (P = .003), and number of oral medications for spasticity (P = .002). There was no difference between the 2 groups in the progression of hip flexor weakness or in the proportion of patients who became nonambulatory.

CONCLUSIONS

Our findings suggest that ITB can effectively reduce spasticity and related symptoms without compromising function in selected patients with U-MND.

Authors+Show Affiliations

1Cleveland Clinic, Ohio, USA.No affiliation info availableNo affiliation info availableNo 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

23884016

Citation

Bethoux, Francois, et al. "Use of Intrathecal Baclofen for Treatment of Severe Spasticity in Selected Patients With Motor Neuron Disease." Neurorehabilitation and Neural Repair, vol. 27, no. 9, 2013, pp. 828-33.
Bethoux F, Boulis N, McClelland S, et al. Use of intrathecal baclofen for treatment of severe spasticity in selected patients with motor neuron disease. Neurorehabil Neural Repair. 2013;27(9):828-33.
Bethoux, F., Boulis, N., McClelland, S., Willis, M. A., Hussain, M., Machado, A., Mychkovsky, L., Stough, D., Sutliff, M., & Pioro, E. P. (2013). Use of intrathecal baclofen for treatment of severe spasticity in selected patients with motor neuron disease. Neurorehabilitation and Neural Repair, 27(9), 828-33. https://doi.org/10.1177/1545968313496325
Bethoux F, et al. Use of Intrathecal Baclofen for Treatment of Severe Spasticity in Selected Patients With Motor Neuron Disease. Neurorehabil Neural Repair. 2013;27(9):828-33. PubMed PMID: 23884016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of intrathecal baclofen for treatment of severe spasticity in selected patients with motor neuron disease. AU - Bethoux,Francois, AU - Boulis,Nicholas, AU - McClelland,Shearwood,3rd AU - Willis,Mary Alissa, AU - Hussain,Mariam, AU - Machado,Andre, AU - Mychkovsky,Lydia, AU - Stough,Darlene, AU - Sutliff,Matt, AU - Pioro,Erik P, Y1 - 2013/07/24/ PY - 2013/7/26/entrez PY - 2013/7/26/pubmed PY - 2014/7/18/medline KW - intrathecal baclofen KW - motor neuron disease KW - spasticity SP - 828 EP - 33 JF - Neurorehabilitation and neural repair JO - Neurorehabil Neural Repair VL - 27 IS - 9 N2 - OBJECTIVE: To assess the safety and efficacy of intrathecal baclofen (ITB) therapy for severe spasticity in patients with upper-motor neuron predominant motor neuron disease (U-MND). METHODS: A total of 44 patients with U-MND were referred for discussion of ITB therapy. Baseline and outcomes data were extracted on 35 patients from a clinical spasticity registry at a tertiary referral center. Patients choosing to initiate ITB (n = 20) were compared with those choosing conservative therapy (n = 15). RESULTS: At baseline, lower average pain score in the non-ITB group was the only significant difference between the 2 groups. A significant reduction in pain scores, Modified Ashworth Scale (MAS), Spasm Frequency Scale, and requirement for oral spasticity medications was observed within the ITB group at early and late follow-up. Within the non-ITB group, there was a significant increase in MAS scores between baseline and late follow-up. A statistically significant difference favoring the ITB group was observed for change in MAS score (P < .0001), Numerical Rating Scale pain score (P = .04), dose of oral baclofen (P = .002) and tizanidine (P = .003), and number of oral medications for spasticity (P = .002). There was no difference between the 2 groups in the progression of hip flexor weakness or in the proportion of patients who became nonambulatory. CONCLUSIONS: Our findings suggest that ITB can effectively reduce spasticity and related symptoms without compromising function in selected patients with U-MND. SN - 1552-6844 UR - https://www.unboundmedicine.com/medline/citation/23884016/Use_of_intrathecal_baclofen_for_treatment_of_severe_spasticity_in_selected_patients_with_motor_neuron_disease_ L2 - http://journals.sagepub.com/doi/full/10.1177/1545968313496325?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -