Randomized trial of 4-aminopyridine in patients with chronic incomplete spinal cord injury.

To test the efficacy of 4-aminopyridine (4-AP) on functional status, walking speed and vibration perception in patients with chronic, incomplete spinal cord injury.
Twenty SCI patients were randomized in a trial with a double-blind, crossover design to receive four weeks of orally administered 4-AP, followed by a two-week wash-out period and four weeks of placebo, or vice versa. The total daily dose of 4-AP during the four weeks of treatment was systematically increased to a maximum of 0.5 mg/kg body weight. Evaluation of (side-)effects took place at the beginning, after one week, and at the end of each four-week study period.
No significant benefit was found on functional status (COOP-WONCA). A statistically significant treatment effect was found on the vibration perception threshold (VPT) in the left fingers, during the first study period. On average, patients receiving 4-AP treatment responded less favourably (mean increase in VPT of 0.29 (0.31) microm) than patients receiving placebo (mean decrease in VPT of 0.05 (0.35) microm) (p=0.04). Neither comfortable nor maximum walking speed altered significantly following 4-AP treatment.
No statistically significant, functional benefit from 4-AP was found for patients in the present study. Furthermore, no support was found for the possibility that an a priory selection of responsive patients would have yielded more favourable results.
AuthorsM A van der Bruggen, H B Huisman, H Beckerman, F W Bertelsmann, C H Polman, G J Lankhorst
JournalJournal of neurology (J Neurol) Vol. 248 Issue 8 Pg. 665-71 (Aug 2001) ISSN: 0340-5354 [Print] Germany
PMID11569894 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • 4-Aminopyridine
  • 4-Aminopyridine (adverse effects, therapeutic use)
  • Adult
  • Aged
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sensory Thresholds (drug effects)
  • Spinal Cord Injuries (drug therapy)
  • Treatment Outcome
  • Vibration
  • Walking

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