John Kramer, ICORD/University of British Columbia, Vancouver, Canada

NO PAIN, NO GAIN? The effects of anticonvulsants on neurological recovery following acute spinal cord injury

Funded in: 2016, 2017, 2018


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Problem: Currently no treatment for SCI exists

Target: Preliminary data show a link between pain medication with anticonvulsants and better functional outcome in SCI patients

Goal: Purposing Pregabalin as a treatment for SCI

 

There are currently no medications that help people recover after a spinal cord injury (SCI). This means that lost sensation and muscle strength rarely fully return, and people with SCI are left with severe disabilities. While promising new treatments are being discovered, these are still in the early stages of development, and are likely years away from being tested in patients.

Most patients receive multiple types of pain medication after SCI, but we have little information on how these medications affect their recovery. Recently my lab found that people who receive anticonvulsants, a particular class of pain medication, achieve greater returns of muscle strength compared to patients who receive other pain medications. At the same time, experiments in mice found that a specific type of anticonvulsant, pregabalin, helps to restore lost connections in the injured spinal cord. Together these exciting findings suggest that we might be able to repurpose pregabalin to improve the lives of people with SCI by increasing the amount of muscle strength they recover.

Before we can test pregabalin as a treatment for SCI (rather than simply a treatment for pain), more research is required to answer several questions. Does it matter how long after SCI patients receive pregabalin? Is the amount of pregabalin administered important to consider? Finally, do the improvements in muscle strength that we measure in the laboratory result in changes in how people can actually function in the world (e.g., walk or use their hands)? We will study the medical records of a large number of SCI patients, record what pain medications they receive after their injury, and link this information with their extent of muscle strength recovery. If we determine that pregabalin is leading to greater recovery of muscle strength, it will be a significant milestone toward using this medication to enhance long-term health outcomes for individuals with SCI.