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  4. Bumetanide increases postsynaptic inhibition after chronic SCI and decreases presynaptic inhibition with step-training

Bumetanide increases postsynaptic inhibition after chronic SCI and decreases presynaptic inhibition with step-training

J Physiol, 2023 · DOI: 10.1113/JP283753 · Published: April 1, 2023

Spinal Cord InjuryPharmacologyNeurorehabilitation

Simple Explanation

This study investigates bumetanide's effect on spinal inhibition after spinal cord injury (SCI), comparing it to step-training, which improves spinal inhibition by restoring chloride homeostasis. The research showed that bumetanide increased postsynaptic inhibition in SCI rats, hyperpolarizing the reversal potential for inhibitory postsynaptic potentials (IPSPs). However, in step-trained SCI rats, bumetanide decreased presynaptic inhibition, suggesting it might improve postsynaptic inhibition after SCI but hinder the recovery of presynaptic inhibition with step-training.

Study Duration
6 weeks
Participants
Sprague Dawley rats (250–360g)
Evidence Level
Not specified

Key Findings

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    A prolonged bumetanide treatment increases postsynaptic inhibition towards values observed in step-trained animals.
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    Bumetanide increased postsynaptic inhibition by hyperpolarizing the reversal potential for IPSPs after SCI.
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    An acute delivery of bumetanide decreases presynaptic inhibition evoked by PBSt group I afferents in SCI step-trained animals.

Research Summary

This study provides the first evidence that bumetanide increases postsynaptic inhibition of the H-reflex after chronic SCI. By using in vivo intracellular recordings of motoneurons, we show that bumetanide increases postsynaptic inhibition by hyperpolarizing EIPSP after chronic SCI. We further demonstrate that the acute delivery of bumetanide decreases the activity-dependent recovery of presynaptic inhibition with step-training.

Practical Implications

Therapeutic Potential

Bumetanide could be a viable option to improve postsynaptic inhibition after SCI.

Combination Therapy Considerations

Bumetanide decreases the recovery of presynaptic inhibition with step-training.

Clinical Trial Design

Future clinical trials should consider patients' levels of postsynaptic and presynaptic inhibition.

Study Limitations

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