Functional improvement in individuals with chronic spinal cord injury treated with 4-aminopyridine: A systematic review

Frontiers in Neurology, 2022 · DOI: 10.3389/fneur.2022.1034730 · Published: November 29, 2022

Spinal Cord Injury Pharmacology Neurology

Simple Explanation

4-Aminopyridine (4-AP) is a medication that can help nerve signals travel better along damaged nerve fibers. This review looked at studies on the use of 4-AP in people with long-term spinal cord injuries to see if it could improve their function. The review found that 4-AP may improve motor skills, sensation, and other functions in people with spinal cord injuries, but more research is needed.

Study Duration

Not specified

Participants

Systematic review of 10 articles

Evidence Level

Level 1: Systematic Review of Randomized Controlled Trials

Key Findings

1
The review confirms the efficacy of 4-AP in improving several conditions resulting from SCI.
2
Significant improvements were observed in motor and sensory functions, functional independence, sphincter control and sexual function.
3
Efficacy of 4-AP to improve function mainly depends on two circumstances: first, that the tract is preserved and the extent to which it is myelinated; and second, the main objective of each study.

Research Summary

This systematic review examined existing literature on the eﬃcacy of 4-aminopyridine (4-AP) as a treatment for spinal cord injury (SCI). The remaining seven studies provided evidence that in various respects 4-AP improved functionality in individuals with traumatic SCI. Although this systematic review provides information showing that 4-AP is an eﬀective treatment for improving some functions after chronic SCI, further randomized clinical trials with 4-AP involving larger sample sizes are needed.

Practical Implications

Clinical Practice

4-AP can be considered as a potential treatment option for individuals with chronic SCI to improve motor, sensory, and sexual functions, sphincter control, spasticity, ability to function independently, quality of life, central motor conduction, and pain.

Research

Future research should focus on conducting randomized clinical trials with larger sample sizes and using uniform outcome measures to allow adequate data acquisition and analysis.

Patient care

Clinicians should comprehensively evaluate bladder and anal sphincter control, quality of life and functional independence, along with sensory and motor functions to evaluate patient outcomes

Study Limitations

1
Limiting this systematic review to literature in English entailed the risk of language bias.
2
The inclusion of studies with heterogeneous results did not allow us to perform a meta-analysis, only a qualitative synthesis.
3
Varied outcome measures were used in the studies reviewed, which made it diﬃcult to compare results.

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