Effects of severe spasticity treatment with intrathecal Baclofen in multiple sclerosis patients: Long term follow-up

Stampacchia, G.; Gerini, Adriana; Mazzoleni, Stefano

doi:10.3233/nre-161329

Cited by 5 publications

(10 citation statements)

References 33 publications

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“…Nine of these studies reported a significant difference in AS/MAS scores between pre-and post-ITB implantation at some point during the follow-up period in each. [6][7][8][9]12,14,15,17,21 Among these 13 studies, 7 reported AS scores, with an average percent reduction from pre-to post-ITB implantation of 61.25%. Four reported MAS scores, with an average percent reduction of 58.23%.…”

Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

“…15 Also, Stampacchia et al reported median values for both upper and lower extremities; for the upper extremities, the median and IQR of values showed no change from pre-to postimplantation at two separate time points (12 and 24 months). 21 Thus, in the calculation of percent reduction, the MAS score from 24 months postimplantation (latest time point) was subtracted from the preimplantation MAS score for the lower extremities. 21 Additionally, Sammaraiee et al reported AS for 106 patients from pretrial to 1-year postimplantation.…”

Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

“…21 Thus, in the calculation of percent reduction, the MAS score from 24 months postimplantation (latest time point) was subtracted from the preimplantation MAS score for the lower extremities. 21 Additionally, Sammaraiee et al reported AS for 106 patients from pretrial to 1-year postimplantation. 17 At later follow-ups, there was an attrition of patients.…”

Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

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Outcomes, complications, and dosing of intrathecal baclofen in the treatment of multiple sclerosis: a systematic review

Cozzi,

Zuckerman,

Sacknovitz

et al. 2024

Neurosurgical Focus

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OBJECTIVE The purpose of this systematic review was to evaluate empirical outcomes of studies in the literature that investigated effectiveness of intrathecal baclofen (ITB) in the treatment of multiple sclerosis (MS)–related spasticity (MSRS) based on various metrics. Since the first description of this route of baclofen delivery for MS patients by Penn and Kroin in 1984, numerous studies have contributed to the medical community’s knowledge of this treatment modality. The authors sought to add to the literature a systematic review of studies over the last 2 decades that elucidates the clinical impact of ITB in treating MSRS with the following endpoints: impact on patient-centered outcomes, such as spasticity reduction (primary), complications (secondary), and dosing (secondary). METHODS The authors queried three databases (PubMed, Scopus, and Cochrane Library) using the following search terms: (intrathecal baclofen) AND (multiple sclerosis). The set inclusion criteria were as follows: 1) original, full-text article; 2) written in the English language; 3) published between and including the years 2000 and 2023; 4) discussion of pre- and post-ITB pump implantation outcomes (e.g., reduction in spasticity and improved comfort) in MSRS patients with long-term ITB treatment; and 5) contained a minimum of 5 MS patients. Data on study type, patient demographics, follow-up periods, primary outcomes, and secondary outcomes were extracted from the included studies. RESULTS The authors’ search yielded 465 studies, of which 17 met inclusion criteria. Overall, they found evidence for the effectiveness of ITB in treating MSRS patients whose condition was refractory to oral medications, with significant reported changes in spasm frequency from pre- to postimplantation. They also found evidence supporting the positive impact of ITB on MSRS patients’ quality of life. Moreover, the authors found that most complications were surgical rather than pharmacological. In addition, the average 1-year dose of ITB (reported in 7 of the included studies) was 191.93 μg/day, which is substantially lower than ITB doses reported in the literature for patients with central (non-MS) or spinal origins of spasticity at 1-year follow-up. CONCLUSIONS The evidence supports ITB as a clinically effective treatment for MSRS, particularly in patients in whom oral antispasmodics and physiotherapy have failed. This systematic review contributes a comprehensive synthesis of clinical benefits, complications, and dosing of ITB reported over the past 2 decades, which furthers an understanding of ITB’s clinical utility in practice.

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Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

Section: Ashworth Scale and Modified Ashworth Scalementioning

confidence: 99%

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Outcomes, complications, and dosing of intrathecal baclofen in the treatment of multiple sclerosis: a systematic review

Cozzi,

Zuckerman,

Sacknovitz

et al. 2024

Neurosurgical Focus

View full text Add to dashboard Cite

show abstract

“…In the "year" column it can be seen when the paper was published, and in the "number of patients" the amount of people that took participation in the research. In general, the "follow-up" period [14]; [33][34][35][36][37][38][39][40][41]. NS = not specified.…”

Section: Infusion Pumps In Spasticitymentioning

confidence: 99%

Neurosurgical Spasticity Treatment: From Lesion to Neuromodulation Procedures

Carrillo-Ruíz¹,

Beltrán²,

Carrillo-Márquez³

et al. 2021

Frontiers in Clinical Neurosurgery

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Spasticity is one of the most important and residual signs after pyramidal and para-pyramidal catastrophic lesions after diverse neurological insults, including stroke, brain and spine trauma and post-radiation; infection and immunological diseases affecting nervous system, between others. Spasticity is normally a compensatory motor mechanism that could ameliorate the patients´ disability. Nevertheless, disastrous spasticity is described when the extremities force is diminished in the affected limbs, or when is impossible to wake o to take objects, maximum when hand or foot deformity is exposed. The objective of this chapter is centered in the neurosurgical treatment of spasticity, including brain lesions with specific targets and the spine with its different modalities. This review shows not only the basic aspects in these techniques, but also the option of infusion pumps and deep brain stimulation. To close, a proposal is stablished to determinate the possible path to treat the spasticity in the future.

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“…Intrathecal baclofen (ITB) is administered via a catheter passing into the spinal CSF space and connected to a subcutaneously located pump into the abdomen in a closed system; thus, it is highly effective and lacks the systemic side effects. Chronic and refractory spasticity due to cerebral palsy, multiple sclerosis (MS), spinal cord injuries, traumatic brain injuries, and stroke are among the established indications for ITB treatment [7-13]. However, data on patients with rare conditions such as ataxia and ITB treatment are limited [14-17].…”

Section: Introductionmentioning

confidence: 99%

Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms

Berntsson

Gauffin

Melberg

et al. 2019

Stereotact Funct Neurosurg

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Background: Intrathecal baclofen (ITB) treatment is considered a powerful tool in the management of severe spasticity in neurological conditions such as multiple sclerosis, cerebral palsy, and traumatic spinal cord and brain injury. Objectives: The objective of this study was to assess the effectiveness of the ITB in patients with inherited ataxia suffering from severe painful spasms and/or spasticity. Method: A total of 5 patients with spinocerebellar ataxia 3 or 7 or Friedreich’s ataxia were included in this observational multicenter study. The patients were interviewed and completed outcome measures assessing pain (The Brief Pain Inventory), fatigue (Fatigue Severity Scale), and life satisfaction (LiSAT-9) before and 1 year after the treatment. Spasticity (Modified Ashworth Scale) and spasm frequency (SPFS) were measured objectively for each patient. Results: The mean treatment time was 1.9 years. Evaluation of established standard forms revealed symptomatic relief from spasticity, spasms, pain, and fatigue in addition to improved body posture, sleep, and life satisfaction after ITB treatment. Conclusions: We report the potential beneficial effects of ITB treatment in patients with inherited ataxia who also suffer from spasticity/spasms. ITB treatment indication in neurological disorders allows for extension to the treatment of spasticity/ spasms in patients with hereditary ataxia.

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Effects of severe spasticity treatment with intrathecal Baclofen in multiple sclerosis patients: Long term follow-up

Abstract: A reduced spasticity and pain was observed after the intrathecal Baclofen infusion for at least 76 months. To obtain these results a dosage adjustment was needed only in the first year after the implantation.

Cited by 5 publications

References 33 publications

Outcomes, complications, and dosing of intrathecal baclofen in the treatment of multiple sclerosis: a systematic review

Outcomes, complications, and dosing of intrathecal baclofen in the treatment of multiple sclerosis: a systematic review

Neurosurgical Spasticity Treatment: From Lesion to Neuromodulation Procedures

Inherited Ataxia and Intrathecal Baclofen for the Treatment of Spasticity and Painful Spasms

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