The primary clinical goal of the research is to test if chronic intrathecal balclofen is a safe and effective means of treating spasticity due to cerebral trauma and cerebral palsy. As in our prior studies, balanced randomized double-blind crossover trials on and off balclofen will be performed. Tests appropriate to each patient's disability will be used to measure muscle tone, reflexes, spasms and voluntary motor control. Activities of daily living on and off baclofen will also bes assessed. If improvement is found, baclofen will be continued and long-term monitoring will be carried out to determine the frequency of drug and device problems. Previously treated multiple sclerosis and spinal cord injury patients will continue to be followed, since they are the original group of patients treated with baclofen and are therefore an important resource of judging long-term efficacy. A secondary goal will be to study the effects of intrathecal baclofen on spinal reflexes and voluntary control. the Motor Control Laboratory testing will quantify changes in monosynaptic and polysynaptic reflexes and patterns of voluntary muscle activation on and off baclofen. This project has broader importance than just a unique treatment for spasticity. It could demonstrate the efficacy of long-term direct perfusion of neurotransmitters and their agonists and antagonists into the central nervous system. This novel approach, if successful, should encourage further experimental drug therapies for a wide range of neurological diseases.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS015630-11
Application #
3396379
Study Section
Neurology A Study Section (NEUA)
Project Start
1979-07-01
Project End
1992-08-31
Budget Start
1990-09-01
Budget End
1991-08-31
Support Year
11
Fiscal Year
1990
Total Cost
Indirect Cost
Name
Rush University
Department
Type
Schools of Medicine
DUNS #
City
Chicago
State
IL
Country
United States
Zip Code
60612
Latash, M L; Penn, R D (1996) Changes in voluntary motor control induced by intrathecal baclofen in patients with spasticity of different etiology. Physiother Res Int 1:229-46
Kravitz, H M; Corcos, D M; Hansen, G et al. (1992) Intrathecal baclofen. Effects on nocturnal leg muscle spasticity. Am J Phys Med Rehabil 71:48-52
Latash, M L; Gottlieb, G L (1990) Compliant characteristics of single joints: preservation of equifinality with phasic reactions. Biol Cybern 62:331-6
Nanninga, J B; Frost, F; Penn, R (1989) Effect of intrathecal baclofen on bladder and sphincter function. J Urol 142:101-5
Parke, B; Penn, R D; Savoy, S M et al. (1989) Functional outcome after delivery of intrathecal baclofen. Arch Phys Med Rehabil 70:30-2
Latash, M L; Penn, R D; Corcos, D M et al. (1989) Short-term effects of intrathecal baclofen in spasticity. Exp Neurol 103:165-72
Latash, M L (1988) Spectral analysis of the electromyogram (EMG) in spinal cord trauma patients: I: Different types of the EMG and corresponding spectra. Electromyogr Clin Neurophysiol 28:319-27
Latash, M L (1988) Spectral analysis of the electromyogram (EMG) in spinal cord trauma patients: II. Motor unit and interference EMG power spectra. Electromyogr Clin Neurophysiol 28:329-34
Myklebust, B M; Gottlieb, G L; Agarwal, G C (1986) Stretch reflexes of the normal infant. Dev Med Child Neurol 28:440-9
Corcos, D M; Gottlieb, G L; Penn, R D et al. (1986) Movement deficits caused by hyperexcitable stretch reflexes in spastic humans. Brain 109 ( Pt 5):1043-58

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