Does Edaravone Improve Neurological Recovery in Acute Spinal Cord Injury? A Pilot Study

Presented at SMISS Annual Forum 2016
By Rajeshwar Srivastava MS
With Amar Chandra Sharma MSC, Saloni Raj MBBS,

Disclosures: Rajeshwar Srivastava MS None Amar Sharma MSC None, Saloni Raj MBBS None,

Introduction

Spinal cord injury (SCI) triggers several secondary effects which play a major role in biochemical and pathological changes in spinal cord tissue. Free radical generation and lipid peroxidation are early events subsequent to SCI. Edaravone is a known neuroprotective antioxidant and strongly scavenge free radicals, protecting against oxidative stress and neuronal apoptosis and is in use in cerebral ischemia and traumatic brain injury (TBI). We hypothesized that spinal cord being CNS, liken brain should respond similarly. 

Aims/Objectives

To study the role of Edaravone in neurological recovery of Acute Spinal Cord Injury (ASCI) cases. 

Methods

The study was conducted on 28 thoracolumbar injuries admitted within 72 hrs. Polytrauma and head injuries needing intervention were excluded. Patients were recruited in two groups. Group1 were controls in which patient did not receive Edaravone and Group2 were cases where 30mg Edaravone was given twice a day for 14 days. The subjects were followed for 12 weeks and their neurological status recorded at baseline and at 4th and 12th week. 

Results

Neurological recovery was assessed by AIS neurological grading and motor, sensory scores. The recovery was maximum in interventional group (Group2) in comparison to conventional group (Group1) at 4th week (p=0.001) (p=0.02) and at 12th weak (p=0.000) (p=0.03) and this was statistically significant. 

Conclusions

Edaravone (antioxidant) is a neuroprotective agent and may be involved in the prevention of secondary damage and/or restoration of neurological function in incomplete SCI. To the best of our knowledge this is the first study using Edaravone in SCI patient with positive outcome. Consequently, it may prove to be an effective strategy for therapeutic intervention in SCI.