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PubMed1990

Olivopontocerebellar atrophy: MR diagnosis and relationship to multisystem atrophy.

Clinical diagnosis of olivopontocerebellar atrophy (OPCA) must be confirmed by radiologic demonstration of atrophy in an appropriate distribution. OPCA may be associated with degeneration of other systems in multisystem atrophy (MSA). The authors report 23 cases of OPCA, eight of which were associated with MSA. Atrophy involved the cerebellum, pons, and middle cerebellar peduncles in all cases. On intermediate and T2-weighted magnetic resonance (MR) images, abnormal signal intensity was always observed in the transverse pontine fibers, middle cerebellar peduncles, and cerebellum, structures known from pathologic study to degenerate in OPCA. Pyramidal tracts and superior cerebellar peduncles stood out because of their normal signal intensity. Of the eight patients with MSA, four also had variable abnormal signal intensities in the putamen. The authors believe that the combination of atrophy and abnormal signal intensity in the appropriate distribution strongly supports the diagnosis of OPCA. In some cases, MR imaging may demonstrate involvement of different systems, thus confirming the diagnosis of MSA.

Adult↗
PubMed1992

Patterns of hemodynamic responses associated with central activation of coronary vasoconstriction.

Previous studies in our laboratory have identified several central sites from which coronary vasoconstriction can be elicited by electrical stimulation. The present study was conducted to determine if specific patterns of hemodynamic responses are associated with activation of the coronary vasoconstrictor pathway in the hypothalamus, pons, and medulla. Cats anesthetized with chloralose were instrumented for recording arterial pressure, heart rate, and coronary, femoral, renal, and mesenteric blood flow velocities. After vagotomy and atenolol (1 mg/kg iv), anterior hypothalamus (AHA), parabrachial nucleus (PBN), a site very close to the ventral surface of the pons lateral to the pyramidal tract, and rostral ventrolateral medulla (RVLM) were stimulated electrically. Stimulation produced a decrease in coronary blood flow that was associated with all of the cardiovascular components of the defense reaction, an integrated response that included a decrease in hindquarter vascular resistance (blocked by methyl atropine), increases in renal and mesenteric vascular resistances, and a pressor response, except no change in renal vascular resistance from RVLM. Different patterns of hemodynamic responses were obtained from sites outside the coronary vasoconstrictor areas. From these results we conclude that coronary vasoconstriction is a frequent component of the defense reaction.

Animals↗
PubMed1997

Rates of local cerebral protein synthesis in fetal and neonatal sheep.

During gestation there is likely to be a constantly changing rate of protein synthesis in the brain that may exhibit regional specificity. With the use of the quantitative autoradiographic L-[1-(14)C]leucine method for the determination of local rates of leucine incorporation into cerebral protein (lCPS(Leu)), we have sought to characterize this important process. lCPS(Leu) was measured in nine fetal sheep (118-139 days gestational age) and five newborn lambs (1-5 days of age). In other experiments, the fraction of leucine in the precursor pool for protein synthesis in the brain derived from the arterial plasma was determined to be 0.57 +/- 0.04 (mean +/- SE) in one fetus and two lambs. This value was used in the calculation of lCPS(Leu) in 35 regions of the central nervous system, pineal body, and whole brain. Regardless of age, lCPS(Leu) was highest in the pineal body, brain stem, and hypothalamic nuclei and lowest in white matter. In sensorimotor cortex, corona radiata, pyramidal tracts, and whole brain, lCPS(Leu) was positively correlated with prenatal age (P < or = 0.05). These increases in lCPS(Leu) probably reflect myelination in the cerebrum, which is known to occur in late gestation.

Aging↗
PubMed1984

Ventrolateral medullary surface blood flow determined by hydrogen clearance.

The H2 clearance technique was used to determine the blood flow of the postulated respiratory chemosensitive areas near the ventrolateral surface of the medulla. In 12 pentobarbital sodium-anesthetized cats, flow (mean +/- SD) was measured from 25-micron Teflon-coated platinum wire electrodes implanted to a depth of 0.3-0.7 mm. Flow (in ml X min-1 X 100 g-1, n = 35) was 52.8 +/- 28.5 in hypocapnia [arterial CO2 partial pressure (PaCO2) = 21.8 +/- 1.6 Torr], 57.8 +/- 27.5 in normocapnia (PaCO2 = 31.9 +/- 2.2 Torr), and 75.0 +/- 31.7 in hypercapnia (PaCO2 = 44.5 +/- 3.0 Torr). Flow determined from 15 electrodes in adjacent pyramidal tracts (white matter) was less at all levels of CO2; 22.9 +/- 12.3 in hypocapnia, 29.1 +/- 15.9 in normocapnia, and 33.9 +/- 13.9 in hypercapnia. In hypoxia [arterial O2 partial pressure (PaO2) = 39.9 +/- 6.3 Torr] ventrolateral surface flow rose to 87.9 +/- 47.6, and adjacent white matter flow was 35.8 +/- 15.6. These results indicate that flow in the postulated central chemoreceptor areas exceeds that of white matter and is sensitive to variations in PaCO2 and PaO2.

Animals↗
PubMed2005

Quantification of motor cortex activity and full-body biomechanics during unconstrained locomotion.

Recent progress in the understanding of motor cortex function has been achieved primarily by simultaneously recording motor cortex neuron activity and the movement kinematics of the corresponding limb. We have expanded this approach by combining high-quality cortical single-unit activity recordings with synchronized recordings of full-body kinematics and kinetics in the freely behaving cat. The method is illustrated by selected results obtained from two cats tested while walking on a flat surface. Using this method, the activity of 43 pyramidal tract neurons (PTNs) was recorded, averaged over 10 bins of a locomotion cycle, and compared with full-body mechanics by means of principal component and multivariate linear regression analyses. Patterns of 24 PTNs (56%) and 219 biomechanical variables (73%) were classified into just four groups of inter-correlated variables that accounted for 91% of the total variance, indicating that many of the recorded variables had similar patterns. The ensemble activity of different groups of two to eight PTNs accurately predicted the 10-bin patterns of all biomechanical variables (neural decoding) and vice versa; different small groups of mechanical variables accurately predicted the 10-bin pattern of each PTN (neural encoding). We conclude that comparison of motor cortex activity with full-body biomechanics may be a useful tool in further elucidating the function of the motor cortex.

Action Potentials↗
PubMed2004

Cortical involvement in the recruitment of wrist muscles.

In executing a voluntary movement, one is faced with the problem of translating a specification of the movement in task space (e.g., a visual goal) into a muscle-recruitment pattern. Among many brain regions, the primary motor cortex (MI) plays a prominent role in the specification of movements. In what coordinate frame MI represents movement has been a topic of considerable debate. In a two-dimensional wrist step-tracking experiment, Kakei et al. described some MI cells as encoding movement in a muscle-coordinate frame and other cells as encoding movement in an extrinsic-coordinate frame. This result was interpreted as evidence for a cascade of transformations within MI from an extrinsic representation of movement to a muscle-like representation. However, we present a model that demonstrates that, given a realistic extrinsic-like representation of movement, a simple linear network is capable of representing the transformation from an extrinsic space to the muscle-recruitment patterns implementing the movements on which Kakei et al. focused. This suggests that cells exhibiting extrinsic-like qualities can be involved in the direct recruitment of spinal motor neurons. These results call into question models that presume a serial cascade of transformations terminating with MI pyramidal tract neurons that vary their activation exclusively with muscle activity. Further analysis of the model shows that the correlation between the activity of an MI neuron and a muscle does not predict the strength of the connection between the MI neuron and muscle. This result cautions against the use of correlation methods as a measure of cellular connectivity.

Animals↗
PubMed2006

Measurement of time-dependent changes in the irregularity of neural spiking.

Irregularity of firing in spike trains has been associated with coding processes and information transfer or alternatively treated as noise. Previous studies of irregularity have mainly used the coefficient of variation (CV) of the interspike interval distribution. Proper estimation of CV requires a constant underlying firing rate, a condition that most experimental situations do not fulfill either within or across trials. Here we introduce a novel irregularity metric based on the ratio of adjacent intervals in the spike train. The new metric is not affected by firing rate and is very localized in time so that it can be used to examine the time course of irregularity relative to an alignment marker. We characterized properties of the new metric with simulated spike trains of known characteristics and then applied it to data recorded from 108 single neurons in the motor cortex of two monkeys during performance of a precision grip task. Fifty-six cells were antidromically identified as pyramidal tract neurons (PTNs). Sixty-one cells (30 PTNs) exhibited significant temporal modulation of their irregularity during task performance with the contralateral hand. The irregularity modulations generally differed in sign and latency from the modulations of firing rate. High irregularity tended to occur during the task phases requiring the most detailed control of movement, whereas neural firing became more regular during the steady hold phase. Such irregularity modulation could have important consequences for the response of downstream neurons and may provide insight into the nature of the cortical code.

Algorithms↗
PubMed1979

Supplementary motor area in the monkey: activity of neurons during performance of a learned motor task.

1. Recordings were made of the natural discharges of neurons in the supplementary motor area (SMA) of conscious monkeys trained to perform stereotyped motor task, pulling a horizontal lever, with either hand. 2. Of the total population of cells, 80% showed modulation of their activity during particular movements of either limb. Many cells had a similar pattern of modulation regardless of whether the contralateral or ipsilateral hand was used. Of the remaining 20%, some cells were related to leg or body movements or to visual experience. 3. Cells whose activity was related to movements of distal joints were found in approximately equal numbers to those whose discharges occurred with proximal movements. 4. Only 5% of cells tested sent their axons into the pyramidal tract, and only 14% of units investigated showed responses to passive manipulation of the limbs. The effective afferent input usually was of a rather complex kind. 5. The findings suggest that the discharges of a large number of neurons in SMA are changing during particular movements of either arm, and that only a small number of cells receive peripheral afferent sensory input. These results contrast with those obtained in the primary motor area and suggest a different role for SMA in the control of movement.

Animals↗
PubMed1984

Effects of stimulation of corpus callosum on precentral neuron activity in the awake monkey.

The effects of stimulation of the corpus callosum (CC) on precentral neurons were studied in monkeys performing motor tasks with either forelimb. Of a total of 246 precentral neurons that were tested with CC stimulation, 70 were orthodromically and 12 were antidromically activated. The percentages of neurons orthodromically activated by CC stimulation were the same in pyramidal tract neurons (PTNs) (31%) and non-PTNs (31%). The mean latency of neuronal activation by CC stimulation was similar in PTNs and non-PTNs. Precentral neurons were divided into two groups with respect to muscular contractions evoked by intracortical stimulation: neurons related to finger, wrist, and elbow movements (distal group) and those related to shoulder or axial movements (proximal group). The percentages of neurons orthodromically activated by CC stimulation were similar in both groups; 25% in distal and 29% in proximal groups. However, the mean latency of orthodromic CC activation was significantly shorter for the proximal than for the distal group. Precentral neurons were classified into three groups; neurons related to finger and/or wrist movement tasks (F-W group), those related to arm movement tasks in addition to finger and/or wrist tasks (F, W + A group), and those related to arm movements only (A group). The percentages of neurons orthodromically activated by CC stimulation were similar in the three groups. The mean latencies of neuronal activities were a little longer in the F-W group than in the A group or the F, W + A group. Precentral neurons were classified into three groups in relation to ipsilateral or contralateral forelimb movements: neurons related to ipsilateral movements (ipsi neurons, n = 13), those related to ipsilateral as well as contralateral movements (bilat neurons, n = 50) and those related to contralateral movements (contra neurons, n = 136). The percentages of neurons orthodromically activated by CC stimulation were 15 (2/13, ipsi neurons), 24.0 (12/50, bilat neurons), and 25.0% (34/136, contra neurons), respectively. The mean latencies of neuronal activation were compared between two groups; one group was composed of ipsi and bilat neurons, and the other group was of contra neurons. The mean latency was a little shorter for the ipsi + bilat group than for the contra group.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1986

Localization of central rhythm generator involved in cortically induced rhythmical masticatory jaw-opening movement in the guinea pig.

The location of the central rhythm generator involved in the cortically induced rhythmical masticatory jaw-opening movement was studied in the ketamine-anesthetized guinea pig. These studies show that a population of neurons is activated by a nonrhythmical input from the cortical masticatory area (CMA) and produces a rhythmical output to the trigeminal motoneurons innervating the jaw-opening muscles. Repetitive stimulation (30 Hz) of the pyramidal tract (PT) rostral to the middle level of the medulla oblongata, in the animal with a precollicular transection as well as with an intact neuraxis, induced a rhythmical reciprocal EMG activity in the anterior digastric and masseter muscles. The rhythmical activity could be monitored by a rhythmical burst in the efferent discharge in the mylohyoid nerve innervating the anterior digastric muscle. Essentially the same pattern was observed when stimulating the PT as that induced by repetitive stimulation of the CMA. The rhythmical efferent burst in the mylohyoid nerve could still be induced after paralyzing the animal. Repetitive PT stimulation in the isolated brain stem after precollicular and bulbospinal transections induced a rhythmical pattern in the anterior digastric EMG and an efferent activity in the mylohyoid nerve. The rhythmical mylohyoid nerve burst could be induced after paralyzing the animal. After section of the medial part of the brain stem at the pontobulbar junction, including the PT, repetitive PT stimulation at the pontine level did not induce any masticatory activity either in the digastric EMG or in the efferent discharge in the mylohyoid nerve, while stimulation at the rostral bulbar level still induced a rhythmicity that was essentially the same pattern as before the section. By testing the effects of total and partial transections of the brain stem in coronal and sagittal planes at various locations, we found that the medial bulbar reticular formation, the lateral pons including the trigeminal motor nucleus and nerve, and the reticulotrigeminal motoneuronal pathways composed the minimum structures that must be left intact to induce a rhythmicity in the anterior digastric EMG and the efferent discharge in the mylohyoid nerve by repetitively stimulating the PT. Repetitive PT stimulation induced a field potential in the medial bulbar reticular formation, which periodically fluctuated in the masticatory rhythm coincident with the rhythmical activity in the digastric EMG. This fluctuation persisted in the same rhythm after paralysis of the animal.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

Serotonin has different effects on two classes of Betz cells from the cat.

1. Intracellular recording from cat Betz cells in vitro revealed a strong correlation between the dominant effect of serotonin (5-HT) and the Betz cell subtype in which it occurred. In large Betz cells that show posthyperpolarization excitation (termed PHE cells), 5-HT evoked a long-lasting membrane depolarization, whereas 5-HT evoked an initial hyperpolarization of variable duration in smaller Betz cells that show posthyperpolorization inhibition (termed PHI cells). 2. Voltage-clamp studies revealed that 5-HT caused a depolarizing shift of activation of the cation current Ih, which resulted in the depolarization in PHE cells, whereas the hyperpolarization in PHI cells is caused by an increase in a resting potassium conductance. 3. The effect of 5-HT on firing properties during constant current stimulation also differed consistently in the two types of Betz cells. In PHE cells the initial firing rate increased after 5-HT application, but the steady firing was unaffected. The depolarizing shift of Ih activation caused the increase of initial firing rate. 4. In PHI cells 5-HT caused a decrease in spike frequency adaptation. The decrease in adaptation was caused by a combination of two conductance changes. First, 5-HT caused a slow afterdepolarization in PHI cells that could trigger repetitive firing in the absence of further stimulation. The sADP depended on calcium entry through voltage-gated channels and was associated with a decrease in membrane conductance. Second, 5-HT caused reduction of a slow calcium-dependent potassium current that normally contributes to slow adaptation. 5. In conclusion, the effect of 5-HT on excitability differs systematically in Betz cell subtypes in part because they have different dominant ionic mechanisms that are modulated. If we assume that PHE cells and PHI cells represent fast and slow pyramidal tract (PT) neurons respectively, 5-HT will cause early recruitment of fast PT cells and delay recruitment of slow PT cells during low levels of synaptic excitation.

Animals↗
PubMed2000

Precise spatiotemporal repeating patterns in monkey primary and supplementary motor areas occur at chance levels.

Precise spatiotemporal patterns in neural discharge are a possible mechanism for information encoding in the brain. Previous studies have found that such patterns repeat and appear to relate to key behavioral events. Whether these patterns occur above chance levels remains controversial. To address this question, we have made simultaneous recordings from between two and nine neurons in the primary motor cortex and supplementary motor area of three monkeys while they performed a precision grip task. Out of a total of 67 neurons, 46 were antidromically identified as pyramidal tract neurons. Sections of recordings 60 s long were searched for patterns involving three or more spikes that repeated at least twice. The allowed jitter for pattern repetition was 3 ms, and the pattern length was limited to 192 ms. In all 11 recordings analyzed, large numbers of repeating patterns were found. To assess the expected chance level of patterns, "surrogate" datasets were generated. These had the same moment-by-moment modulation in firing rate as the experimental spike trains, and matched their interspike interval distribution, but did not preserve the precise timing of individual spikes. The number of repeating patterns in 10 randomly generated surrogates was used to form 99% confidence limits on the repeating pattern count expected by chance. There was close agreement between these confidence limits and the number of patterns seen in the experimental data. Analysis of high complexity patterns was carried out in four long recordings (mean duration 23.2 min, mean number of neurons simultaneously recorded 7.5). This analysis logged only patterns composed of a larger number (7-11) of spikes. The number of patterns seen in the surrogate datasets showed a small but significant excess over those seen in the original experimental data; this is discussed in the context of surrogate generation. The occurrence of repeating patterns in the experimental data were strongly associated with particular phases of the precision grip task; however, a similar task dependence was seen for the surrogate data. When a repeating pattern was used as a template to find inexact matches, in which up to half of the component spikes could be missing, similar numbers of matches were found in experimental and surrogate data, and the time of occurrence of such matches showed the same task dependence. We conclude that the existence of precise repeating patterns in our data are not due to cortical mechanisms that favor this form of coding, since as many, if not more, patterns are produced by spike trains constructed only to modulate their firing rate in the same way as the experimental data, and to match the interspike interval histograms. The task dependence of pattern occurrence is explicable as an artifact of the modulation of neural firing rate. The consequences for theories of temporal coding in the cortex are discussed.

Action Potentials↗
PubMed2001

Synchronization in monkey motor cortex during a precision grip task. I. Task-dependent modulation in single-unit synchrony.

Neural synchronization in the cortex, and its potential role in information coding, has attracted much recent attention. In this study, we have recorded long spike trains (mean, 33,000 spikes) simultaneously from multiple single neurons in the primary motor cortex (M1) of two conscious macaque monkeys performing a precision grip task. The task required the monkey to use its index finger and thumb to move two spring-loaded levers into a target, hold them there for 1 s, and release for a food reward. Synchrony was analyzed using a time-resolved cross-correlation method, normalized using an estimate of the instantaneous firing rate of the cell. This was shown to be more reliable than methods using trial-averaged firing rate. A total of 375 neurons was recorded from the M1 hand area; 235 were identified as pyramidal tract neurons. Synchrony was weak [mean k' = 1.05 +/- 0.04 (SD)] but widespread among pairs of M1 neurons (218/1359 pairs with above-chance synchrony), including output neurons. Synchrony usually took the form of a broad central peak [average width, 18.7 +/- 8.7 (SD) ms]. There were marked changes during different phases of the task. As a population, synchrony was greatest during the steady hold period in striking contrast to the averaged cell firing rate, which was maximal when the animal was moving the levers into target. However, the modulation of synchrony during task performance showed considerable variation across individual cell pairs. Two types of synchrony were identified: oscillatory (with periodic side lobes in the cross-correlation) and nonoscillatory. Their relative contributions were quantified by filtering the cross-correlations to exclude either frequencies from 18 to 37 Hz or all higher and lower frequencies. At the peak of population synchrony during the hold period, about half (51.7% in one monkey, 56.2% in the other) of the synchronization was within this oscillatory bandwidth. This study provides strong support for assemblies of neurons being synchronized during specific phases of a complex task with potentially important consequences for both information processing within M1 and for the impact of M1 commands on target motoneurons.

Action Potentials↗
PubMed2001

Putative feed-forward control of jaw-closing muscle activity during rhythmic jaw movements in the anesthetized rabbit.

When a thin plastic test strip of various hardness is placed between the upper and lower teeth during rhythmical jaw movements induced by electrical stimulation of the cortical masticatory area (CMA) in anesthetized rabbits, electromyographic (EMG) activity of the masseter muscle is facilitated in a hardness-dependent manner. This facilitatory masseteric response (FMR) often occurred prior to contact of the teeth to the strip, and thus preceded the onset of the masticatory force. Since this finding suggests involvement of a feed-forward mechanism in the induction of the FMR, the temporal relationship between the onset of the FMR and that of the masticatory force was analyzed in five sequential masticatory cycles after application of the strip. The FMR was found to precede the onset of masticatory force from the second masticatory cycle after application of the strip, but never did in the first cycle. This finding supports the concept of a feed-forward control mechanism that modulates FMR timing. Furthermore, the FMR preceding the force onset disappeared after making a lesion of the mesencephalic trigeminal nucleus (MesV) where the ganglion cells of the muscle spindle afferents from the jaw-closing muscles are located. In contrast, no such change occurred after blocking periodontal afferents by transection of both the maxillary and the inferior alveolar nerves. The putative feed-forward control of the FMR is therefore dependent mainly on sensory inputs from the muscle spindles, but little on those from the periodontal receptors, if any. We further examined the involvement of the CMA with the putative feed-forward control of the FMR via the transcortical loop. For this purpose, rhythmical jaw movements were induced by stimulation of the pyramidal tract. No significant change in the timing of the FMR occurred after the CMA ablation, which strongly suggests that the CMA is not involved in the putative feed-forward control of the FMR. The FMR was also noted to increase significantly in a hardness-dependent manner even after the MesV lesion, although the rate of increment decreased significantly. Contribution of muscle spindles and periodontal receptors to the hardness-dependent change of the FMR is discussed.

Anesthesia↗
PubMed2002

Discharge characteristics of neurons in the red nucleus during voluntary gait modifications: a comparison with the motor cortex.

We have examined the contribution of the red nucleus to the control of locomotion in the cat. Neuronal activity was recorded from 157 rubral neurons, including identified rubrospinal neurons, in three cats trained to walk on a treadmill and to step over obstacles attached to the moving belt. Of 72 neurons with a receptive field confined to the contralateral forelimb, 66 were phasically active during unobstructed locomotion. The maximal activity of the majority of neurons (59/66) was centered around the swing phase of locomotion. Slightly more than half of the neurons (36/66) were phasically activity during both swing and stance. In addition, some rubral neurons (14/66) showed multiple periods of phasic activity within the swing phase of the locomotor cycle. Periods of phasic discharge temporally coincident with the swing phase of the ipsilateral limb were observed in 7/66 neurons. During voluntary gait modifications, most forelimb-related neurons (70/72) showed a significant increase in their discharge activity when the contralateral limb was the first to step over the obstacle (lead condition). Maximal activity in nearly all cells (63/70) was observed during the swing phase, and 23/63 rubral neurons exhibited multiple increases of activity during the modified swing phase. A number of cells (18/70) showed multiple periods of increased activity during swing and stance. Many of the neurons (35/63, 56%) showed an increase in activity at the end of the swing phase; this period of activity was temporally coincident with the period of activity in wrist dorsiflexors, such as the extensor digitorum communis. A smaller proportion of neurons with receptive fields restricted to the hindlimbs showed similar characteristics to those observed in the population of forelimb-related neurons. The overall characteristics of these rubral neurons are similar to those that we obtained previously from pyramidal tract neurons recorded from the motor cortex during an identical task. However, in contrast to the results obtained in the rubral neurons, most motor cortical neurons showed only one period of increased activity during the step cycle. We suggest that both structures contribute to the modifications of the pattern of EMG activity that are required to produce the change in limb trajectory needed to step over an obstacle. However, the results suggest an additional role for the red nucleus in regulating intra- and interlimb coordination.

Action Potentials↗
PubMed2005

[Gabapentin for spasticity: a randomized, double-blind, placebo-controlled trial].

BACKGROUND AND OBJECTIVE: We aimed to demonstrate the efficacy and safety of gabapentin for the treatment of spasticity in patients with upper motor neuron syndrome. PATIENTS AND METHOD: Thirty patients with pyramidal-tract lesions were randomized to up to 3,600 mg/day of gabapentin (n = 15) or placebo (n = 15) in a double-blind, pilot 10-week trial. The primary efficacy variable was the Ashworth Scale score. Secondary variables included the Spasm Frequency Scale, maximal range of movement, H/M Amplitude Ratio, and the Barthel Index for quality of life. Adverse events were recorded. All data were analyzed on an intent-to-treat basis. RESULTS: Demographic and baseline characteristics were similar between the 2 treatment groups. The gabapentin group showed significant improvement in Ashworth Scale total scores, and scores for individual affected muscle groups. Fifteen of the randomized patients had spasms; the total Spasm Frequency Scale score was not significantly different between groups. Nevertheless, when affected individual muscle groups were analyzed, a significant effect of gabapentin vs placebo was observed at all visits. Gabapentin did not modify the scores of the range of movement, the H/M Amplitude Ratio, or the Barthel Index tests. No gait or displacement impairment were seen during treatment with gabapentin. Related adverse events occurred less frequently in the gabapentin group, and fewer gabapentin patients withdrew because of adverse events. CONCLUSIONS: Gabapentin demonstrated efficacy and safety at doses between 2,700 and 3,600 mg/day as a therapy for the spasticity associated with the upper motor neuron syndrome.

Adult↗