Written by Keshav Suresh
Spinal injuries are known to be uniquely fearsome — most are severe enough to outright kill a person, and in the unlikely case that the person lives they are left in a limbo of paralysis and constant pain for the rest of their lives. These types of injuries have been written off as hopeless and the victim, if still alive, is doomed to a short, expensive, and painful life. However, the work of scientists at the German Center for Neurodegenerative Diseases (DZNE) expands on previous use of pregabalin for spinal cord injuries and shows promise in changing the outlook for people who have suffered spinal cord injuries.
Pregabalin is a type of medication that works by blocking calcium channels in the central nervous system, which the spine is a part of. By blocking the calcium ion channels in nerve endings, it has been found to prevent multiple symptoms that result from spinal injuries, making it a very versatile drug. It is also a very practical pharmaceutical since it only takes an hour to be fully incorporated into the bloodstream and takes effect as early as two days after the drug is started. Finally, it is not affected by liver enzymes like most medication, which means there is no fear of adverse drug-to-drug interactions [1].
Pregabalin has undergone extensive testing with rats and shows extremely promising results. When comparing paralyzed rats treated with pregabalin with other medication, there was a notable increase in locomotor ability and weight. It also had neuroprotective effects, diminishing further harmful effects due to spinal injuries [2]. Now that we know pregabalin has the potential to work as effective medication, the next thing to consider is how it works. Pregabalin binds to the calcium sites at nerve endings and inhibits the influx of calcium ions that normally results from a spinal cord injury.
Normally after a spinal injury there is a phenomenon called excitotoxicity that occurs in which an overflow of hormones and other neurotransmitters are sent out, damaging different types of nerve cells These hormones, usually essential to normal body function, end up activating an excess of enzymes in the nerve cells which lead to their death [3]. The death of these cells leads to the paralysis associated with spinal injuries. Pregabalin stops this entire process at the very first step with the overload of calcium.
The work of DZNE researchers have found that extended administration of pregabalin over a couple weeks actually helps regenerate some of the once dead neurons [4]. These regrown neurons help the entire network of the central nervous system function properly which means a decrease in pain and regaining motor function, giving hope for people that have once been written off.
References:
- Ben-Menachem, E. (2004), Pregabalin Pharmacology and Its Relevance to Clinical Practice. Epilepsia, 45 : 13–18.
- Ha, Kee-Yong, Young-Hoon Kim, Kee-Won Rhyu, and Soon-Eok Kwon. “Pregabalin as aNeuroprotector after Spinal Cord Injury in Rats.” European Spine Journal 17.6 (2008): 864-72.
- Cardenas, D. D., E. C. Nieshoff, K. Suda, S.-I. Goto, L. Sanin, T. Kaneko, J. Sporn, B. Parsons, M. Soulsby, R. Yang, E. Whalen, J. M. Scavone, M. M. Suzuki, and L. E. Knapp.
- “A Randomized Trial of Pregabalin in Patients with Neuropathic Pain Due to Spinal Cord Injury.” Neurology 80.6 (2013): 533-39. Web.
- DZNE Abt. Fuer Presse- Und Oeffentlichkeitsarbeit. “Researchers Activate Repair Program for Nerve Fibers.” DZNE. DZNE, n.d. Web. 02 Nov. 2016.