PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 10668769

Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial.

N C Cutter·D D Scott·J C Johnson·G Whiteneck
View original source ↗Export metadata ↓

Abstract

OBJECTIVE: To investigate the effect of gabapentin on subject self-report and physician-administered spasticity scales in individuals with multiple sclerosis. DESIGN: Prospective, double-masked, placebo-controlled, crossover design. SETTING: The Multiple Sclerosis Center at the Denver Veterans Affairs Medical Center. INTERVENTION: Subjects were titrated to either 900 mg gabapentin orally three times a day or placebo over a 6-day period. Subjects underwent a 14-day washout and then were crossed over. No other changes were made to their medication regimen. MAIN OUTCOME MEASURES: The outcome measures were divided into two categories: subject self-report scales physician-administered scales. Subject self-report scales included the spasm frequency scale, spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale. Physician-administered scales included the Modified Ashworth Scale, clonus scale, deep tendon reflexes, plantar stimulation response, and the Kurtzke Expanded Disability Status (EDSS) Scale. Digit Span and Digit Symbol subtests of the WAIS-R Intelligence Scale were administered to assess for possible impaired concentration. The Fatigue Impact Scale was administered to assess for changes in fatigue. The adjective generation technique was administered to assess for alterations in mood. RESULTS: A statistically significant reduction in the impairment of spasticity was found in the gabapentin-treated subjects compared with placebo as measured by the self-report scales of the spasm severity scale, interference with function scale, painful spasm scale, and global assessment scale and by the physician-administered scales of the Modified Ashworth and plantar stimulation response. No significant difference was noted in the Digit Span, Digit Symbol, adjective generation technique, and EDSS. CONCLUSION: Gabapentin reduces the impairment of spasticity, compared with placebo, without the side effects of worsening concentration and fatigue.

Explore related subjects

AcetatesAdolescentAdultAgedAged, 80 and overAminesAnticonvulsantsCross-Over StudiesCyclohexanecarboxylic AcidsDisability EvaluationDouble-Blind MethodFemaleGabapentinHumansMaleMiddle AgedMultiple SclerosisMuscle FatigueMuscle SpasticityProspective StudiesTreatment Outcomegamma-Aminobutyric AcidClinical TrialComparative StudyJournal ArticleRandomized Controlled TrialResearch Support, U.S. Gov't, Non-P.H.S.

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

N C Cutter, D D Scott, J C Johnson, G Whiteneck. 2000. Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial.. https://doi.org/10.1016/s0003-9993(00)90135-7

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Neural network prediction of thermophilic (65 degrees C) sulfidogenic fluidized-bed reactor performance for the treatment of metal-containing wastewater.

The performance of a fluidized-bed reactor (FBR) based sulfate reducing bioprocess was predicted using artificial neural network (ANN). The FBR was operated at high (65 degrees C) temperature and it was fed with iron (40-90 mg/L) and sulfate (1,000-1,500 mg/L) containing acidic (pH = 3.5-6) synthetic wastewater. Ethanol was supplemented as carbon and electron source for sulfate reducing bacteria (SRB). The wastewater pH of 4.3-4.4 was neutralized by the alkalinity produced in acetate oxidation and the average effluent pH was 7.8 +/- 0.8. The oxidation of acetate is the rate-limiting step in the sulfidogenic ethanol oxidation by thermophilic SRB, which resulted in acetate accumulation. Sulfate reduction and acetate oxidation rates showed variation depending on the operational conditions with the maximum rates of 1 g/L/d (0.2 g/g volatile solids (VS)/d) and 0.3 g/L/d (0.06 g/g VS/d), respectively. This study presents an ANN model predicting the performance of the reactor and determining the optimal architecture of this model; such as best back-propagation (BP) algorithm and neuron numbers. The Levenberg-Marquardt algorithm was selected as the best of 12 BP algorithms and optimal neuron number was determined as 20. The developed ANN model predicted acetate (R=0.91), sulfate (R=0.95), sulfide (R=0.97), and alkalinity (R=0.94) in the FBR effluent. Hence, the ANN based model can be used to predict the FBR performance, to control the operational conditions for improved process performance.

Acetates↗
PubMed2007

Short-term temperature effects on the anaerobic metabolism of glycogen accumulating organisms.

Proliferation of glycogen accumulating organisms (GAO) has been identified as a potential cause of enhanced biological phosphorus removal (EBPR) failure in wastewater treatment plants (WWTP). GAO compete for substrate with polyphosphate accumulating organisms (PAO) that are the microorganisms responsible for the phosphorus removal process. In the present article, the effects of temperature on the anaerobic metabolism of GAO were studied in a broad temperature range (from 10 to 40 degrees C). Additionally, maximum acetate uptake rate of PAO, between 20 and 40 degrees C, was also evaluated. It was found that GAO had clear advantages over PAO for substrate uptake at temperatures higher than 20 degrees C. Below 20 degrees C, maximum acetate uptake rates of both microorganisms were similar. However, lower maintenance requirements at temperature lower than 30 degrees C give PAO metabolic advantages in the PAO-GAO competition. Consequently, PAO could be considered to be psychrophilic microorganisms while GAO appear to be mesophilic. These findings contribute to understand the observed stability of the EBPR process in WWTP operated under cold weather conditions. They may also explain the proliferation of GAO in WWTP and thus, EBPR instability, observed in hot climate regions or when treating warm industrial effluents. It is suggested to take into account the observed temperature dependencies of PAO and GAO in order to extend the applicability of current activated sludge models to a wider temperature range.

Acetates↗
PubMed2007

Long-term performance of peat biofilters treating ethyl acetate, toluene, and its mixture in air.

Three laboratory-scale peat biofilters were operated at 90 s empty bed residence time (EBRT) for over a year. Biodegradation of ethyl acetate, toluene, or a 1:1 mixture were investigated. In first stage, inlet concentration was progressively increased from 0.4 to 4.5 g/m(3). The maximum elimination capacity (EC) found for ethyl acetate was 190 gC/m(3).h, and it was not affected by toluene. The maximum EC found for toluene as a sole contaminant was 150 gC/m(3).h, but the presence of ethyl acetate decreased the toluene maximum EC to 80 gC/m(3).h. From respirometry monitoring, values of 3.19 g CO(2)/gC and 3.06 g CO(2)/gC for pure ethyl acetate and pure toluene, respectively, were found, with overall yield coefficients of 0.13 g dry biomass produced per gram ethyl acetate consumed and 0.28 g dry biomass produced per gram toluene consumed. CO(2) production in the 1:1 mixture was successfully simulated. Dynamics of living and dead cells were monitored in four sections of the biofilters. Concentrations ranged between 2.6 x 10(9) and 3.0 x 10(10) cells per gram-dry peat for total bacteria, and 2.4 x 10(9)-1.9 x 10(10) cells per gram-dry peat for living bacteria. At high loads loss of bacterial density in the inlet zones, and increase in the dead cells percentages up to 60% was observed. In second stage, long-term performance at an inlet concentration of 1.5 g/m(3) was evaluated to show the process feasibility. Good agreement with previous data was obtained in terms of EC and CO(2) production. Restoration of living cells proportion was also observed.

Acetates↗