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Intrathecal Baclofen: Effects on Spasticity, Pain, and Consciousness in Disorders of Consciousness and Locked-in Syndrome

  • Neuromodulation (M Gofeld, Section Editor)
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Abstract

Disorders of consciousness (DOCs) include coma, vegetative state (VS), and minimally conscious state (MCS). Coma is characterized by impaired wakefulness and consciousness, while VS and MCS are defined by lacking or discontinuous consciousness despite recovered wakefulness. Conversely, locked-in syndrome (LIS) is characterized by quadriplegia and lower cranial nerve paralysis with preserved consciousness. Intrathecal baclofen (ITB) is a useful treatment to improve spasticity both in patients with DOCs and LIS. Moreover, it supports the recovery of consciousness in some patients with VS or MCS. The precise mechanism underlying this recovery has not yet been elucidated. It has been hypothesized that ITB may act by reducing the overload of dysfunctional sensory stimuli reaching the injured brain or by stabilizing the imbalanced circadian rhythms. Although the current indication of ITB is the management of severe spasticity, its potential use in speeding the recovery of consciousness merits further investigation.

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Conflict of Interest

Dr. Francesca Pistoia, Dr. Simona Sacco, Dr. Marco Sarà, Dr. Marco Franceschini, and Dr. Antonio Carolei each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio, 67100, L’Aquila, Italy

    Francesca Pistoia, Simona Sacco & Antonio Carolei

  2. Post-Coma Intensive Care Unit, IRCCS San Raffaele Pisana, Rome-Cassino, Via della Pisana 235, 00163, Rome, Italy

    Marco Sarà & Marco Franceschini

Authors
  1. Francesca Pistoia
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  2. Simona Sacco
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Correspondence to Francesca Pistoia.

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Pistoia, F., Sacco, S., Sarà, M. et al. Intrathecal Baclofen: Effects on Spasticity, Pain, and Consciousness in Disorders of Consciousness and Locked-in Syndrome. Curr Pain Headache Rep 19, 466 (2015). https://doi.org/10.1007/s11916-014-0466-8

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  • DOI: https://doi.org/10.1007/s11916-014-0466-8

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