Clinical Drug Investigation

, Volume 34, Issue 5, pp 361–366 | Cite as

Immediate Neurological Recovery Following Perispinal Etanercept Years After Brain Injury

  • Edward TobinickEmail author
  • Helen Rodriguez-Romanacce
  • Arthur Levine
  • Tracey A. Ignatowski
  • Robert N. Spengler
Case Report


Positron emission tomographic brain imaging and pathological examination have revealed that a chronic, intracerebral neuroinflammatory response lasting for years after a single brain injury may occur in humans. Evidence suggests the immune signaling molecule, tumor necrosis factor (TNF), is centrally involved in this pathology through its modulation of microglial activation, role in synaptic dysfunction, and induction of depressive symptoms and neuropathic pain. Etanercept is a recombinant TNF receptor fusion protein and potent TNF inhibitor that has been found to reduce microglial activation and neuropathic pain in multiple experimental models. We report that a single dose of perispinal etanercept produced an immediate, profound, and sustained improvement in expressive aphasia, speech apraxia, and left hemiparesis in a patient with chronic, intractable, debilitating neurological dysfunction present for more than 3 years after acute brain injury. These results indicate that acute brain injury-induced pathologic levels of TNF may provide a therapeutic target that can be addressed years after injury. Perispinal administration of etanercept is capable of producing immediate relief from brain injury-mediated neurological dysfunction.


Traumatic Brain Injury Neuropathic Pain Etanercept Tumor Necrosis Factor Inhibitor Apraxia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Dr. Edward Tobinick has multiple issued and pending US and foreign patents, assigned to TACT IP LLC, which claim methods of use of etanercept for the treatment of neurological disorders, including, but not limited to, US patents 6419944, 6537549, 6982089, 7214658, 7629311, 8119127, 8236306, and 8349323, all assigned to TACT IP LLC; and Australian patent 758523. Dr. Tobinick is the founder of the Institute of Neurological Recovery, a group of medical practices that utilize perispinal etanercept as a therapeutic modality, and also train physicians; he is also the Chief Executive Officer of TACT IP LLC. Helen Rodriguez-Romanacce and Arthur Levine are employees of the Institute of Neurological Recovery, Boca Raton, FL, USA. The professional activities of Tracey Ignatowski and Robert Spengler include their work as co-directors of neuroscience at NanoAxis, LLC, a company formed to foster the commercial development of products and applications in the field of nanomedicine, which include novel methods of inhibiting TNF.

Supplementary material

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Supplementary material 1 (DOCX 283 kb)

Supplementary material 2 (MPG 56592 kb)


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Edward Tobinick
    • 1
    Email author
  • Helen Rodriguez-Romanacce
    • 1
  • Arthur Levine
    • 1
  • Tracey A. Ignatowski
    • 2
    • 3
  • Robert N. Spengler
    • 4
  1. 1.Institute of Neurological RecoveryBoca RatonUSA
  2. 2.Department of Pathology and Anatomical Sciences, School of Medicine and Biomedical Sciences, University at BuffaloThe State University of New YorkBuffaloUSA
  3. 3.Program for Neuroscience, School of Medicine and Biomedical Sciences, University at BuffaloThe State University of New YorkBuffaloUSA
  4. 4.BuffaloUSA

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