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4‐Aminopyridine Improves Pulmonary Function in Quadriplegic Humans with Longstanding Spinal Cord Injury
Author(s) -
Segal Jack L.,
Brunnemann Sherry R.
Publication year - 1997
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1997.tb03051.x
Subject(s) - medicine , spinal cord injury , pulmonary function testing , anesthesia , vital capacity , spinal cord , physical therapy , lung , lung function , psychiatry , diffusing capacity
Study Objective . To test the hypothesis that 4‐aminopyridine (4‐AP) might cause clinically evident improvement in pulmonary function in humans with chronic spinal cord injury (chronic SCI). Design . Balanced, open‐label study with subjects consecutively enrolled. Setting . Spinal Cord Injury Service, university‐affiliated tertiary level care Department of Veterans Affairs Medical Center. Patients . Seventeen healthy men and women suffering from traumatic SCI (11 quadriplegic, 6 paraplegic patients) for more than 1 year. Interventions . Each subject was given a single dose of 4‐AP 10 mg orally in an immediate‐release formulation. Measurements and Main Results . Significant increases in mean values of forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) that persisted for at least 12 hours were demonstrated in quadriplegic patients beginning 6 hours after 4‐AP administration. Tests of pulmonary function that demonstrated statistically significant increases at any time were also numerically, if not statistically, increased at 24 hours compared with pretreatment values obtained in 4‐AP‐naive subjects. Conclusions . The administration of a single dose of an immediate‐release formulation of 4‐AP to humans with longstanding, traumatic quadriplegia is associated with sustained, clinically meaningful, and statistically significant improvements in pulmonary function. We suggest that the administration of 4‐AP may have a salutary effect in patients suffering from SCI and appears to be associated with potentially clinically significant reductions in the pathophysiologic pulmonary sequelae of SCI.