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Corva DM, Doeven EH, Parke B, Adams SD, Tye SJ, Hashemi P, Berk M, Kouzani AZ. SmartFSCV: An Artificial Intelligence Enabled Miniaturised FSCV Device Targeting Serotonin. IEEE Open J Eng Med Biol 2024; 5:75-85. [PMID: 38487099 PMCID: PMC10939322 DOI: 10.1109/ojemb.2024.3356177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 03/17/2024] Open
Abstract
Goal: Dynamically monitoring serotonin in real-time within target brain regions would significantly improve the diagnostic and therapeutic approaches to a variety of neurological and psychiatric disorders. Current systems for measuring serotonin lack immediacy and portability and are bulky and expensive. Methods: We present a new miniaturised device, named SmartFSCV, designed to monitor dynamic changes of serotonin using fast-scan cyclic voltammetry (FSCV). This device outputs a precision voltage potential between -3 to +3 V, and measures current between -1.5 to +1.5 μA with nano-ampere accuracy. The device can output modifiable arbitrary waveforms for various measurements and uses an N-shaped waveform at a scan-rate of 1000 V/s for sensing serotonin. Results: Four experiments were conducted to validate SmartFSCV: static bench test, dynamic serotonin test and two artificial intelligence (AI) algorithm tests. Conclusions: These tests confirmed the ability of SmartFSCV to accurately sense and make informed decisions about the presence of serotonin using AI.
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Affiliation(s)
- Dean M. Corva
- School of EngineeringDeakin UniversityGeelongVIC3216Australia
| | - Egan H. Doeven
- School of Life and Environmental SciencesDeakin UniversityGeelongVIC3216Australia
| | - Brenna Parke
- Department of BioengineeringImperial College LondonSW7 2AZLondonU.K.
| | - Scott D. Adams
- School of EngineeringDeakin UniversityGeelongVIC3216Australia
| | - Susannah J. Tye
- Queensland Brain InstituteThe University of QueenslandSt. LuciaQLD4072Australia
| | - Parastoo Hashemi
- Department of BioengineeringImperial College LondonSW7 2AZLondonU.K.
| | - Michael Berk
- School of Medicine, IMPACTDeakin UniversityGeelongVIC3216Australia
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2
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Witt CE, Mena S, Holmes J, Hersey M, Buchanan AM, Parke B, Saylor R, Honan LE, Berger SN, Lumbreras S, Nijhout FH, Reed MC, Best J, Fadel J, Schloss P, Lau T, Hashemi P. Serotonin is a common thread linking different classes of antidepressants. Cell Chem Biol 2023; 30:1557-1570.e6. [PMID: 37992715 DOI: 10.1016/j.chembiol.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/07/2023] [Accepted: 10/12/2023] [Indexed: 11/24/2023]
Abstract
Depression pathology remains elusive. The monoamine hypothesis has placed much focus on serotonin, but due to the variable clinical efficacy of monoamine reuptake inhibitors, the community is looking for alternative therapies such as ketamine (neurogenesis theory of antidepressant action). There is evidence that different classes of antidepressants may affect serotonin levels; a notion we test here. We measure hippocampal serotonin in mice with voltammetry and study the effects of acute challenges of escitalopram, fluoxetine, reboxetine, and ketamine. We find that pseudo-equivalent doses of these drugs similarly raise ambient serotonin levels, despite their differing pharmacodynamics because of differences in Uptake 1 and 2, rapid SERT trafficking, and modulation of serotonin by histamine. These antidepressants have different pharmacodynamics but have strikingly similar effects on extracellular serotonin. Our findings suggest that serotonin is a common thread that links clinically effective antidepressants, synergizing different theories of depression (synaptic plasticity, neurogenesis, and the monoamine hypothesis).
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Affiliation(s)
- Colby E Witt
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Sergio Mena
- Department of Bioengineering, Imperial College London, London, UK
| | - Jordan Holmes
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Melinda Hersey
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA; Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Anna Marie Buchanan
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA; Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Brenna Parke
- Department of Bioengineering, Imperial College London, London, UK
| | - Rachel Saylor
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Lauren E Honan
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Shane N Berger
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Sara Lumbreras
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Michael C Reed
- Department of Mathematics, Duke University, Durham, NC, USA
| | - Janet Best
- Department of Mathematics, The Ohio State University, Columbus, OH, USA
| | - James Fadel
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Patrick Schloss
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany
| | - Thorsten Lau
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany; Department of Neuroanatomy, Mannheim Centre for Translational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Parastoo Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA; Department of Bioengineering, Imperial College London, London, UK.
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3
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Agramunt J, Parke B, Mena S, Ubels V, Jimenez F, Williams G, Rhodes ADY, Limbu S, Hexter M, Knight L, Hashemi P, Kozlov AS, Higgins CA. Mechanical stimulation of human hair follicle outer root sheath cultures activates adjacent sensory neurons. Sci Adv 2023; 9:eadh3273. [PMID: 37889977 PMCID: PMC10610912 DOI: 10.1126/sciadv.adh3273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Mechanical stimuli, such as stroking or pressing on the skin, activate mechanoreceptors transmitting information to the sensory nervous system and brain. It is well accepted that deflection of the hair fiber that occurs with a light breeze or touch directly activates the sensory neurons surrounding the hair follicle, facilitating transmission of mechanical information. Here, we hypothesized that hair follicle outer root sheath cells act as transducers of mechanical stimuli to sensory neurons surrounding the hair follicle. Using electrochemical analysis on human hair follicle preparations in vitro, we were able to show that outer root sheath cells release ATP and the neurotransmitters serotonin and histamine in response to mechanical stimulation. Using calcium imaging combined with pharmacology in a coculture of outer root sheath cells with sensory neurons, we found that the release of these three molecules from hair follicle cells leads to activation of sensory neurons.
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Affiliation(s)
- Julià Agramunt
- Department of Bioengineering, Imperial College London, London, UK
| | - Brenna Parke
- Department of Bioengineering, Imperial College London, London, UK
| | - Sergio Mena
- Department of Bioengineering, Imperial College London, London, UK
| | - Victor Ubels
- Department of Bioengineering, Imperial College London, London, UK
| | - Francisco Jimenez
- Mediteknia Clinic, Las Palmas, Gran Canaria, Spain
- University Fernando Pessoa Canarias, Gran Canaria, Spain
| | | | - Anna DY Rhodes
- Department of Bioengineering, Imperial College London, London, UK
| | - Summik Limbu
- Department of Bioengineering, Imperial College London, London, UK
| | - Melissa Hexter
- Department of Bioengineering, Imperial College London, London, UK
| | | | - Parastoo Hashemi
- Department of Bioengineering, Imperial College London, London, UK
| | - Andriy S. Kozlov
- Department of Bioengineering, Imperial College London, London, UK
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4
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Witt CE, Mena S, Holmes J, Hersey M, Buchanan AM, Parke B, Saylor R, Honan LE, Berger SN, Lumbreras S, Nijhout FH, Reed MC, Best J, Fadel J, Schloss P, Lau T, Hashemi P. Serotonin is a Common Thread Linking Different Classes of Antidepressants. Res Sq 2023:rs.3.rs-2741902. [PMID: 37034599 PMCID: PMC10081366 DOI: 10.21203/rs.3.rs-2741902/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Depression pathology remains elusive. The monoamine hypothesis has placed much focus on serotonin, but due to the variable clinical efficacy of monoamine reuptake inhibitors, the community is looking for alternative therapies such as ketamine (synaptic plasticity and neurogenesis theory of antidepressant action). There is evidence that different classes of antidepressants may affect serotonin levels; a notion we test here. We measure hippocampal serotonin in mice with voltammetry and study the effects of acute challenges of antidepressants. We find that pseudo-equivalent doses of these drugs similarly raise ambient serotonin levels, despite their differing pharmacodynamics because of differences in Uptake 1 and 2, rapid SERT trafficking and modulation of serotonin by histamine. These antidepressants have different pharmacodynamics but have strikingly similar effects on extracellular serotonin. Our findings suggest that serotonin is a common thread that links clinically effective antidepressants, synergizing different theories of depression (synaptic plasticity, neurogenesis and the monoamine hypothesis).
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Affiliation(s)
- Colby E. Witt
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Sergio Mena
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Jordan Holmes
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Melinda Hersey
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Anna Marie Buchanan
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Brenna Parke
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Rachel Saylor
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Lauren E. Honan
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Shane N. Berger
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Sara Lumbreras
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Janet Best
- Department of Mathematics, The Ohio State University, Columbus, OH, USA
| | - James Fadel
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Patrick Schloss
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany
| | - Thorsten Lau
- Department of Psychiatry and Psychotherapy, Biochemical Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim, Heidelberg University, Mannheim, Germany
- Department of Neuroanatomy, Mannheim Centre for Translational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Parastoo Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
- Department of Bioengineering, Imperial College London, London, United Kingdom
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5
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Holmes J, Lau T, Saylor R, Fernández-Novel N, Hersey M, Keen D, Hampel L, Horschitz S, Ladewig J, Parke B, Reed MC, Nijhout HF, Best J, Koch P, Hashemi P. Voltammetric Approach for Characterizing the Biophysical and Chemical Functionality of Human Induced Pluripotent Stem Cell-Derived Serotonin Neurons. Anal Chem 2022; 94:8847-8856. [PMID: 35713335 DOI: 10.1021/acs.analchem.1c05082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Depression is quickly becoming one of the world's most pressing public health crises, and there is an urgent need for better diagnostics and therapeutics. Behavioral models in animals and humans have not adequately addressed the diagnosis and treatment of depression, and biomarkers of mental illnesses remain ill-defined. It has been very difficult to identify biomarkers of depression because of in vivo measurement challenges. While our group has made important strides in developing in vivo tools to measure such biomarkers (e.g., serotonin) in mice using voltammetry, these tools cannot be easily applied for depression diagnosis and drug screening in humans due to the inaccessibility of the human brain. In this work, we take a chemical approach, ex vivo, to introduce a human-derived system to investigate brain serotonin. We utilize human induced pluripotent stem cells differentiated into serotonin neurons and establish a new ex vivo model of real-time serotonin neurotransmission measurements. We show that evoked serotonin release responds to stimulation intensity and tryptophan preloading, and that serotonin release and reuptake kinetics resemble those found in vivo in rodents. Finally, after selective serotonin reuptake inhibitor (SSRI) exposure, we find dose-dependent internalization of the serotonin reuptake transporters (a signature of the in vivo response to SSRI). Our new human-derived chemical model has great potential to provide an ex vivo chemical platform as a translational tool for in vivo neuropsychopharmacology.
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Affiliation(s)
- Jordan Holmes
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina 29208, United States
| | - Thorsten Lau
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Rachel Saylor
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina 29208, United States
| | - Nadine Fernández-Novel
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Melinda Hersey
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina 29208, United States.,Department of Pharmacology, Physiology, & Neuroscience, University of South Carolina, Columbia, South Carolina 29209, United States
| | - Deanna Keen
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina 29208, United States
| | - Lena Hampel
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Sandra Horschitz
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Julia Ladewig
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Brenna Parke
- Department of Bioengineering, Imperial College London, London SW7 2AZ, U.K
| | - Michael C Reed
- Department of Mathematics, Duke University, Durham, North Carolina 27708, United States
| | - H Frederik Nijhout
- Department of Biology, Duke University, Durham, North Carolina 27708, United States
| | - Janet Best
- Department of Mathematics, The Ohio State University, Columbus, Ohio 43210, United States
| | - Philipp Koch
- Department of Translational Brain Research, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Germany.,German Cancer Research Center, 69120 Heidelberg, Germany.,HITBR Hector Institute for Translational Brain Research gGmbH, 68159 Mannheim, Germany
| | - Parastoo Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina 29208, United States.,Department of Bioengineering, Imperial College London, London SW7 2AZ, U.K
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6
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Ribaudo G, Bortoli M, Witt CE, Parke B, Mena S, Oselladore E, Zagotto G, Hashemi P, Orian L. ROS-Scavenging Selenofluoxetine Derivatives Inhibit In Vivo Serotonin Reuptake. ACS Omega 2022; 7:8314-8322. [PMID: 35309454 PMCID: PMC8928538 DOI: 10.1021/acsomega.1c05567] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
While the neurochemistry that underpins the behavioral phenotypes of depression is the subject of many studies, oxidative stress caused by the inflammation comorbid with depression has not adequately been addressed. In this study, we described novel antidepressant-antioxidant agents consisting of selenium-modified fluoxetine derivatives to simultaneously target serotonin reuptake (antidepressant action) and oxidative stress. Excitingly, we show that one of these agents (1-F) carries the ability to inhibit serotonin reuptake in vivo in mice. We therefore present a frontier dual strategy that paves the way for the future of antidepressant therapies.
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Affiliation(s)
- Giovanni Ribaudo
- Dipartimento
di Medicina Molecolare e Traslazionale, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Marco Bortoli
- Dipartimento
di Scienze Chimiche, Università degli
Studi di Padova Via Marzolo 1, 35131 Padova, Italy
- Institut
de Química Computacional i Catàlisi and Departament
de Química, Universitat de Girona, c/Maria Aurèlia Capmany 69, 17003 Girona, Catalonia, Spain
| | - Colby E. Witt
- Department
of Chemistry and Biochemistry, University
of South Carolina, Columbia South Carolina 29201, United States
| | - Brenna Parke
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, U.K.
| | - Sergio Mena
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, U.K.
| | - Erika Oselladore
- Dipartimento
di Medicina Molecolare e Traslazionale, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Giuseppe Zagotto
- Dipartimento
di Scienze del Farmaco, Università
degli Studi di Padova, Via Marzolo 5, 35131 Padova, Italy
| | - Parastoo Hashemi
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, U.K.
- Department
of Chemistry and Biochemistry, University
of South Carolina, Columbia South Carolina 29201, United States
| | - Laura Orian
- Dipartimento
di Scienze Chimiche, Università degli
Studi di Padova Via Marzolo 1, 35131 Padova, Italy
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7
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Parke B, Mulgrew J. End-of-life care in old age. Can Nurse 2000; 96:12-3. [PMID: 11865501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- B Parke
- Aberdeen Hospital, Capital Health Region, Victoria, B.C
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8
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Abstract
Older adults comprise the majority of people receiving hospital services in many regions of our country today. Current literature is fraught with stories of how risky hospitalization can be for an older adult. Even with the best intentions, being in hospital can set up a cascade of events for older adults and their families that result in longer lengths of stay and functional disability. In a climate of fiscal restraint, competing priorities and public pressure, meeting the challenges of hospitalization for this population is not an easy task. As the number of older adults in acute care rises and the average length of stay continues to decrease, it is necessary for acute care hospitals to rethink their views of caring for older adults; fundamental shifts are required. The purpose of this paper is to describe the "Elder Friendly Hospital" (EFH) concept and explain the strategies taken by the Capital Health Region in Victoria British Columbia.
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Affiliation(s)
- B Parke
- Gerontology, Greater Victoria Hospital Society, Victoria General Hospital, British Columbia, Canada
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10
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Parke B. Pain in the cognitively impaired elderly. Can Nurse 1992; 88:17-20. [PMID: 1394066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
We studied the effect of the intrathecal infusion of baclofen, an agonist of gamma-aminobutyric acid, on abnormal muscle tone and spasms associated with spinal spasticity, in a randomized double-blind crossover study. Twenty patients with spinal spasticity caused by multiple sclerosis or spinal-cord injury who had had no response to treatment with oral baclofen received an intrathecal infusion of baclofen or saline for three days. The infusions were administered by means of a programmable pump implanted in the lumbar subarachnoid space. Muscle tone decreased in all 20 patients (mean [+/- SD] Ashworth score for rigidity, from 4.0 +/- 1.0 to 1.2 +/- 0.4; P less than 0.0001), and spasms were decreased in 18 of the 19 patients who had spasms (mean [+/- SD] score for spasm frequency, from 3.3 +/- 1.2 to 0.4 +/- 0.8; P less than 0.0005). Tests for motor function, neurologic examination, and assessments by the patients correctly indicated when baclofen was being infused in all cases. All patients were then entered in an open long-term trial of continuous infusion of intrathecal baclofen. During a mean follow-up period of 19.2 months (range, 10 to 33), muscle tone has been maintained within the normal range (mean Ashworth score, 1.0 +/- 0.1) and spasms have been reduced to a level that does not interfere with activities of daily living (mean spasm score, 0.3 +/- 0.6). No drowsiness or confusion occurred, one pump failed, and two catheters became dislodged and had to be replaced. No infections were observed. Our observations suggest that intrathecal baclofen is an effective long-term treatment for spinal spasticity that has not responded to oral baclofen.
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Affiliation(s)
- R D Penn
- Department of Neurosurgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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12
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Parke B, Penn RD, Savoy SM, Corcos D. Functional outcome after delivery of intrathecal baclofen. Arch Phys Med Rehabil 1989; 70:30-2. [PMID: 2916915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Patients with multiple sclerosis or spinal cord injury often have severe, disabling spasticity. This is frequently treated with oral medications or with destructive neurosurgical procedures. We report on a group of patients with spasticity not relieved by these methods. These patients were subsequently treated with intrathecal baclofen delivered by an implanted programmable drug pump. Twenty-one patients have received this form of treatment, and the functional status of eight has been tracked by the Patient Evaluation Conference System (PECS) for at least six months. In most cases, spasticity, performance of bowel and bladder programs, and performance of ADL improved after delivery of intrathecal baclofen. The improvements appear to be due to the decrease in hypertonicity and the increased ease of movement (passive or active) in affected extremities. Intrathecal baclofen should be considered as a treatment method in patients with severe spasticity of spinal origin.
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Affiliation(s)
- B Parke
- Department of Rehabilitation Medicine, Rush Medical College, Chicago, IL 60612
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13
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Cockram DB, Wickman E, Parke B. Criteria for the diagnosis of malnutrition. JAMA 1987; 257:486-7. [PMID: 3795430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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14
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Parke B, Cavanaugh J. Amyloidosis complicating the rehabilitation of a patient with a right cerebrovascular accident. Am J Phys Med 1986; 65:63-8. [PMID: 3963166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Physiatrists are rarely presented with a case of amyloidosis. Its unrelenting course must be appreciated in order to speed the process of rehabilitation and help in setting appropriate and rapidly achievable goals. These rehabilitation challenges are discussed with respect to a patient with amyloidosis and a right cerebrovascular accident. The need for medical management of the systemic symptoms of amyloidosis is also addressed. It is felt that the addition of such a progressive terminal disease to the diagnosis of stroke leads to unique interactions among the rehabilitation staff, the patient, and the patient's family, and the need for an aggressive approach to goal-setting and discharge planning.
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