The effect of minocycline on neurological outcome of spinal cord injury patients

Abstract

Patients with acute traumatic spinal cord injuries are experience severe loss of function and profoundly impaired quality of life, and the development of interventions to improve motor recovery is critically important. In clinical studies, have attributed neuroprotective properties to the antibiotic minocycline, and in animal studies it has been used. It supports it in several neurological diseases. In animal models of spinal cord injury, minocycline improves neurological and histological outcomes, reduces neuronal and oligodendroglial apoptosis, reduces microglial activation, and reduces inflammation. But they have not yet proven that they have significant benefits for humans or not. Therefore, in this study, we investigated the use of minocycline in the management of acute traumatic SCI in humans. Methods: In a double-blind randomized clinical trial, 54 patients with acute traumatic SCI (first 8 hours of injury) at Tabriz University of Medical Sciences were included in the study. They were randomly divided into case and control groups. After admission all included patients received a bolus dose of MP at 33 mg/kg intravenously (IV) for 15 minutes. Then, after 45 minutes, MP infusion was continued for 24 to 48 hours at a 5.4 mg/kg IV dose. The case group received an additional dose of minocycline 50 mg orally every 12 hours for up to seven days. sensory and motor functions were evaluated according to the American Spinal Injury Association (ASIA) grading score upon admission, on the first, fourth and seventh days, three months and 6 months after admission. Data were analyzed by SPSS version 20. A P-Value of < 0.05 was considered as statistically significant

Results: We found that grade B in the Frankel grading system was the highest frequent in both groups after admission. After treatment we detected several shifts between different grades in both groups. The Frankel scale was significantly different between the MP plus minocycline and MP monotherapy groups 6 months after treatment (Table 8) (p=0.04). The differences were insignificant on days 1, 4 and 7 and three months after the intervention.