Dose-response relationship between the H-reflex and continuous intrathecal baclofen administration for management of spasticity

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
Dobrivoje S StokicJake Olivier

Abstract

To determine the relationship between the H-reflex (H/M ratio) and continuous intrathecal baclofen (CITB) dose after pump implantation for control of spastic hypertonia. Soleus H-reflexes were serially recorded in 34 subjects (19 men, mean age 32 years, mean follow-up 1.7 years) during simple continuous mode of CITB delivery. Different fitting methods were explored to determine which function best described changes in H/M ratio with increasing CITB dose. We then calculated effective CITB doses yielding H/M ratios equal to 75, 50, and 25% (ED75, ED50, ED25) of the baseline recorded before the implant in 22 subjects. We found a significant dose-response relationship between the soleus H/M ratio and CITB dose. A two-decay exponential function was the best fit on each side for pooled data, but a general linear model when controlling for subject. The mean ED75, ED50, ED25 were 30, 70, and 110 mcg/day. Logistical regression predicted with high probability that the H/M ratio should be less than 30% at CITB doses above 150 mcg/day. H/M ratio is strongly dependent on CITB dose. It sharply decreases up to 150 mcg/day of CITB followed by a plateau. Establishing the relationship between the H/M ratio and CITB dose may be useful for dose ti...Continue Reading

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Citations

Feb 3, 2012·Journal of Neurosurgery. Pediatrics·Sadahiro NomuraMichiyasu Suzuki
May 19, 2012·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Dobrivoje S Stokic, Stuart A Yablon
Mar 1, 2011·European Journal of Pharmaceutics and Biopharmaceutics : Official Journal of Arbeitsgemeinschaft Für Pharmazeutische Verfahrenstechnik E.V·Lorenzo PrianoAlessandro Mauro
Jul 6, 2010·PM & R : the Journal of Injury, Function, and Rehabilitation·Eric M DvorakMary Elizabeth S Nelson
Apr 10, 2007·Neurophysiologie clinique = Clinical neurophysiology·C BleyenheuftT Lejeune
Jun 9, 2006·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·M A HovingUNKNOWN Dutch Study Group On Child Spasticity
Aug 14, 2009·Neurorehabilitation and Neural Repair·Dobrivoje S StokicJakob Udby Blicher
Jul 8, 2020·Acta Neurologica Scandinavica·Domizia VecchioRoberto Cantello
Jul 11, 2018·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Amir EftekharJonathan R Wolpaw

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