Abstract
Study design
Prospective observational cohort study.
Objectives
To assess the effects of gabapentin on neuropsychological variables including memory, attention, and executive function in individuals with spinal cord injury.
Setting
Santa Clara Valley Medical Center inpatient spinal cord injury unit.
Methods
Ten patients (three females, seven males) with traumatic spinal cord injury underwent testing, with a mean age of 35.6 years (range 19–59, SD ±15.74). There were five patients with tetraplegia and five with paraplegia. Nine tests to assess neuropsychological function and two tests to assess pain were performed at 1 week post initiation of therapy, and at 4 weeks post initiation of therapy. The neuropsychological tests assessed aspects of memory, attention, and executive function.
Results
The average score for six out of the nine neuropsychological items administered at 1 week post initiation of gabapentin displayed a decrease in cognitive function when compared to baseline. The average score for five out of nine neuropsychological items improved from 1 week post initiation of treatment to 4 weeks post initiation of treatment.
Conclusions
Gabapentin therapy is associated with a tangible decline in memory, executive function, and attention in individuals with spinal cord injury. However, owing to small sample size, loss of patient follow-up at the 4 week post-treatment assessment, and lack of a control group, we cannot definitively state that any decreases in cognition are solely attributable to treatment with gabapentin.
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References
Rintala DH, Loubser PG, Castro J, Hart KA, Fuhrer MJ. Chronic pain in a community-based sample of men with spinal cord injury: prevalence, severity, and relationship with impairment, disability, handicap, and subjective well-being. Arch Phys Med Rehabil. 1998;79:604–14.
Turner JA, Cardenas DD, Warms CA, McClellan CB. Chronic pain associated with spinal cord injuries: a community survey. Arch Phys Med Rehabil. 2001;82:501–9.
New PW, Lim TC, Hill ST, Brown DJ. A survey of pain during rehabilitation after acute spinal cord injury. Spinal Cord. 1997;35:658–63.
Werhagen L, Hultling C, Molander C. The prevalence of neuropathic pain after non-traumatic spinal cord lesion. Spinal Cord. 2007;45:609–15.
Finnerup NB, Johannesen IL, Sindrup SH, Bach FW, Jensen TS. Pain and dysesthesia in patients with spinal cord injury: a postal survey. Spinal Cord. 2001;39:256–62.
Siddall PJ, McClelland JM, Rutkowski SB, Cousins MJ. A longitudinal study of the prevalence and characteristics of pain in the first five years following spinal cord injury. Pain. 2003;103:249–57.
Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–5.
Cavenagh J, Good, Ravenscroft P. Neuropathic pain: are we out of the woods yet? Intern J Med. 2006;36:251–5.
Eide PK. Pathophysiological mechanisms of central neuropathic pain after spinal cord injury. Spinal Cord. 1998;36:601–12.
Moriarty O, Mcguire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol. 2011;93:385–404.
Taylor CP, Gee NS, Su TZ, Kocsis JD, Welty DF, Brown JP, et al. A summary of mechanistic hypotheses of Gabapentin pharmacology. Epilepsy Res. 1998;29:233–49.
Putzke JD, Richards JS, Kezar L, Hicken BL, Ness TJ. Long-term use of Gabapentin for treatment of pain after traumatic spinal cord injury. Clin J Pain. 2002;18:116–21.
Levendoglu F, Ogun CO, Ozerbil O, Ogun TC, Ugurlu H. Gabapentin is a first line drug for the treatment of neuropathic pain in spinal cord injury. Spine. 2004;29:743–51.
Ahn SH, Park HW, Lee BS, Moon HW, Jang SH, Bae JH. Gabapentin effect on neuropathic pain compared among patients with spinal cord injury and different durations of symptoms. Spine. 2003;28:341–4.
Tai Q, Kirshblum S, Chen B, Millis S, Johnston M, DeLisa JA. Gabapentin in the treatment of neuropathic pain after spinal cord injury: A prospective, randomized, double-blind, crossover trial. J Spinal Cord Med. 2002;25:100–5.
To TP, Lim TC, Hill ST, Frauman AG, Cooper N, Kirsa SW, et al. Gabapentin for neuropathic pain following spinal cord injury. Spinal Cord. 2002;40:282–5.
Leach JP, Girvan J, Paul A, Brodie MJ. Gabapentin and cognition: a double blind, dose ranging, placebo controlled study in refractory epilepsy. J Neurol Neurosurg Psych. 1997;62:372–6.
Salinsky MC, Storzbach D, Spencer DC, Oken BS, Landry T, Dodrill CB. Effects of topiramate and Gabapentin on cognitive abilities in healthy volunteers. Neurology. 2005;64:792–8.
Meador KJ, Loring DW, Ray PG, Murro AM, King DW, Nichols ME, et al. Differential cognitive effects of carbamazepine and Gabapentin. Epilepsia. 1999;40:1279–85.
Martin R, Meador K, Turrentine L, Faught E, Sinclair K, Kuzniekcy R, et al. Comparative cognitive effects of carbamazepine and Gabapentin in healthy senior adults. Epilepsia. 2001;42:764–71.
Salinsky MC, Binder LM, Oken BS, Storzbach D, Aron CR, Dodrill CB. Effects of Gabapentin and carbamazepine on the EEG and cognition in healthy volunteers. Epilepsia. 2002;43:482–90.
Mendoza T, Mayne T, Rublee D, Cleeland C. Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis. Eur J Pain. 2006;4:353–61.
Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, et al. Prevalence of dementia in the United States: The aging, demographics, and memory study. Neuroepidemiology. 2007;29:125–32.
Wechsler D. WAIS-III Technical and Interpretive Manual. San Antonio, TX, USA: The Psychological Corporation; 2003.
Wechsler D. WMS-III Technical and Interpretive Manual. San Antonio, TX, USA: The Psychological Corporation; 2004.
Golden J. Stroop Color Word Test. Chicago, IL, USA: Soelting Co.; 1978.
Loonstra A, Tarlow A, Sellers AH. COWAT Metanorms across age, education, and gender. Appl Neuropsychol. 2001;8:161–6.
Barncord S. The Oral Trail Making Test: a validity investigation. Arch Clin Neuropsychol. 2002;17:827.
Strauss E, Sherman E, Spreen, Otfried. A. Compendium of Neuropsychological Tests. New York, NY, USA: Oxford University Press; 2006.
Quintero GC. Review about gabapentin misuse, interactions, contraindications and side effects. J Exp Pharmacol. 2017;9:13–21.
Kaufman KR, Struck PJ. Gabapentin-induced sexual dysfunction. Epilepsy Behav. 2011;21:324–6.
Ersek M, Cherrier MM, Overman SS, Irving GA. The cognitive effects of opioids. Pain Manag Nurs. 2004;5:75–78.
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Shem, K., Barncord, S., Flavin, K. et al. Adverse cognitive effect of gabapentin in individuals with spinal cord injury: preliminary findings. Spinal Cord Ser Cases 4, 9 (2018). https://doi.org/10.1038/s41394-018-0038-y
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DOI: https://doi.org/10.1038/s41394-018-0038-y
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