Spinal cord injury

Abstract

Poster 276 Impact of Age on Motor Recovery Following Acute Spinal Cord Injury. Brian T. Kucer, MD (Thomas Jefferson University Hospital, Philadelphia, PA); Anthony S. Burns, MD; Fred H. Geisler, MD, PhD.; William P. Coleman, PhD. Disclosure: B.T. Kucer, None; A.S. Burns, None; F.H. Geisler, Fidia Pharmaceutical; Christopher Reeve Foundation; W.P. Coleman, Fidia Pharmaceutical; Christopher Reeve Foundation; International Collaboration on Repair Discoveries; International Campaign for Cures of Spinal Cord Injury Paralysis. Objective: To study the effect of age on motor recovery following acute spinal cord injury (SCI). Design: Secondary analysis of the Sygen (GM-1 ganglioside) Trial. Setting: Multicenter trial. Participants: Subjects with acute SCI. Intervention: Placebo versus drug. Main Outcome Measures: Percentage of motor score recovery (% recovery) and absolute change in motor score ( MS). Results: Subjects with baseline and 52-week data were included (N 616), then grouped by age (in years): 10 to 29 (n 308), 30 to 49 (n 237), and 50 to 69 (n 71). Each age group was then stratified using the American Spinal Injury Association (ASIA) Impairment Scale: ASIA grade A (complete), ASIA grade B (sensory incomplete), and ASIA grade C and D (motor incomplete). MS and % recovery were calculated at 52 weeks. Placebo and Sygen arms were compared and no significant differences were noted. Treatment arms were combined for further analysis. For ASIA grade A injuries, there were no significant differences between age groups. For ASIA grade B injuries, MS and % recovery were lower for the 30-to-49 group compared with the 10to-29 group (27 vs 42 motor points; P .007; 34% vs 54%, P .005), respectively. Recovery was also less for the 50-to-69 group compared with the 10-to-29 group (28 vs 42 motor points; 34% vs 54% recovery), but failed to reach significance, which we attribute to the small number of subjects (n 10) in the older group. For ASIA grade C and D injuries, MS and % recovery were lower for the 50-to-69 group compared with the 10-to-29 group (43 vs 53 motor points, P .049; 65% vs 86%, P .001), respectively. Recovery for the 10-to-29 compared with the 30-to-49 group was essentially the same. Conclusions: Age may not impact motor recovery following clinically complete injuries. Compared with younger subjects (age range, 10 29y), there is less neurologic recovery for sensory incomplete injuries, starting at ages 30 to 49 years, and motor incomplete injuries, starting at ages 50 to 69 years.