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Clin Neurophysiol. 2012 Nov;123(11):2200-4. doi: 10.1016/j.clinph.2012.04.007. Epub 2012 May 16.

Effect of concentration and mode of intrathecal baclofen administration on soleus H-reflex in patients with muscle hypertonia.

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  • 1Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, MS, USA.



Assess spinal reflex excitability after increasing intrathecal baclofen (ITB) flow by manipulation of drug concentration and mode of administration.


The effect of concentration was assessed by comparing changes in H-reflex (H/M ratio) 1-6h after a 50μg ITB bolus at 50μg/ml concentration administered manually via lumbar puncture (LP, duration 1-2min, n=27) to a 50μg bolus at 500μg/ml concentration programmed through the pump and delivered via intrathecal catheter (IC, duration 10min) above simple continuous dose (25-100μg/day, n=16). The effect of mode of administration was assessed by comparing peak changes in H/M ratio after 50μg IC bolus above simple continuous dose (complex continuous mode, n=27) to simple continuous mode only (n=22) at equivalent daily doses (75-150μg/day).


H/M decrease was faster and overall greater after LP than IC bolus (mean 1-h 77% vs. 63%, p=0.012; 1-6h 91% vs. 82%, p<0.001, respectively). H/M ratio also decreased significantly more with complex (91%) than simple continuous mode of administration (78%, p=0.025).


Lower ITB concentration and complex continuous mode of administration lead to greater decrease in H/M ratio.


Decreased spinal reflex excitability after adjustment of drug and pump parameters to increase ITB flow may result in better clinical response.

Copyright © 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

[PubMed - indexed for MEDLINE]
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