{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T10:24:52Z","timestamp":1768040692999,"version":"3.49.0"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,3]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Baclofen, the most effective drug for treating spasticity, is a specific agonist of gamma-aminobutyric acid-B receptors, and is very abundant in the superficial layers of the spinal cord. Given orally, baclofen does not easily penetrate the blood-brain barrier, and is distributed equally to the brain and spinal cord. Direct intrathecal administration was given in order to change the distribution of the drug by preferentially perfusing the spinal cord. Eighteen patients presenting a severe spastic syndrome were treated with chronic intrathecal infusion of baclofen in the lumbar cerebrospinal fluid. After clinical preselection, 38 patients were implanted with a lumbar access port allowing long-term trials in order to determine the efficacy of baclofen therapy and the effective 12-hour dose. The 18 patients selected for chronic administration were implanted with a programmable pump. The pathology in these cases was: multiple sclerosis (6 cases), posttrauma spastic syndrome (eight cases), and (one case each) cerebral palsy, ischemic cerebral lesion, spinal ischemia, and transverse myelitis. The mean follow-up period was 18 months (range 4 to 43 months).<\/jats:p>\n<jats:p content-type=\"fine-print\">The clinical results were evaluated according to muscular hypertony on Ashworth's scale (changed for occurrence of painful spasms) and functional improvement. Results were better for spastic syndrome secondary to traumatic medullary lesion than for demyelinating disease. Hypertonia was improved in all cases as confirmed by the registration of the Hoffman (H) reflex. Painful muscular spasms disappeared in 14 of the 16 affected patients. Significant functional improvement was noted in nine patients and was considerable in three. The risk of side effects secondary to overdose (such as excessive hypotonia or central depression) and the absence of a specific baclofen antagonist stresses the necessity for accurate determination of the efficient dose. After an initial titration period and adjustment of the therapeutic dose, the individual doses were from 21 to 500 <jats:italic>\u00b5<\/jats:italic>g\/24 hrs (mean 160 <jats:italic>\u00b5<\/jats:italic>g\/24 hrs). This new conservative method is very effective, perfectly reversible, and safe when administered in conditions favorable to its use.<\/jats:p>","DOI":"10.3171\/jns.1990.72.3.0393","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T18:20:02Z","timestamp":1242238802000},"page":"393-402","source":"Crossref","is-referenced-by-count":160,"title":["Chronic intrathecal baclofen administration for control of severe spasticity"],"prefix":"10.3171","volume":"72","author":[{"given":"Yves","family":"Lazorthes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Sallerin-Caute","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Claude","family":"Verdie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Bastide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Carillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Minerva Med","first-page":"2723","article-title":"Un farmaco ad azione antispastica della musculatura striata. Sperimentatione clinica di un derivato del gasa.","volume":"57","author":"Bergamini","year":"1966"},{"key":"b2","series-title":"TIPS","first-page":"400","article-title":"Baclofen 10 years on.","author":"Bowery","year":"1982"},{"key":"b3","series-title":"Nature","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1038\/283092a0","article-title":"Baclofen decreases neurotransmitter release in the mammalian CNS by an action at a novel GABA receptor.","volume":"283","author":"Bowery","year":"1980"},{"key":"b4","series-title":"NY State J Med","first-page":"2868","article-title":"Chronic dorsal column stimulation in multiple sclerosis.","volume":"73","author":"Cook","year":"1973"},{"key":"b5","series-title":"Lancet","first-page":"206","article-title":"Effect of chronic stimulation of anterior cerebellum on neurological diseases.","volume":"1","author":"Cooper","year":"1973"},{"key":"b6","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1212\/WNL.24.10.957","article-title":"The effects of Lioresal on synaptic activity in the isolated spinal cord.","volume":"24","author":"Davidoff","year":"1974"},{"key":"b7","series-title":"Appl Neurophysiol","first-page":"230","article-title":"Technical problems and advances in the cerebellar-stimulating systems used for reduction of spasticity and seizures.","volume":"43","author":"Davis","year":"1980"},{"key":"b8","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1227\/00006123-198502000-00015","article-title":"Control of spasticity by implantable continuous flow morphine pump.","volume":"16","author":"Erickson","year":"1985"},{"key":"b9","series-title":"Surg Gynecol Obstet","first-page":"463","article-title":"On the indications and results of the excision of posterior spinal nerve root in men.","volume":"16","author":"Foerster","year":"1913"},{"key":"b10","series-title":"Med J Aust","doi-asserted-by":"publisher","first-page":"465","DOI":"10.5694\/j.1326-5377.1986.tb113877.x","article-title":"Intrathecal baclofen for severe spasticity.","volume":"145","author":"Hankey","year":"1986"},{"key":"b11","series-title":"Clin Neurosurg","first-page":"523","article-title":"Controversies in the surgical management of spasticity.","volume":"33","author":"Kasdon","year":"1986"},{"key":"b12","series-title":"Brain Res","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/0006-8993(87)90999-1","article-title":"Phaclofen: a peripheral and control baclofen antagonist.","volume":"405","author":"Kerr","year":"1987"},{"key":"b13","series-title":"J Neurol Sci","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/0022-510X(74)90163-4","article-title":"Plasma and cerebrospinal fluid levels of baclofen (Lioresal) at optimal therapeutic responses in spastic paresis.","volume":"23","author":"Knuttson","year":"1974"},{"key":"b14","series-title":"Exp Brain Res","first-page":"191","article-title":"Reduced spinal reflexes following intrathecal baclofen in the rabbit.","volume":"54","author":"Kroin","year":"1984"},{"key":"b15","series-title":"Cerebellar Stimulation for Spasticity and Seizures.","first-page":"217","article-title":"Chronic cerebellar cortex stimulation for grades spastic cerebral palsy patients","author":"Lazorthes","year":"1984"},{"key":"b16","series-title":"Infusion Systems in Medicine.","first-page":"327","article-title":"Chronic intrathecal administration of baclofen in severe spasticity","author":"Lazorthes","year":"1987"},{"key":"b17","series-title":"Local-spinal Therapy of Spasticity.","first-page":"215","article-title":"Chronic intrathecal administration of baclofen in treatment of severe spasticity","author":"Lazorthes","year":"1988"},{"key":"b18","series-title":"Neurochirurgie","first-page":"95","article-title":"Neuropharmacologie en application intrath\u00e9cale.","volume":"31","author":"Lazorthes","year":"1985"},{"key":"b19","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1007\/BF00314294","article-title":"The effect of baclofen on electrical muscle activity in spasticity.","volume":"234","author":"M\u00fcller","year":"1987"},{"key":"b20","series-title":"Local-spinal Therapy of Spasticity.","first-page":"155","article-title":"Intrathecal baclofen in spasticity","author":"M\u00fcller","year":"1988"},{"key":"b21","series-title":"Local-spinal Therapy of Spasticity.","first-page":"253","article-title":"Physostigmine reversal of baclofen-induced sedation","author":"M\u00fcller-Schwefe","year":"1988"},{"key":"b22","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/00006123-198201000-00023","article-title":"Chronic cerebellar stimulation for cerebral palsy: a review.","volume":"10","author":"Penn","year":"1982"},{"key":"b23","series-title":"Local-spinal Therapy of Spasticity.","first-page":"151","article-title":"Chronic intrathecal baclofen for severe rigidity and spasms","author":"Penn","year":"1988"},{"key":"b24","series-title":"Lancet","first-page":"125","article-title":"Continuous intrathecal baclofen for severe spasticity.","volume":"2","author":"Penn","year":"1985"},{"key":"b25","series-title":"Lancet","first-page":"1078","article-title":"Intrathecal baclofen alleviates spinal cord spasticity.","volume":"1","author":"Penn","year":"1984"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3171\/jns.1987.66.2.0181","article-title":"Long-term intrathecal baclofen infusion for treatment of spasticity.","volume":"66","author":"Penn","year":"1987"},{"key":"b27","series-title":"Nature","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1038\/307071a0","article-title":"Are baclofen-sensitive GABA-\u03b2 receptors present on primary afferent terminals of the spinal cord?","volume":"307","author":"Price","year":"1984"},{"key":"b28","series-title":"J Liquid Chromatography","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1080\/01483918808076735","article-title":"A sensitive method for determination of baclofen in human CSF by high performance liquid chromatography.","volume":"11","author":"Sallerin-Caute","year":"1988"},{"key":"b29","series-title":"Exp Brain Res","first-page":"618","article-title":"Delta-amino-valeric acid antagonizes the pharmacological actions of baclofen in the central nervous system.","volume":"70","author":"Schwartz","year":"1988"},{"key":"b30","series-title":"Neurochirurgie","first-page":"1","article-title":"La neurostimulation \u00e9lectrique th\u00e9rapeutique.","volume":"24","year":"1978"},{"key":"b31","series-title":"Neurochirurgie","first-page":"1","article-title":"La neurochirurgie fonctionnelle de l'infirmit\u00e9 motrice d'origine c\u00e9r\u00e9brale.","volume":"31","year":"1985"},{"key":"b32","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/978-3-7091-8909-2_31","article-title":"Intrathecal application of baclofen in the treatment of spasticity.","volume":"39","author":"Siegfried","year":"1987"},{"key":"b33","series-title":"Rev Neurol","first-page":"201","article-title":"La radicellotomie post\u00e9rieure s\u00e9lective dans le traitement des spasticit\u00e9s.","volume":"130","author":"Sindou","year":"1974"},{"key":"b34","series-title":"Appl Neurophysiol","first-page":"244","article-title":"Multi-lead spinal cord stimulation for control of motor disorders.","volume":"44","author":"Waltz","year":"1981"},{"key":"b35","series-title":"Brain Res","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/0006-8993(80)90507-7","article-title":"Evidence for a direct spinal mechanism in morphine-induced inhibition of nociceptive reflexes in humans.","volume":"187","author":"Wilier","year":"1980"},{"key":"b36","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1056\/NEJM198101083040207","article-title":"Drug therapy: spasticity.","volume":"304","author":"Young","year":"1981"},{"key":"b37","series-title":"Local-spinal Therapy of Spasticity.","first-page":"37","article-title":"The neuropharmacology of baclofen","author":"Zieglg\u00e4nsberger","year":"1988"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/72\/3\/article-p393.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/72\/3\/article-p393.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/72\/3\/article-p393.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T22:15:03Z","timestamp":1679868903000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/72\/3\/article-p393.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,3]]},"references-count":37,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1990.72.3.0393","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1990,3]]}}}