Gabapentin may speed recovery after stroke

Ohio State scientists have discovered that an already approved and widely prescribed drug called gabapentin can help the brain repair itself after a stroke.

Gabapentin is currently used to control seizures and help manage nerve pain, but in mice with blood clot-induced strokes, the drug helped the animals regain fine motor control in their limbs. superior, with lasting improvement even after the end of treatment.

The finding builds on previous research, where researchers learned that gabapentin blocks a protein in the brain that can impede healing.

More than 600,000 people have their first stroke each year.

“When this protein is elevated, it interferes with neurological recovery,” Andrea Tedeschi, assistant professor of neuroscience at Ohio State, said in a statement.

He compared the protein to a brake pedal in a car. If you lock on the brake, you won’t go too far no matter how hard you press the gas pedal.

“If you start lifting off the brake pedal and continuously pressing the accelerator, you can really speed up the recovery,” Tedeschi said. “We think it’s the effect of gabapentin on neurons, and there’s a contribution from non-neuronal cells that harness this process and make it even more efficient.”

Recovery after a stroke: An ischemic stroke is caused by a clot that cuts off the blood supply to part of the brain, leading to the death of brain cells in the affected area.

This can lead to long-term complications, including loss of muscle use, difficulty speaking and swallowing, and emotional and memory problems.

“Restoring these functions enables independent living and is therefore a high priority for people with stroke,” the researchers wrote in their study, published in Brain.

According to the CDC, more than 600,000 people have their first stroke each year, which means millions of people will need help recovering in the next few years alone.

Scientists have found that an already approved and widely prescribed drug called gabapentin can help the brain repair itself after a stroke.

The natural repair system: First-level treatment for ischemic stroke is to restore blood flow as quickly as possible, but researchers found that this crucial step had no impact on gabapentin’s effectiveness, improving motor function occurring, whether the mice received the drug one hour or one day. after the onset of the stroke.

After the mice suffered a stroke, neurons responsible for sending signals to muscles on the intact sides of their brains began sprouting axons to form new connections, commonly referred to as “plasticity”. – the ability of different parts of the brain to adapt. and repair damaged circuits and structures.

“The mammalian nervous system has some intrinsic ability to self-repair,” Tedeschi said, but not enough.

Injured neurons can become “hyper-excited”, emitting signals that can cause muscle twitching and pain. If a brain protein called alpha2delta2 is over-expressed after a damaging incident like a stroke, it can contribute to this condition, while slowing the growth of axons.

A better solution: Gabapentin inhibits this protein, allowing nerve cells to regenerate and reorganize more efficiently.

“We blocked the receptor with the drug and asked, will there be even more plasticity? The answer is yes,” Tedeschi said.

Gabapentin restored forelimb motor control in mice.

Mice given gabapentin daily for six weeks regained fine motor control in their forelimbs, which lasted for up to two weeks after dosing was stopped; control mice that did not receive gabapentin did not regain motor control.

Although far from safe in humans, the researchers believe their study could be a first step towards finding a new use for an already approved drug. Because the drug is already so widely used and understood, trials in humans may be faster and easier than for new drugs.

“These observations highlight the strong potential for repurposing gabapentinoids as a promising treatment strategy for stroke repair,” they wrote.

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