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Effect of Low-Dose Baclofen Administration on Plasma Insulin-like Growth Factor-I in Persons With Spinal Cord Injury

From the Veterans Affairs Rehabilitation Research and Development Center of Excellence, Veterans Affairs Medical Center, Bronx, New York (Dr Bauman, Ms Morrison, Mr Cirnigliaro, Dr Zhang, Dr Spungen); the Spinal Cord Damage Research Center, Veterans Affairs Medical Center, Bronx, New York (Dr Bauman, Ms Morrison, Mr Cirnigliaro, Dr Zhang, Dr Spungen); the Medical, Spinal Cord Injury and Research Services, Veterans Affairs Medical Center, Bronx, New York (Dr Bauman); the Departments of Medicine and Rehabilitation Medicine, Mount Sinai School of Medicine, New York, New York (Dr Bauman, Dr Spungen); the Kessler Institute of Rehabilitation, West Orange, New Jersey (Dr Kirshblum, Mr Cirnigliaro); the Department of Physical Medicine and Rehabilitation, University Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr Kirshblum).

Patients with chronic spinal cord injury (SCI), a condition associated with reduced physical function, have been reported to have lower plasma insulin-like growth factor-I (IGF-I) levels than able-bodied persons. We evaluated the potential for daily low-dose baclofen administered over several weeks to increase plasma IGF-I levels. Ten healthy male outpatients with chronic SCI were studied prospectively. Patients received escalating doses of baclofen for 4 weeks at each dose level (5, 10, and 20 mg/d). At each dose of baclofen, an increase in the plasma IGF-I was noted; significant increases in plasma IGF-I occurred at 2 weeks after administration of drug at doses of 10 and 20 mg/d, with a subsequent rise to peak levels on baclofen 20 mg/d [baseline, 205 ± 74; peak, 218 ± 76 (not significant), 239 ± 83 (P < .05), 263 ± 87 µg/L (P < .05), at baclofen 5, 10, and 20 mg/d, respectively]. In conclusion, low-dose baclofen administration for 4 weeks stimulated the growth hormone-IGF-I axis in persons with SCI, with the potential for beneficial effects on body composition.

Key Words: -aminobutyric acid • growth hormone • paraplegia

Address for reprints: William A. Bauman, MD, Spinal Cord Damage Research Center, Room 1E-02, Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468

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