Effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy: a double-blinded, placebo-controlled randomised controlled trial.

Abstract

PURPOSE:

To evaluate the effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy using clinical parameters and DTI analysis.

METHODS:

Early cervical myelopathy cases with MJOA scores ≥13, were recruited for the double-blinded, placebo-controlled randomised control trial. Thirty cases with fifteen cases each in the test and placebo group were studied. Analysis was done using diffusion tensor imaging (DTI) and clinical evaluation, pre- and post-institution of sodium channel blocker Riluzole for a period of 1 month (50 mg twice daily). Placebo group was treated with Vitamin B complex tablets. Diffusion co-efficient fractional anisotrophy (FA), apparent diffusion co-efficient (ADC), volume ratio (VR), relative anisotrophy (RA) and Eigen vectors were calculated. Outcomes analysis was based on clinical scores of MJOA, Nurick grading, SF-12, NDI, and statistical analysis of DTI datametrics.

RESULTS:

The mean MJOA score was 15.6 (13-17) with no significant change in the test and control groups. The mean ADC, FA values were 1533.36 (1238-1779) and 494.36 (364-628) and changed to 1531.57 (1312-2091) and 484.86 (294-597), respectively, in the Riluzole group. However, the changes in the values of ADC, FA, and other co-efficients including VR, RA and eigenvectors in the two groups were not statistically significant. The functional scores in the SF-12 and NDI questionnaires did not change significantly.

CONCLUSIONS:

Our study did not show a significant change in the clinical outcome and DTI Indices with the use of Riluzole as a standalone pharmacotherapeutic agent for early cervical myelopathy. More studies may be needed to confirm the usefulness of Riluzole as a treatment option for cervical myelopathy.

• Authors: S Rajasekaran, Siddharth N Aiyer, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Anupama Maheswaran, Janardhan Yerram Shetty
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 25 Issue 6 Pg. 1830-5 (06 2016) ISSN: 1432-0932 [Electronic] Germany
• PMID: 26596730 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Neuroprotective Agents
• Riluzole

Topics

• Diffusion Tensor Imaging
• Double-Blind Method
• Female
• Humans
• Male
• Neuroprotective Agents (administration & dosage, therapeutic use)
• Riluzole (administration & dosage, therapeutic use)
• Spinal Cord Diseases (drug therapy)
• Treatment Outcome