This study will assess how the serotonin precursor, 5-HTP, alter nervous system excitability and motor function in individuals with spinal cord injuries of differing chronicity and severity. Participants will visit the lab on 4 separate occasions where they will be administered four different drugs in a randomized, double-blinded, placebo-controlled crossover design.
This study will assess for the first time the effects of 5-HTP on neural excitability utilizing a combination of neurophysiological and functional testing in subacute motor complete (AIS A/B), chronic motor complete (AIS A/B) and chronic incomplete (AIS C/D) SCI participants. To reduce peripheral side effects such as nausea, these supplements will be co-administered with carbidopa which inhibits the action of peripheral AADC, thereby ensuring that 5-HTP can effectively cross the blood brain barrier prior to being broken down. The neurophysiological outcomes will allow for the determination of the mechanistic actions of each pharmacological agent on different pathways/sites within the central nervous system in three different patient populations with varying degrees of lesion severity and will for the determination of whether increased Amino Acid Decarboxylase (AADC) expression and therefore the efficacy of this approach is correlated to lesion severity and/or chronicity. Importantly, the use of functional testing will allow for the determination of whether these often-reported neurophysiological changes translate to improvements in muscle activation patterns and kinematics during cycling. The effects of 5-HTP will be assessed across three different participant groups: i) subacute (6 months-1 year) AIS A/B SCI individuals, ii) chronic (\>2 years post injury) AIS A/B SCI individuals and iii) chronic AIS C/D SCI individuals.. In a placebo-controlled, randomized crossover design, participants will receive i) 50 mg 5HTP combined with 50 mg carbidopa, ii) 100 mg 5-HTP combined with 50 mg carbidopa, iii) 50 mg carbidopa only or iv) placebo. Ten participants will be recruited in each group. Participants will visit the lab on four separate occasions, separated by at least 72 hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
6
University of Louisville
Louisville, Kentucky, United States
University of Alberta
Edmonton, Alberta, Canada
Change in motoneuron excitability
F waves
Time frame: Pre drug-intake, 30minutes, 60minutes, 90minutes and 120minutes post drug-intake
Change in spinal excitability
H reflex
Time frame: Pre drug-intake, 30minutes, 60minutes, 90minutes and 120minutes post drug-intake
Change in flexor reflex/spasms
Cutaneomuscular reflex
Time frame: Pre drug-intake, 30minutes, 60minutes, 90minutes and 120minutes post drug-intake
Change in functional movement performance
Leg cycling task
Time frame: Pre drug-intake, 120-150minutes post drug-intake
Serum analysis of 5HIAA (UofL Cohort only)
5-HIAA (serum)
Time frame: 90-120minutes post drug-intake
Serum analysis of serotonin (UofL Cohort only)
5-HT (serum and whole blood), cortisol
Time frame: 90-120minutes post drug-intake
Serum analysis of cortisol (UofL Cohort only)
serum cortisol
Time frame: 90-120minutes post drug-intake
Whole blood analysis of Serotonin (UofL Cohort only)
Blood 5HT
Time frame: 90-120minutes post drug-intake
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Placebo