Spinal cord injury - assessing tolerability and use of combined rehabilitation and NeuroAiD (SATURN) study - primary results of an exploratory study.

OBJECTIVE: MLC601/MLC901 has demonstrated neuroprotective and neuroregenerative properties that enhance neurological recovery in stroke and traumatic brain injury. We aimed to evaluate its safety and potential efficacy in patients with severe spinal cord injury. METHODS: Patients with American Spinal Injury Association (ASIA) Impairment Scale (AIS) A and B were included in an open-label cohort study. Each received a course of MLC601/MLC901 for 6 months in addition to standard care and rehabilitation. Key endpoints were safety, AIS grade and motor scores at month 6 (M6). RESULTS: Among 30 patients included (mean age 42.2 ± 17.6 years, 24 men), 20 patients had AIS A while 10 patients had AIS B at baseline. Ten patients experienced 14 adverse events including one serious adverse event and six deaths, none were considered treatment-related. AIS improved in 25% of AIS A and 50% of AIS B. Improvement in ASIA motor score was seen most with cervical injury (median change from baseline 26.5, IQR: 6-55). These findings appear to be better than reported rates of spontaneous recovery for SCI AIS A and B. CONCLUSION: MLC601/MLC901 is safe and may have a role in the treatment of patients with SCI. A controlled trial is justified.

Focus of attention and its impact on movement behaviour.

Investigations into the relative effectiveness of either focusing on movement form (internal focus) or movement effects (external focus) have tended to dominate research on instructional constraints. However, rather than adopting a comparative approach to determine which focus of attention is more effective, analysis of the relative efficacy of each specific instruction focus during motor learning could be more relevant for both researchers and practitioners. Theoretical advances in the motor learning literature from a nonlinear dynamics perspective might explain the processes that underlie the effect of different attentional focus instructions. Referencing ideas and concepts from a current motor learning model, differential effects of either internal or external focus of instructions are examined. This paper also highlights some deficiencies in extant theory and research design on focus of attention which require further investigations.