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Laurance Johnston, Ph.D.

Sponsor: Institute of Spinal Cord Injury, Iceland



Throughout this resource, various therapies have been discussed that may be neuroprotective when administered soon after injury. Because it is important to have quick access to such information, the therapies are briefly summarized here. Those desiring further information can review the more in-depth discussions posted elsewhere.

Some of the therapies represent approaches used by humans for other health purposes (hence, presumably reasonably safe) but have also shown potential in animals with experimental SCI.


Methylprednisolone, a synthetic steroid, is often administered soon after injury. Although widely assumed to be a post-injury standard of care, some scientists are challenging that assumption. The drug minimizes post-injury neurological damage by inhibiting lipid peroxidation, a biochemical process that mediates secondary damage to the injured cord.

Other drugs with therapeutic potential that are in or never completed the clinical trials pipeline are discussed in the appendix.

Commonly Consumed Human Drugs with Suggestive SCI Animal Studies:

Animal studies suggest that some widely consumed and presumably safe human drugs have potential for treating acute SCI. Though one must be careful extrapolating the results of animal studies, the widespread consumption of these drugs makes them easier candidates to be considered for human SCI. To varying degrees, they should be placed in the “little-to-lose-and-everything-to-gain” category.

1) Lipitor (i.e., atorvastatin) is a cholesterol-lowering medicine belonging to the statin-drug group and one of society’s most widely used drugs. Studies suggest that Lipitor or related statin drugs exert a neuroprotective and anti-inflammatory influence for various neurological disorders, including SCI. In Lipitor-treated rats there was more tissue sparing, including 1) less degeneration of neuronal axons, 2) degradation of the conduction-promoting, axon-insulating myelin sheath, 3) scar formation, and 4) programmed cell deaths.

2) Ibuprofen, a non-steroidal anti-inflammatory drug, is marketed under many brand names (e.g., Advil, Motrin, etc). It blocks the injury-triggered production of a protein that 1) inhibits axonal growth and regeneration, and 2) initiates a physiological cascade that results in the death of nearby neuronal cells. Animal studies indicate ibuprofen stimulates the growth of neurons and recovery of walking ability.

3) Erythropoietin (EPO) is a growth hormone produced by the kidney that stimulates red blood cell production. It has been used to treat kidney disease and to ameliorate the side effects of cancer chemotherapy or radiation-induced anemia; and as a blood-doping agent to enhance athletic performance. In animals, EPO 1) blocks injury-related cell death, 2) prevents hypoxia in which limited oxygen reaches the spinal cord, 3) inhibits the damage caused by damaging excitotoxins, 4) reduces injury-site inflammation, 5) restores blood-flow-promoting vascular integrity, and 6) enhances neuronal regeneration through stem-cell stimulation.


Because new drug development is driven by economics, non-patentable herbal remedies are often pushed to the backburner. They also don’t fit well with the process of scientists who prefer to study cause and effect in purified molecules rather than multi-component herbal medicines. Nevertheless, several widely consumed herbal remedies may possess neuroprotective properties after acute SCI, including:

1) Ginkgo Biloba, one of mankind’s most ancient and widely consumed medicines, may provide benefits for a variety of neurological disorders, including SCI. Ginkgo is an antioxidant, maintains cell-membrane integrity, enhances oxygen use and metabolism, augments neurotransmission, and inhibits programmed cell death. In rats, ginkgo lessens damage-causing lipid peroxidation to even a greater degree than methylprednisolone.  Ginkgo-treated rats had smaller injury-related cavities and less conduction-inhibiting demyelination.  

2) Buyang Huanwu Decoction is a Traditional Chinese multi-component herbal medicine that has been used for centuries to treat a variety of disorders, including paralysis. From traditional philosophy, it invigorates the body, promotes blood circulation, and activates energy channels. Animal studies indicate that BYHWD promotes nerve regeneration and functional recovery after stroke and both peripheral-nerve and spinal-cord injuries. It 1) stimulates the outgrowth and differentiation of budding neuronal stem cells, 2) inhibits post-injury, programmed cell death; and 3) decreases damage-perpetuating free-radical generation and lipid peroxidation.


Animal studies suggest that fasting every other day improved functional recovery, preserved neuronal integrity, reduced injury-site lesion size, increased axonal sprouting, and raised the blood levels of neuroprotective agents. Similar neuroprotection has also been observed for traumatic brain injury.


Melatonin, readily available from vitamin stores as a sleep aid, is produced by the pineal gland and is a powerful antioxidant. Like methylprednisolone, animal studies indicate that melatonin inhibits lipid peroxidation and various injury-aggravating inflammatory processes, reduces the size of the injury-site cavity, and promotes functional recovery.

Quercetin is another common nutritional supplement that has been shown to reduce neurological damage in animals after acute injury. Belonging to a family of molecules called flavonoids, quercetin imbues coloring to many foods. Like melatonin, quercetin is an antioxidant. By scavenging free radicals, it inhibits the damage-perpetuating lipid peroxidation that occurs soon after injury.

Vitamin E also appears to be neuroprotective after acute injury. Like quercetin and melatonin, this vitamin is an antioxidant that protects cell membranes from lipid-peroxidation and, by so doing, preserves neighboring neurons and axons.


1) Acupuncture may restore some function in both acute and chronic SCI. Under Traditional Chinese Medicine theory, SCI damages key energy meridians which channel live force energy throughout the body. Acupuncture’s goal is to clear and activate these meridians, reversing energy stagnation.  A number of potential mechanisms by which acupuncture could exert beneficial effects after SCI have been suggested, including 1) reducing the levels of proteins and cells (e.g., astrocytes) fostering injury-site scar formation, 2) reducing the creation of damage-perpetuating free-radicals, 3) lessening spinal cord atrophy after injury, 4) decreasing stress as measured by the production of cortisol, 5) raising the levels of various regeneration-enhancing molecules, 6) increasing blood flow, and 7) releasing neuroprotective, endorphin-like molecules. Acupuncture also influences the expression of stem cells.

2) Scalp Acupuncture, a specialized form of acupuncture, is especially helpful for nervous-system disorders. Many individuals with SCI have been treated and have accrued significant benefits. Greater benefits accrue if scalp acupuncture is administered soon after injury.


Hyperbaric oxygen therapy (HBO) is commonly used to treat decompression sickness in divers. Patients are placed in chambers pressurized at 2-3 atmospheres containing up to 100% oxygen. Animal and human studies suggests that HBO is beneficial for treating a variety of neurological disorders in which blood-flow-related oxygenation may be compromised, including acute SCI. The therapeutic premise is that HBO will force oxygen into oxygen-deprived, injured CNS tissue. HBO also stimulates the body’s production of stem cells, which may exert regenerative influences.


1) Diapulse directs a pulsed-electromagnetic field to an area of injury. Animal and human studies indicate that this treatment soon after SCI protects neurons, promotes regeneration, and minimizes lost function.

2) Oscillating Field Stimulation: Animal and human studies suggest that OFS promotes neuronal regeneration after acute injury. Based upon observations that electrical cues can guide and promote neuronal growth, electrodes are placed above and below the injury site with alternating polarity to stimulate regeneration of both ascending and descending neurons. OFS is only beneficial for acute injury. 


Functional Electrical Stimulation (FES) uses electrical current to stimulate functions lost through nervous-system impairment. Various FES devices have been developed to enhance grasping, and, if used soon after injury, some may improve voluntary control.


With varying degrees of success, there is a long experimental history of using hypothermic cooling after acute injury to slow down damage-mediating physiological processes. Earlier efforts used localized procedures which directly cooled the spinal-cord injury site. More recently, efforts have focused on systemic cooling in which a cooling catheter is placed in the patient’s blood vessel, and a thermo-regulating device closely monitors and adjusts blood temperature as it passes by the catheter. 




bulletSygen or GM-1 decreases injury-induced, over-release of damage-perpetuating excitatory substances.
bulletThyrotropin-releasing hormone is a small peptide that improves motor recovery by minimizing some of the physiological processes that mediate secondary injury.
bulletGacyclidine blocks the damage caused by the post-injury release of excitatory substances.
bulletNeotrofin stimulates growth-factor production, enhances proliferation of CNS stem cells, and protects neurons from the release of excitatory substances.
bulletMinocycline, an antibiotic used to treat skin disorders, promotes functional recovery, enhances axonal survival, and reduces injury-site lesion size.
bulletCethrin blocks the production of a molecule that 1) inhibits axonal growth and regeneration and 2) initiates a cascade resulting in the death of nearby neurons.
bulletAnti-Nogo blocks a molecule that inhibits regenerating neurons.