Human neural stem cells were surgically implanted in trial participants with chronic (4-24 months post-injury) cervical SCI and assessed for neurological improvement focusing on the UEMS (Upper Extremity Motor Score) of the ISNCSCI (International Standards for Neurological Classification of SCI) and GRASSP (Graded Redefined Assessment of Strength, Sensation and Prehension) measures for upper extremity function. (Levi et al 2018; RCT). Of the secondary measures in this RCT, the MAS revealed a non-significant decrease in spasticity over 6 months of observation in the treated group.
Similarly, the primary outcome of a pre-post trial for intrathecal administration of autologous mesenchymal stromal cells in chronic (13.65+/-14.79 years post-injury) SCI was the ISNCSCI for sensory and motor improvements and spasticity was assessed secondarily using the Ashworth and Penn scales (Vaquero et al 2018). No statistical difference was seen in spasticity, pre and post stem cell administration. However, variable improvement was documented during the trial without persistence of effect to the end of follow-up.
Level 1b evidence (Levi et al 2018; RCT,N=10) has not demonstrated that transplantation of human neural stem cells results in persistent spasticity reduction in participants with chronic cervical SCI.
Level 4 evidence (Vaquero et al 2018; Pre/post, N=11) reveals that initial improvements in spasticity are not persistent as a result of intrathecal administration of autologous mesenchymal stem cells in SCI.
Human neural stem cell transplantation in chronic SCI does not reduce spasticity secondary to SCI.
Intrathecal injection of autologous mesenchymal stem cells in people with chronic SCI is unlikely to result in persistent spasticity reduction