The impact of combination therapy in spinal cord injury treatment

Our study investigates the potential synergistic effect of regenerative therapy combining electrical stimulation with application of anti-inflammatory drug atorvastatin (ATR) following spinal cord injury (SCI). Using an isoflurane anesthesia, we induced SCI at the T9 segment with a compression device for 15 minutes under a 40g weight. An oscillating field stimulator (OFS) implanted subcutaneously delivered a weak electric current (50 µA), alternating polarity every 15 minutes for 6 weeks to encourage axonal growth from the lesion site. Wistar albino female rats were randomly divided to four groups: SCI with functional stimulator (OFS+SCI), SCI with non-functional stimulator (nOFS+SCI), and two SCI groups that received atorvastatin in addition to stimulator for 7 days after injury (OFS+SCI+ATR, nOFS+SCI+ATR). Behavioral testing (BBB scale and hot-plate test) demonstrated improvements in motor and sensory functions in animals receiving combination therapy. We analyzed protein levels for astrocytes (GFAP), neurofilaments (NF-L), newly growing nerve fibers (GAP-43) and oligodendrocytes (CNPase) using Western Blot. Protein analysis revealed increased levels of neurofilaments, oligodendrocytes and newly growing nerve fiber in the groups with applied partial and combination therapy, indicating a neuroprotective effect. Optical density decreased in the order OFS+SCI+ATR, nOFS+SCI+ATR, OFS+SCI, and nOFS+SCI. Furthermore, the level of astrocytes proteins, as an indicator of inflammation, decreased more in the OFS+SCI+ATR group compared to others. These findings suggest a synergistic effect of atorvastatin and OFS stimulation in promoting neural recovery post-SCI, highlighting the potential of combination therapies in enhancing regenerative outcomes.