Enhancement of recurrent inhibition by intravenous administration of L-acetylcarnitine in spastic patients.

The recurrent inhibition of the soleus alpha-motoneurons at rest, evaluated by a specially designed method of paired H reflexes, was estimated in 10 patients with spastic paraparesis. In three of these patients, Renshaw cell activity produced inhibition of the corresponding alpha-motor neurons comparable to that obtained in normal subjects, while the inhibition was reduced in five and absent in two. The effects of intravenously administered L-acetylcarnitine on the activity of Renshaw cells were studied in these patients. In all patients except the two with no evidence of recurrent inhibition, L-acetylcarnitine was found to significantly increase the amount of recurrent inhibition. Its effect became evident at about 30 minutes, reached a maximum around 50 minutes and vanished about 70 minutes from the onset of administration. A significant correlation was found between Renshaw cell activity and the ability of the drug to increase it. L-acetylcarnitine appeared to act specifically by enhancing recurrent inhibition, since no variation in the excitability of the monosynaptic reflex arc was observed.