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. 2015:2015:656582.
doi: 10.1155/2015/656582. Epub 2015 Jan 29.

Sativex in the management of multiple sclerosis-related spasticity: role of the corticospinal modulation

Margherita Russo  1 , Rocco Salvatore Calabrò  1 , Antonino Naro  1 , Edoardo Sessa  1 , Carmela Rifici  1 , Giangaetano D'Aleo  1 , Antonino Leo  1 , Rosaria De Luca  1 , Angelo Quartarone  2 , Placido Bramanti  1
Affiliations

Sativex in the management of multiple sclerosis-related spasticity: role of the corticospinal modulation

Margherita Russo et al. Neural Plast. 2015.

Abstract

Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability.

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Figures

Figure 1
Figure 1
MEP, SICI, ICF, and CSP modifications after one month of Sativex intake.
Figure 2
Figure 2
Hmax⁡/Mmax⁡ ratio modification without any changes in SAI and LAI after one month of Sativex intake.
See this image and copyright information in PMC

References

    1. Beard S., Hunn A., Wight J. Treatments for spasticity and pain in multiple sclerosis: a systematic review. Health Technology Assessment. 2003;7:1–11. - PubMed
    1. Russo E., Guy G. W. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses. 2006;66(2):234–246. doi: 10.1016/j.mehy.2005.08.026. - DOI - PubMed
    1. Pertwee R. G. Neuropharmacology and therapeutic potential of cannabinoids. Addiction Biology. 2000;5(1):37–44. doi: 10.1080/13556210071252. - DOI - PubMed
    1. Koehler J. Who benefits most from THC:CBD spray? Learning from clinical experience. European Neurology. 2014;71(supplement 1):10–15. doi: 10.1159/000357743. - DOI - PubMed
    1. Novotna A., Mares J., Ratcliffe S., et al. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols (Sativex), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. European Journal of Neurology. 2011;18(9):1122–1131. doi: 10.1111/j.1468-1331.2010.03328.x. - DOI - PubMed

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