Fox P, Bain P G, Glickman S, Carroll C, Zajicek J
Peninsula Medical School, Plymouth, UK.
Neurology. 2004 Apr 13;62(7):1105-9. doi: 10.1212/01.wnl.0000118203.67138.3e.
Disabling tremor is common in patients with multiple sclerosis (MS). Data from animal model experiments and subjective and small objective studies involving patients suggest that cannabis may be an effective treatment for tremor associated with MS. To our knowledge, there are no published double-blind randomized controlled trials of cannabis as a treatment for tremor in MS patients.
The authors conducted a randomized double-blind placebo-controlled crossover trial to examine the effect of oral cannador (cannabis extract) on 14 patients with MS with upper limb tremors. There were eight women and six men, with a mean age of 45 years and mean Expanded Disability Status Scale score of 6.25. Patients were randomly assigned to receive each treatment and the doses escalated over a 2-week period before each assessment. The primary outcome was change on a tremor index, measured using a validated tremor rating scale. The study was powered to detect a functionally significant 50% improvement in the tremor index. Secondary outcomes included accelerometry, an ataxia scale, spiral drawing, finger tapping, and nine-hole pegboard test performance.
Analysis of the data showed no significant improvement in any of the objective measures of upper limb tremor with cannabis extract compared to placebo. Finger tapping was faster on placebo compared to cannabis extract (p < 0.02). However, there was a nonsignificant trend for patients to experience more subjective relief from their tremors while on cannabis extract compared to placebo.
Cannabis extract does not produce a functionally significant improvement in MS-associated tremor.
致残性震颤在多发性硬化症（MS）患者中很常见。来自动物模型实验以及涉及患者的主观和小型客观研究的数据表明，大麻可能是治疗与MS相关震颤的有效方法。据我们所知，尚无关于大麻治疗MS患者震颤的双盲随机对照试验发表。
作者进行了一项随机双盲安慰剂对照交叉试验，以研究口服大麻提取物对14例患有上肢震颤的MS患者的影响。其中有8名女性和6名男性，平均年龄45岁，扩展残疾状态量表平均评分为6.25。患者被随机分配接受每种治疗，并在每次评估前的2周内逐步增加剂量。主要结局是使用经过验证的震颤评定量表测量的震颤指数变化。该研究旨在检测震颤指数在功能上有显著意义的50%的改善。次要结局包括加速度测量、共济失调量表、螺旋线图、手指敲击以及九孔插板测试表现。
数据分析显示，与安慰剂相比，大麻提取物在任何上肢震颤的客观测量指标上均无显著改善。与大麻提取物相比，安慰剂组的手指敲击速度更快（p < 0.02）。然而，与安慰剂相比，患者在服用大麻提取物时主观上从震颤中获得更多缓解的趋势并不显著。
大麻提取物对MS相关震颤没有产生功能上显著的改善。
