Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Acta Neurol Scand. 2020 Oct;142(4):333-338. doi: 10.1111/ane.13313. Epub 2020 Jul 21.
To investigate the action of cannabinoids on spasticity and pain in secondary progressive multiple sclerosis, by means of neurophysiological indexes.
We assessed 15 patients with progressive MS (11 females) using clinical scales for spasticity and pain, as well as neurophysiological variables (H/M ratio, cutaneous silent period or CSP). Testing occurred before (T0) and during (T1) a standard treatment with an oral spray containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Neurophysiological measures at T0 were compared with those of 14 healthy controls of similar age and sex (HC). We then compared the patient results at the two time points (T1 vs T0).
At T0, neurophysiological variables did not differ significantly between patients and controls. At T1, spasticity and pain scores improved, as detected by the Modified Ashworth Scale or MAS (P = .001), 9-Hole Peg Test or 9HPT (P = .018), numeric rating scale for spasticity or NRS (P = .001), and visual analogue scale for pain or VAS (P = .005). At the same time, the CSP was significantly prolonged (P = .001).
The THC-CBD spray improved spasticity and pain in secondary progressive MS patients. The spray prolonged CSP duration, which appears a promising tool for assessing and monitoring the analgesic effects of THC-CBD in MS.
通过神经生理指标，研究大麻素对继发进展性多发性硬化症痉挛和疼痛的作用。
我们评估了 15 名进展性 MS 患者（11 名女性），使用痉挛和疼痛的临床量表以及神经生理变量（H/M 比、皮肤静息期或 CSP）。测试在（T0）和（T1）进行，在（T1）期间，患者接受含有大麻二酚（CBD）和Δ9-四氢大麻酚（THC）的口服喷雾剂的标准治疗。T0 时的神经生理测量值与 14 名年龄和性别相匹配的健康对照（HC）进行比较。然后，我们比较了两个时间点（T1 与 T0）的患者结果。
在 T0 时，患者和对照组之间的神经生理变量没有显著差异。在 T1 时，改良 Ashworth 量表或 MAS（P=0.001）、9 孔钉测试或 9HPT（P=0.018）、痉挛数字评分或 NRS（P=0.001）和疼痛视觉模拟评分或 VAS（P=0.005）均显示痉挛和疼痛评分改善。同时，CSP 显著延长（P=0.001）。
THC-CBD 喷雾剂改善了继发进展性多发性硬化症患者的痉挛和疼痛。该喷雾剂延长了 CSP 持续时间，这似乎是评估和监测 THC-CBD 在多发性硬化症中镇痛作用的有前途的工具。
