Holden Samantha K, Domen Christopher H, Sillau Stefan, Liu Ying, Leehey Maureen A
Department of Neurology University of Colorado Anschutz Medical Campus Aurora Colorado USA.
Department of Neurosurgery University of Colorado Anschutz Medical Campus Aurora Colorado USA.
Mov Disord Clin Pract. 2022 Jan 28;9(3):340-350. doi: 10.1002/mdc3.13414. eCollection 2022 Apr.
Despite limited evidence, people with Parkinson's disease (PD) use cannabis for therapeutic purposes. Given barriers to performing randomized trials, exploring real-world experiences with cannabis in PD is valuable.
Investigate the frequency and magnitude of symptomatic effects reported with cannabis use in PD.
An anonymous, 15-question, web-based survey was deployed on Fox Insight. Cannabis product types were defined (by relative tetrahydrocannabinol [THC] and cannabidiol [CBD] content) and respondents were asked to reference product labels. Questions focused on use patterns and subjective effects on 36 predefined symptoms (rated -2-markedly worse to +2-markedly better).
1,881 people with PD responded (58.5% men; mean age 66.5; 50.5% <3 years of PD). 73.0% of respondents reported medicinal use, though 30.8% did not inform their doctor. 86.7% knew their type of cannabis product: 54.6% took higher CBD, 30.2% higher THC, and 15.2% took similar amounts of THC and CBD products. Most common use was oral administration, once daily, for less than six months. Frequent improvements were reported for pain, anxiety, agitation, and sleep (>50% of respondents, mean magnitude 1.28-1.51). Dry mouth, dizziness, and cognitive changes were common adverse effects (20.9%-30.8%, mean -1.13 to -1.21). Higher THC users reported more frequent improvements in depression, anxiety, and tremor, and more frequent worsening in dry mouth and bradykinesia than other product types.
Respondents with PD reported using more CBD products, via oral administration, with mild subjective benefits primarily for sleep, pain, and mood. Higher THC products may be higher risk/higher reward for PD-related symptoms.
尽管证据有限，但帕金森病（PD）患者仍将大麻用于治疗目的。鉴于开展随机试验存在障碍，探索PD患者使用大麻的真实世界经验很有价值。
调查PD患者使用大麻后报告的症状改善频率和程度。
在Fox Insight上开展了一项基于网络的匿名15题调查。定义了大麻产品类型（根据相对四氢大麻酚[THC]和大麻二酚[CBD]含量），并要求受访者参考产品标签。问题集中在使用模式以及对36种预定义症状的主观影响（评分从-2表示明显恶化到+2表示明显改善）。
1881名PD患者做出回应（男性占58.5%；平均年龄66.5岁；50.5%的患者病程<3年）。73.0%的受访者报告有药用，不过30.8%未告知医生。86.7%知道自己使用的大麻产品类型：54.6%使用的产品CBD含量较高，30.2%使用的产品THC含量较高，15.2%使用的产品THC和CBD含量相近。最常见的使用方式是口服，每天一次，持续时间不到六个月。报告称疼痛、焦虑、激动和睡眠方面有频繁改善（超过50%的受访者，平均改善幅度为1.28 - 1.51）。口干、头晕和认知改变是常见的不良反应（20.9% - 30.8%，平均评分为-1.13至-1.21）。与其他产品类型相比，使用THC含量较高产品的患者报告称抑郁、焦虑和震颤方面的改善更频繁，口干和运动迟缓恶化更频繁。
PD受访者报告称更多使用CBD产品，通过口服方式，主要在睡眠、疼痛和情绪方面有轻微主观益处。THC含量较高的产品对PD相关症状可能风险更高/益处更大。
