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患有卡里布-萨格奈常染色体隐性痉挛性共济失调症患者的大麻使用情况。

Cannabis use in patients with Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay.

机构信息

Pharmacology-physiology Department, Université de Sherbrooke, Saguenay, QC, Canada; Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada.

Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada; Family Medicine and Emergency Department, Université de Sherbrooke, Saguenay, QC, Canada.

出版信息

J Clin Neurosci. 2022 Sep;103:44-48. doi: 10.1016/j.jocn.2022.06.019. Epub 2022 Jul 6.

Abstract

Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset cerebellar ataxia with often presence of peripheral sensorimotor neuropathy and lower limb spasticity. Recently, the presence of pain has been associated with ARSACS in a quarter of the population in relation to spasms and neuropathic pain. However, limited therapeutic options available to patients and the occurrence of persistent symptoms despite treatment with the usual pharmacologic agents have led to exploring cannabis as a potential alternative. The aim of this study was to characterize the profile of cannabis use among patients with ARSACS. Phone interviews were conducted to document current or former cannabis use. Reasons of cannabis use and the characteristics of use were also investigated. Among the 50 study participants, 18% currently used cannabis, 40% reported at least one occurrence of cannabis use and 42% reported having never used cannabis. A greater proportion of patients with regular cannabis use reported chronic pain in comparison to those who never used. Although less frequent than ataxia, spasticity, muscle cramps or muscle spasms, which were independently reported by more than half of the studied sample, chronic pain was notably present in 30% of participants. While our study did not assess the therapeutic effects of cannabis, our results highlight that there is a potential role for cannabis and cannabinoids in the management of multiple ARSACS-associated symptoms and that agents modulating the endocannabinoid system need to be properly investigated.

摘要

常染色体隐性痉挛性共济失调(ARSA-C)是一种早发性小脑共济失调,常伴有周围感觉运动神经病和下肢痉挛。最近,有四分之一的 ARSA-C 患者出现与痉挛和神经病理性疼痛相关的疼痛。然而,由于患者的治疗选择有限,并且尽管使用常规药物治疗仍会出现持续症状,因此探索大麻作为潜在的替代疗法。本研究旨在描述 ARSA-C 患者的大麻使用情况。通过电话访谈记录当前或以前的大麻使用情况。还调查了大麻使用的原因和使用特点。在 50 名研究参与者中,18%的人目前使用大麻,40%的人报告至少发生过一次大麻使用,42%的人报告从未使用过大麻。与从未使用过的患者相比,定期使用大麻的患者报告慢性疼痛的比例更高。尽管与超过一半的研究样本独立报告的共济失调、痉挛、肌肉抽搐或肌肉痉挛相比,慢性疼痛的频率较低,但在 30%的参与者中明显存在。虽然我们的研究没有评估大麻的治疗效果,但我们的结果强调了大麻和大麻素在管理多种 ARSA-C 相关症状方面具有潜在作用,需要对调节内源性大麻素系统的药物进行适当研究。

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