63. A study of cortical and spinal excitability in patients affected by multiple sclerosis and spasticity after oromucosal cannabinoid spray (THC/CBD)

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• 作者：F. Donato ; M. Turri ; G. Zanette ; V. Tugnoli ; L. Deotto ; F. Teatini ; S. Romito ; G. Moretto ; G. Squintani
• 刊名：Clinical Neurophysiology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：127
• 期：4
• 页码：e147
• 全文大小：32 K

文摘

The therapeutic efficacy of oromucosal cannabinoid spray (THC/CBD) for the treatment of spasticity is well documented by clinical trials, and THC/CBD has been approved in Italy for the treatment of spasticity in multiple sclerosis (MS). Our study aims to assess the neurophysiological correlates of the THC/CBD effect on spasticity in MS. We enrolled 16 MS patients who underwent a neurological examination (together with modified Ashworth scale) and neurophysiological testing. For the assessment of the cortical and spinal excitability, we performed duble-pulse TMS to evaluate LICI, SICI and ICF; we also studied CSP, H/M ratio and H reflex recovery cycle. Clinical and neurophysiological results were tested before and after one month of THC/CBD spray treatment and compared with data obtained from 10 healthy controls. Patients referred a subjective decrease of spasticity after THC/CBD, confirmed by modified Ashworth scale, and showed a significant difference of the H recovery cycle (at ISI 500 ms) and LICI compared to controls, that normalized after THC/CBD. CSP did not differ from healthy subjects. Our data showed that THC/CBD oromucosal spray is effective in spasticity treatment and that it probably acts at spinal and subcortical level by modulating the GABA-ergic inhibitory circuitry.