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Cannabinoids in multiple sclerosis: A neurophysiological analysis.

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Cannabinoid spray effectively reduced spasticity and pain in multiple sclerosis patients. This treatment also prolonged the cutaneous silent period (CSP), a neurophysiological marker indicating therapeutic effects.

Keywords:
cannabinoidsmultiple sclerosis I spasticity I pain I H/M ratio I cutaneous silent period

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Clinical Medicine

Background:

  • Multiple Sclerosis (MS) is a progressive neurodegenerative disease characterized by spasticity and pain.
  • Current treatments for MS symptoms have limitations, necessitating exploration of novel therapeutic agents.
  • Cannabinoids, specifically delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have shown potential in managing neurological symptoms.

Purpose of the Study:

  • To evaluate the efficacy of a THC-CBD oral spray in alleviating spasticity and pain in patients with secondary progressive multiple sclerosis (SPMS).
  • To investigate the effects of the cannabinoid treatment on neurophysiological indexes, specifically the cutaneous silent period (CSP) and H/M ratio.
  • To establish a correlation between clinical improvements and neurophysiological changes induced by the THC-CBD spray.

Main Methods:

  • A cohort of 15 SPMS patients was assessed using clinical scales (e.g., Modified Ashworth Scale, 9-Hole Peg Test, NRS, VAS) for spasticity and pain.
  • Neurophysiological variables, including the H/M ratio and cutaneous silent period (CSP), were measured before (T0) and during (T1) treatment with a THC-CBD oral spray.
  • Patient data at T0 were compared with 14 healthy controls (HC), and patient outcomes were compared between T0 and T1.

Main Results:

  • At baseline (T0), no significant differences in neurophysiological variables were observed between SPMS patients and healthy controls.
  • Following treatment with the THC-CBD spray (T1), patients reported significant improvements in spasticity and pain scores across all clinical scales.
  • A significant prolongation of the cutaneous silent period (CSP) was observed in SPMS patients during THC-CBD treatment (P = .001).

Conclusions:

  • The oral THC-CBD spray demonstrated significant efficacy in reducing spasticity and pain in patients with secondary progressive multiple sclerosis.
  • The observed prolongation of the cutaneous silent period (CSP) suggests it may serve as a valuable neurophysiological marker for monitoring the analgesic effects of THC-CBD.
  • This study highlights the therapeutic potential of cannabinoids in managing complex symptoms of MS and provides a potential objective measure for treatment efficacy.