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Resting-state functional connectivity in multiple sclerosis patients receiving nabiximols for spasticity
Alberto Gajofatto1,2, Nicolò Cardobi3, Francesca Gobbin3,4
1Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, Verona, 37134, Italy. alberto.gajofatto@univr.it.
BMC Neurology
|March 29, 2023
Summary
Nabiximols (Sativex®) treatment increased brain connectivity in multiple sclerosis (MS) patients with spasticity. This cannabinoid therapy modulated sensorimotor and cerebellar networks, suggesting a potential mechanism for its effects.
Area of Science:
- Neuroimaging
- Clinical Neurology
- Pharmacology
Background:
- Nabiximols (Sativex®) is a cannabinoid-based medication used for multiple sclerosis (MS)-related spasticity.
- Its precise mechanism of action and variable efficacy warrant further investigation.
Purpose of the Study:
- To explore changes in brain network connectivity using resting-state functional MRI (fMRI) in MS patients undergoing nabiximols treatment.
- To analyze alterations in functional connectivity before and after treatment initiation.
Main Methods:
- Resting-state fMRI scans were acquired from MS patients treated with Sativex® before (T0) and after (T1) treatment.
- Patient response was defined by a ≥20% reduction in spasticity scores.
- Connectivity analyses included ROI-to-ROI and seed-to-voxel approaches, comparing T0 and T1 data.
Main Results:
- Seven out of twelve MS patients (58.3%) were classified as Sativex® responders.
- Nabiximols treatment correlated with increased global brain connectivity, especially in responders.
- Decreased connectivity in motor areas and altered connectivity of the left cerebellum with cortical regions were observed.
Conclusions:
- Nabiximols administration is associated with enhanced brain connectivity in MS patients experiencing spasticity.
- The modulation of sensorimotor cortical areas and cerebellar connectivity may contribute to the therapeutic effects of nabiximols.
