Saturday, 26 March 2016

Cannabis inhibits Spasticity

Marinelli L, Mori L, Canneva S, Colombano F, CurrĂ  A, Fattapposta F, Bandini F, Capello E, Abbruzzese G, Trompetto C. The effect of cannabinoids on the stretch reflex in multiple sclerosis spasticity. Int Clin Psychopharmacol. 2016 Mar 21. [Epub ahead of print]

The aim of this observational study was to assess the efficacy of a tetrahydrocannabinol-cannabidiol (THC : CBD) oromucosal spray on spasticity using the stretch reflex in patients with multiple sclerosis (MS). Numeric rating scale (NRS) for spasticity, modified Ashworth scale (MAS), and the stretch reflex were assessed before and during treatment in 57 MS patients with spasticity eligible for THC : CBD treatment.  A significant reduction in stretch reflex amplitude as well as significant reductions of NRS and MAS scores were observed. There was a low concordance between the three measures (stretch reflex, NRS, and MAS), likely related to the different aspects of muscle hypertonia assessed. Stretch reflex responders were taking a significantly higher number of puffs, whereas no differences were found in the responders by the other scales, suggesting that a higher dosage would add benefit if tolerated. The present study confirms the efficacy of cannabinoids in reducing spasticity in patients with MS, suggesting a higher sensitivity and specificity of the stretch reflex compared with other measures. As an objective and quantitative measure of spasticity, the stretch reflex is particularly useful to assess the effects of cannabinoids on spinal excitability and may play a role in future pharmacological studies

It is amazing that in the clinical trials of oral cannabis and of sativex spray they could not find an effect on the Ashworth scale involving trials of hundreds of people but now in the post licencing age when we realise that some people respond and others do not that you can get positive effects with 30-60 people. In this study of savitex spray there were positive effects but worryingly there was poor correlation between physician assess Ashworth scale (what do your muscle look like (normal, stiff, very stiff etc), patient assessed responses (how do you feel out of a scale 1-10) or a stretch response.


But this study further supports our prior animal work that cannabinoids can control spasticity. However our prior work also shows the achilles heel of the approach is the side effect issue and the capacity to cause sedation and psychoactive effects and there is a small window between therapy and a high which some people do not want....some do.

CoI we are attempting to develop alternative treatment to Cannabis

CLICK HERE  FOR DETAILS

In our clinical trial we are looking at the Ashworth scale, the Numeric rating scale and a thing called the Tardieu response with is a bit of a stretch test, where you lie down and you flex the muscle and you see when the stiffness occurs and how much the leg bends at different speeds of flexing the muscles.

Now if you fit the criteria and are interested and 
willing to try something different and live in London (you can be taxied to the centre doing the studies each day) or are willing to travel and stay in London for a few days (someone has come from hundreds of miles away) then you could come to Barts or Queens Square or the nearest test centre.

However, if you live near Liverpool you can now go to the Walton Centre, where they are now actively recruiting. Contact details have yet to be put on clinical trials.gov

If you live on the other(the best:-)side of the Pennines then you will I believe be able to go to Sheffield in the very near future too. I'll keep you posted.

2 comments:

  1. If I lived in UK certainly inscribe me for this study.
    I had spasticity early in my recovery of the first outbreak. I had heavy legs and clonus.
    I think that physical activity, you know, helped me in recovery.
    Today I don't feel such symptoms.
    I keep training but I would love to participate in studies like these.

    Twisting long for VSN16R works out as spasticity, as well as fatigue, are not well managed sintlmas still caused by MS.
    And other neurological diseases as well, and if chronic fatigue.

    In this regard, if VSN16R show effective high-performance athletes can then used in the management of cramp/clonus?

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  2. The New South Wales Government has announced a clinical trial of the medical use of Cannabinoid Medicine

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