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Neural Plast. 2015;2015:656582. doi: 10.1155/2015/656582. Epub 2015 Jan 29.

Sativex in the management of multiple sclerosis-related spasticity: role of the corticospinal modulation.

Author information

1
IRCCS Centro Neurolesi Bonino Pulejo, Contrada Casazza, SS 113, 98124 Messina, Italy.
2
Department of Neurosciences, University of Messina, Messina, Italy.

Abstract

Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability.

PMID:
25699191
PMCID:
PMC4325203
DOI:
10.1155/2015/656582
[Indexed for MEDLINE]
Free PMC Article

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