The effect of cannabinoids on the stretch reflex in multiple sclerosis spasticity
The effect of cannabinoids on the stretch reflex in multiple sclerosis spasticity
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DOI：
10.1097/yic.0000000000000126
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发表时间：
2016-07-01
影响因子：
2.6
通讯作者：
Trompetto, Carlo
中科院分区：
文献类型：
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作者：
Marinelli, Lucio;Mori, Laura;Trompetto, Carlo
这项观察性研究的目的是评估四氢大麻酚-大麻二酚（THC：CBD）oromuclidine喷雾剂对多发性硬化症（MS）患者使用牵张反射的痉挛状态的疗效。在治疗前和治疗期间，对57例符合THC：CBD治疗条件的MS痉挛患者进行了痉挛数字评定量表（NRS）、改良Ashworth量表（MAS）和牵张反射评估。观察到牵张反射幅度显著降低以及NRS和MAS评分显著降低。三种测量（牵张反射、NRS和MAS）之间的一致性较低，可能与评估的肌肉张力过高的不同方面有关。牵张反射应答者的抽吸次数显著更高，而其他量表的应答者之间没有差异，表明如果耐受，较高剂量将增加获益。本研究证实了大麻素在减少MS患者痉挛方面的疗效，表明与其他措施相比，牵张反射具有更高的灵敏度和特异性。作为痉挛的客观和定量测量，牵张反射对于评估大麻素对脊髓兴奋性的影响特别有用，并可能在未来的药理学研究中发挥作用。版权所有（C）2016威科医疗集团All rights reserved.
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. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.