Short-Term Effects of Cannabis Therapy on Spasticity in MS

INVESTIGATOR: Jody Corey-Bloom, M.D., Ph.D.

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: Short-Term Effects of Cannabis Therapy on Spasticity in MS

PROJECT TYPE: Clinical Study

STATUS: COMPLETE

RESULTS:

Thirty-seven participants were randomized at the start of the study, 30 of whom completed the trial. Treatment with smoked cannabis resulted in a significant reduction in spasticity using an objective clinician-rated measure. The placebo-controlled trial also resulted in reduced perception of pain, although participants also reported short-term, adverse cognitive effects and increased fatigue. No serious adverse events occurred during the trial.

The full results of this study have been published in CMAJ.

ABSTRACT:

Multiple Sclerosis (MS) is the most common debilitating neurologic disease of young people, affecting at least 250,000 persons in the US, often between the ages of 20 and 40. Symptom manifestation varies considerably from person to person; however, one frequently noted concomitant is spasticity, which causes pain, spasms, loss of function and difficulties in nursing care. The present application is designed to explore the short-term effectiveness and safety of medicinal cannabis on spasticity in patients with MS. There has been significant public discussion on the potential therapeutic uses of cannabis for various neurologic conditions, including MS; however, evidence that cannabis relieves spasticity produced by MS is largely anecdotal. Large-scale trials or controlled studies to compare cannabis or THC with currently available therapies for spasticity have not been performed. There is no published evidence that cannabinoids are superior or equivalent to available anti-spasticity therapies and potential side effects of cannabis need to be clarified. This proposed two-year project aims to examine spasticity and global functioning in 30 MS patients before and after treatment with smoked cannabis in a placebo-controlled, randomized, cross-over design. It is expected that MS subjects will demonstrate improvement in spasticity but impairment on cognitive measures of attention, concentration, and memory assessed before and after medicinal cannabis treatment. Patients will be measured at baseline and for three days after each treatment initiation using sensitive measures of spasticity, cognition, neuropsychiatric features, treatment-emergent effects, and global measures of functioning. Thus, the application's primary goal is to obtain objective assays of short-term efficacy and safety in MS patients treated for spasticity with medicinal cannabis.

PUBLICATIONS:

Type:

Title:

Journal Article Corey-Bloom J, Wolfson T, Gamst A, Jin S, Marcotte T, Bentley H, Gouaux B. (2012). Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial. CMAJ. 2012 Jul 10;184(10):1143-50. doi: 10.1503/cmaj.110837. Epub 2012 May 14.
Meeting Abstract Corey-Bloom J, Wolfson T, Gamst A, Jin S, Marcotte T, Bentley H, Gouaux B. Short-Term Effects of Medicinal Cannabis on Spasticity in Multiple Sclerosis. Poster presented at the 60th Annual Meeting of the American Academy of Neurology (Chicago, IL). 2008.

Study to Examine Possible Effects of Cannabis Compound for Common Movement Disorder

Press Release, UC San Diego Health, September 18, 2018

Researchers at University of California School of Medicine are preparing to launch a novel clinical trial to examine the safety, efficacy and pharmacological properties of cannabis as a potential treatment for adults with essential tremor (ET). Currently, ET is treated using repurposed medications originally developed for high blood pressure or seizures. Surgery is another option.

Scheduled for early 2019, the phase I/II trial will assess efficacy and tolerability of an oral cannabis formulation comprised of cannabidiol (CBD) and low-dose tetrahydrocannabinol (THC). Researchers say it will be the first time this combination has been studied for treatment of ET.

“This study will provide key insights,” said Fatta Nahab, MD, neurologist at UC San Diego Health and associate professor of neurosciences at UC San Diego School of Medicine. “If found to be safe and effective, cannabis would not only serve as an exciting new addition to the limited treatment options currently available for patients with ET, but it might also provide scientists with new insights on essential tremor.”

Read the full press release here


Cannabis for Chronic Nerve Pain: Mechanism Revealed?

Damian McNamara, Medscape, September 7, 2018

New imaging findings show how tetrahydrocannabinol (THC), the psychoactive component of cannabis, works in the brain to effectively treat chronic neuropathic pain.

Results of a small randomized, double-blind, crossover trial show that THC-induced pain relief was associated with reduced functional connectivity between the anterior cingulate cortex (ACC) and the sensorimotor cortex.

"The main message of this paper is that THC, the psychoactive component in cannabis, does seem to exert a beneficial effect on proven chronic nerve pain.

This effect seems to involve a breakdown in functional connectivity between brain regions that process different dimensions that construct the experience of pain," study author Haggai Sharon, MD, who leads the Consciousness & Psychopharmacology research team at Sagol Brain Institute, Tel Aviv, Israel, told Medscape Medical News.

Read the article here


Cannabis Compound May Help Reduce Symptoms of Psychosis

Bob Curley, Healthline, September 5, 2018

Chronic marijuana use has been linked to increased risk of psychiatric problems. There’s even a name for the condition — cannabis-induced psychosis (CIP).

A new study, however, shows that a nonpsychoactive compound found in cannabis seems to reduce abnormal brain functions associated with psychosis, which includes diseases such as schizophrenia and bipolar disorder.

Researchers at King’s College London report in the journal JAMA Psychiatry that a single dose of cannabidiol (CBD) could someday be an effective alternative to the antipsychotic drugs in use since the 1950s.

These include Thorazine and Haldol, which have limited effectiveness and can cause serious side effects.

“It’s clear that the existing drugs have provided a lot of patients with schizophrenia the ability to function in society, but they’re not a cure,” Dr. Igor Grant, chair of the department of psychiatry at the University of California at San Diego School of Medicine and director of the school’s Center for Medicinal Cannabis Research, told Healthline.

Read the story here


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