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Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials
Background. Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) (nabiximols or Sativex(®)) is an oromucosal spray formulation containing THC and CBD at an approximately 1:1 fixed ratio. Its administration for the treatment of pain in patients with multiple sclerosis (MS) has been established. MS pa...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163235/ https://www.ncbi.nlm.nih.gov/pubmed/29933552 http://dx.doi.org/10.3390/medicines5030059 |
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author | Turri, Mara Teatini, Francesco Donato, Francesco Zanette, Giampietro Tugnoli, Valeria Deotto, Luciano Bonetti, Bruno Squintani, Giovanna |
author_facet | Turri, Mara Teatini, Francesco Donato, Francesco Zanette, Giampietro Tugnoli, Valeria Deotto, Luciano Bonetti, Bruno Squintani, Giovanna |
author_sort | Turri, Mara |
collection | PubMed |
description | Background. Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) (nabiximols or Sativex(®)) is an oromucosal spray formulation containing THC and CBD at an approximately 1:1 fixed ratio. Its administration for the treatment of pain in patients with multiple sclerosis (MS) has been established. MS patients generally complain of different kinds of pain, including spasticity-related and neuropathic pain. In this study, we compared and evaluated pain modulation and thermal/pain threshold of MS patients before and after THC/CBD administration. Methods. 19 MS patients underwent clinical examination, numerical rating scale (NRS), quantitative sensory testing (QST), and laser-evoked potentials (LEPs) before and after 1 month of therapy. Psychophysiological and neurophysiological data were compared to sex- and age-matched controls. Results. Patients reported a significant reduction in pain. We found statistically significant differences in LEP parameters between patients and controls but no significant change in LEP measures after THC/CBD therapy. Cold and heat detection thresholds were altered in patients but did not change after THC/CBD therapy. There was a significant increase in cold pain threshold by hand stimulation and a significant reduction in abnormal cold perception thresholds. Conclusions. Our results indicate that Sativex(®) therapy provides pain relief in MS patients and suggest that it might modulate peripheral cold-sensitive TRP channels. |
format | Online Article Text |
id | pubmed-6163235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-61632352018-10-10 Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials Turri, Mara Teatini, Francesco Donato, Francesco Zanette, Giampietro Tugnoli, Valeria Deotto, Luciano Bonetti, Bruno Squintani, Giovanna Medicines (Basel) Article Background. Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) (nabiximols or Sativex(®)) is an oromucosal spray formulation containing THC and CBD at an approximately 1:1 fixed ratio. Its administration for the treatment of pain in patients with multiple sclerosis (MS) has been established. MS patients generally complain of different kinds of pain, including spasticity-related and neuropathic pain. In this study, we compared and evaluated pain modulation and thermal/pain threshold of MS patients before and after THC/CBD administration. Methods. 19 MS patients underwent clinical examination, numerical rating scale (NRS), quantitative sensory testing (QST), and laser-evoked potentials (LEPs) before and after 1 month of therapy. Psychophysiological and neurophysiological data were compared to sex- and age-matched controls. Results. Patients reported a significant reduction in pain. We found statistically significant differences in LEP parameters between patients and controls but no significant change in LEP measures after THC/CBD therapy. Cold and heat detection thresholds were altered in patients but did not change after THC/CBD therapy. There was a significant increase in cold pain threshold by hand stimulation and a significant reduction in abnormal cold perception thresholds. Conclusions. Our results indicate that Sativex(®) therapy provides pain relief in MS patients and suggest that it might modulate peripheral cold-sensitive TRP channels. MDPI 2018-06-21 /pmc/articles/PMC6163235/ /pubmed/29933552 http://dx.doi.org/10.3390/medicines5030059 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Turri, Mara Teatini, Francesco Donato, Francesco Zanette, Giampietro Tugnoli, Valeria Deotto, Luciano Bonetti, Bruno Squintani, Giovanna Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title | Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title_full | Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title_fullStr | Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title_full_unstemmed | Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title_short | Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX(®)) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials |
title_sort | pain modulation after oromucosal cannabinoid spray (sativex(®)) in patients with multiple sclerosis: a study with quantitative sensory testing and laser-evoked potentials |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163235/ https://www.ncbi.nlm.nih.gov/pubmed/29933552 http://dx.doi.org/10.3390/medicines5030059 |
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