Cargando…

The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms

Multiple sclerosis (MS) pathology progressively affects multiple central nervous system (CNS) areas. Due to this fact, MS produces a wide array of symptoms. Symptomatic therapy of one MS symptom can cause or worsen other unwanted symptoms (anticholinergics used for bladder dysfunction produce impair...

Descripción completa

Detalles Bibliográficos
Autores principales: Fernández, Óscar, Costa-Frossard, Lucienne, Martínez-Ginés, Marisa, Montero, Paloma, Prieto, José Maria, Ramió, Lluis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090019/
https://www.ncbi.nlm.nih.gov/pubmed/32256440
http://dx.doi.org/10.3389/fneur.2020.00152
_version_ 1783509843186810880
author Fernández, Óscar
Costa-Frossard, Lucienne
Martínez-Ginés, Marisa
Montero, Paloma
Prieto, José Maria
Ramió, Lluis
author_facet Fernández, Óscar
Costa-Frossard, Lucienne
Martínez-Ginés, Marisa
Montero, Paloma
Prieto, José Maria
Ramió, Lluis
author_sort Fernández, Óscar
collection PubMed
description Multiple sclerosis (MS) pathology progressively affects multiple central nervous system (CNS) areas. Due to this fact, MS produces a wide array of symptoms. Symptomatic therapy of one MS symptom can cause or worsen other unwanted symptoms (anticholinergics used for bladder dysfunction produce impairment of cognition, many MS drugs produce erectile dysfunction, etc.). Appropriate symptomatic therapy is an unmet need. Several important functions/symptoms (muscle tone, sleep, bladder, pain) are mediated, in great part, in the brainstem. Cannabinoid receptors are distributed throughout the CNS irregularly: There is an accumulation of CB(1) and CB(2) receptors in the brainstem. Nabiximols (a combination of THC and CBD oromucosal spray) interact with both CB(1) and CB(2) receptors. In several clinical trials with Nabiximols for MS spasticity, the investigators report improvement not only in spasticity itself, but also in several functions/symptoms mentioned before (spasms, cramps, pain, gait, sleep, bladder function, fatigue, and possibly tremor). We can conceptualize and, therefore, hypothesize, through this indirect information, that it could be considered the existence of a broad “Spasticity-Plus Syndrome” that involves, a cluster of symptoms apart from spasticity itself, the rest of the mentioned functions/symptoms, probably because they are interlinked after the increase of muscle tone and mediated, at least in part, in the same or close areas of the brainstem. If this holds true, there exists the possibility to treat several spasticity-related symptoms induced by MS pathology with a single therapy, which would permit to avoid the unnecessary adverse effects produced by polytherapy. This would result in an important advance in the symptomatic management of MS.
format Online
Article
Text
id pubmed-7090019
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-70900192020-03-31 The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms Fernández, Óscar Costa-Frossard, Lucienne Martínez-Ginés, Marisa Montero, Paloma Prieto, José Maria Ramió, Lluis Front Neurol Neurology Multiple sclerosis (MS) pathology progressively affects multiple central nervous system (CNS) areas. Due to this fact, MS produces a wide array of symptoms. Symptomatic therapy of one MS symptom can cause or worsen other unwanted symptoms (anticholinergics used for bladder dysfunction produce impairment of cognition, many MS drugs produce erectile dysfunction, etc.). Appropriate symptomatic therapy is an unmet need. Several important functions/symptoms (muscle tone, sleep, bladder, pain) are mediated, in great part, in the brainstem. Cannabinoid receptors are distributed throughout the CNS irregularly: There is an accumulation of CB(1) and CB(2) receptors in the brainstem. Nabiximols (a combination of THC and CBD oromucosal spray) interact with both CB(1) and CB(2) receptors. In several clinical trials with Nabiximols for MS spasticity, the investigators report improvement not only in spasticity itself, but also in several functions/symptoms mentioned before (spasms, cramps, pain, gait, sleep, bladder function, fatigue, and possibly tremor). We can conceptualize and, therefore, hypothesize, through this indirect information, that it could be considered the existence of a broad “Spasticity-Plus Syndrome” that involves, a cluster of symptoms apart from spasticity itself, the rest of the mentioned functions/symptoms, probably because they are interlinked after the increase of muscle tone and mediated, at least in part, in the same or close areas of the brainstem. If this holds true, there exists the possibility to treat several spasticity-related symptoms induced by MS pathology with a single therapy, which would permit to avoid the unnecessary adverse effects produced by polytherapy. This would result in an important advance in the symptomatic management of MS. Frontiers Media S.A. 2020-03-17 /pmc/articles/PMC7090019/ /pubmed/32256440 http://dx.doi.org/10.3389/fneur.2020.00152 Text en Copyright © 2020 Fernández, Costa-Frossard, Martínez-Ginés, Montero, Prieto and Ramió. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Fernández, Óscar
Costa-Frossard, Lucienne
Martínez-Ginés, Marisa
Montero, Paloma
Prieto, José Maria
Ramió, Lluis
The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title_full The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title_fullStr The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title_full_unstemmed The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title_short The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms
title_sort broad concept of “spasticity-plus syndrome” in multiple sclerosis: a possible new concept in the management of multiple sclerosis symptoms
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090019/
https://www.ncbi.nlm.nih.gov/pubmed/32256440
http://dx.doi.org/10.3389/fneur.2020.00152
work_keys_str_mv AT fernandezoscar thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT costafrossardlucienne thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT martinezginesmarisa thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT monteropaloma thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT prietojosemaria thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT ramiolluis thebroadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT fernandezoscar broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT costafrossardlucienne broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT martinezginesmarisa broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT monteropaloma broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT prietojosemaria broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms
AT ramiolluis broadconceptofspasticityplussyndromeinmultiplesclerosisapossiblenewconceptinthemanagementofmultiplesclerosissymptoms