Upper motor neuron evaluation in multiple sclerosis patients treated with Sativex®.
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| Title: | Upper motor neuron evaluation in multiple sclerosis patients treated with Sativex®. |
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| Authors: | Carotenuto, A., Iodice, R., Petracca, M., Inglese, M., Cerillo, I., Cocozza, S., Saiote, C., Brunetti, A., Tedeschi, E., Manganelli, F., Orefice, G. |
| Source: | Acta Neurologica Scandinavica. Apr2017, Vol. 135 Issue 4, p442-448. 7p. |
| Subjects: | Multiple sclerosis treatment, Motor neurons, Spasticity, Pyramidal tract, Neural circuitry, Electrophysiology, Statistical correlation |
| Abstract: | Background Spasticity in multiple sclerosis (MS) results from an imbalance of inputs from descending pathways to the spinal motor circuits, as well as from a damage of the corticospinal tract (CST). Objectives To assess CST impairment in MS patients with and without spasticity and to evaluate its evolution under Sativex® treatment. Methods Ten MS patients with spasticity ('cases') underwent clinical (EDSS, 9-hole Peg, Ashworth scale, Timed 25-Foot Walk, and NRS for spasticity), MRI (CST fractional anisotropy [FA]), and electrophysiological (central motor conduction time [CMCT] and H/M ratio) evaluations at baseline and after 12 months. We selected 20 MS patients without spasticity as control group at baseline. Results At baseline, cases showed a lower CST FA (0.492±0.045 vs 0.543±0.047; P=.01) and a higher CMCT ( P=.001) compared to the control group. No correlations were found between clinical, electrophysiological, and MRI features. After 12 months, cases showed a decrease in non-prevalent degree of impairment (PDI) side FA (0.502±0.023 vs 0.516±0.033; P=.01) without differences for electrophysiological features compared to baseline. Treatment with Sativex® resulted in a reduction of NRS for spasticity ( P=.01). Conclusions We confirm the presence of CST impairment in MS patients with spasticity. We did not identify structural/electrophysiological correlates that could explain Sativex® clinical effect. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background Spasticity in multiple sclerosis (MS) results from an imbalance of inputs from descending pathways to the spinal motor circuits, as well as from a damage of the corticospinal tract (CST). Objectives To assess CST impairment in MS patients with and without spasticity and to evaluate its evolution under Sativex® treatment. Methods Ten MS patients with spasticity ('cases') underwent clinical (EDSS, 9-hole Peg, Ashworth scale, Timed 25-Foot Walk, and NRS for spasticity), MRI (CST fractional anisotropy [FA]), and electrophysiological (central motor conduction time [CMCT] and H/M ratio) evaluations at baseline and after 12 months. We selected 20 MS patients without spasticity as control group at baseline. Results At baseline, cases showed a lower CST FA (0.492±0.045 vs 0.543±0.047; P=.01) and a higher CMCT ( P=.001) compared to the control group. No correlations were found between clinical, electrophysiological, and MRI features. After 12 months, cases showed a decrease in non-prevalent degree of impairment (PDI) side FA (0.502±0.023 vs 0.516±0.033; P=.01) without differences for electrophysiological features compared to baseline. Treatment with Sativex® resulted in a reduction of NRS for spasticity ( P=.01). Conclusions We confirm the presence of CST impairment in MS patients with spasticity. We did not identify structural/electrophysiological correlates that could explain Sativex® clinical effect. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00016314 |
| DOI: | 10.1111/ane.12660 |
