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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®.
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]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Upper motor neuron evaluation in multiple sclerosis patients treated with Sativex<superscript>®</superscript>.
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  Data: <searchLink fieldCode="AR" term="%22Carotenuto%2C+A%2E%22">Carotenuto, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Iodice%2C+R%2E%22">Iodice, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Petracca%2C+M%2E%22">Petracca, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Inglese%2C+M%2E%22">Inglese, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Cerillo%2C+I%2E%22">Cerillo, I.</searchLink><br /><searchLink fieldCode="AR" term="%22Cocozza%2C+S%2E%22">Cocozza, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Saiote%2C+C%2E%22">Saiote, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Brunetti%2C+A%2E%22">Brunetti, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Tedeschi%2C+E%2E%22">Tedeschi, E.</searchLink><br /><searchLink fieldCode="AR" term="%22Manganelli%2C+F%2E%22">Manganelli, F.</searchLink><br /><searchLink fieldCode="AR" term="%22Orefice%2C+G%2E%22">Orefice, G.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Apr2017, Vol. 135 Issue 4, p442-448. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Multiple+sclerosis+treatment%22">Multiple sclerosis treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+neurons%22">Motor neurons</searchLink><br /><searchLink fieldCode="DE" term="%22Spasticity%22">Spasticity</searchLink><br /><searchLink fieldCode="DE" term="%22Pyramidal+tract%22">Pyramidal tract</searchLink><br /><searchLink fieldCode="DE" term="%22Neural+circuitry%22">Neural circuitry</searchLink><br /><searchLink fieldCode="DE" term="%22Electrophysiology%22">Electrophysiology</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+correlation%22">Statistical correlation</searchLink>
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  Label: Abstract
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  Data: 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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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ane.12660
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      – SubjectFull: Spasticity
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