Sativex in the Management of Multiple Sclerosis-Related Spasticity: Role of the Corticospinal Modulation

Neural Plasticity
2015
Margherita Russo, Rocco Salvatore Calabrò, Antonino Naro, Edoardo Sessa, Carmela Rifici, Giangaetano D’Aleo, Antonino Leo, Rosaria De Luca, Angelo Quartarone, & Placido Bramanti

Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS).This oromucosal spray, acting as
a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading
to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not
be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect.
The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by
means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete
clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor
evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was
applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant
reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex
could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability

This library aims to empower you with knowledge but it does not replace the personalized advice and guidance a healthcare professional can provide. Before implementing any changes to your health regimen based on the contents of this library, we strongly advise you to consult with a qualified healthcare professional. Your doctor’s expertise is essential for interpreting how these insights may apply to your unique health circumstances.