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Medicines 2018, 5(3), 59; https://doi.org/10.3390/medicines5030059

Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX®) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials

1
Department of Neurology, Central Hospital of Bolzano, 39100 Bolzano, Italy
2
Department of Neurology, SS Giovanni e Paolo Hospital, 30122 Venice, Italy
3
Department of Neurology, Casa di Cura Pederzoli, 37019 Peschiera del Garda, VR, Italy
4
Neurology Unit, Department of Neuroscience and Rehabilitation, S. Anna Hospital, 44124 Ferrara, Italy
5
Neurology Unit, Department of Neuroscience, AOUI Verona, 37126 Verona, Italy
*
Author to whom correspondence should be addressed.
Received: 25 May 2018 / Revised: 15 June 2018 / Accepted: 19 June 2018 / Published: 21 June 2018
(This article belongs to the Special Issue Cannabinoids for Medical Use)
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Abstract

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. View Full-Text
Keywords: pain; multiple sclerosis; oromucosal cannabinoid spray; quantitative sensory testing; laser-evoked potentials pain; multiple sclerosis; oromucosal cannabinoid spray; quantitative sensory testing; laser-evoked potentials
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Turri, M.; Teatini, F.; Donato, F.; Zanette, G.; Tugnoli, V.; Deotto, L.; Bonetti, B.; Squintani, G. Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX®) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials. Medicines 2018, 5, 59.

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