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Multiple sclerosis spasticity

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https://www.readbyqxmd.com/read/29792372/sativex%C3%A2-as-add-on-therapy-vs-further-optimized-first-line-antispastics-savant-in-resistant-multiple-sclerosis-spasticity-a-double-blind-placebo-controlled-randomised-clinical-trial
#1
Jolana Markovà, Ute Essner, Bülent Akmaz, Marcella Marinelli, Christiane Trompke, Arnd Lentschat, Carlos Vila Silván
Purpose/aim: To evaluate the efficacy of tetrahydrocannabinol [THC]:cannabidiol [CBD] oromucosal spray (Sativex®) as add-on therapy to optimized standard antispasticity treatment in patients with moderate to severe multiple sclerosis (MS) spasticity. METHODS: Sativex as Add-on therapy Vs. further optimized first-line ANTispastics (SAVANT) was a two-phase trial. In Phase A, eligible patients received add-on THC:CBD spray for 4 weeks to identify initial responders (≥ 20% improvement from baseline in spasticity 0-10 numerical rating scale [NRS] score)...
May 24, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29761015/the-influence-of-thc-cbd-oromucosal-spray-on-driving-ability-in-patients-with-multiple-sclerosis-related-spasticity
#2
Elisabeth G Celius, Carlos Vila
Background: Driving ability is a key function for the majority of patients with multiple sclerosis (MS) to help maintain daily interactions. Both physical and cognitive disability, as well as treatments, may affect the ability to drive. Spasticity is a common symptom associated with MS, and it may affect driving performance either directly or via the medications used to treat it. In this article, we review the evidence relating the antispasticity medicine, Δ9 -tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray (Sativex® ), and its potential impact on driving performance...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29756588/toward-a-shared-care-model-of-relapsing-remitting-multiple-sclerosis-role-of-the-primary-care-practitioner
#3
Jiwon Oh, Marie-Sarah Gagné-Brosseau, Melanie Guenette, Catherine Larochelle, François Lemieux, Suresh Menon, Sarah A Morrow, Laurence Poliquin-Lasnier, Chantal Roy-Hewitson, Carolina Rush, Anne-Marie Trudelle, Paul S Giacomini
The objective of this study was to develop a shared-care model to enable primary-care physicians to participate more fully in meeting the complex, multidisciplinary healthcare needs of patients with multiple sclerosis (MS). DESIGN: The design consisted of development of consensus recommendations and a shared-care algorithm. PARTICIPANTS: A working group of 11 Canadian neurologists involved in the management of patients with MS were included in this study. MAIN MESSAGE: The clinical management of patients with multiple sclerosis is increasing in complexity as new disease-modifying therapies (DMTs) become available, and ongoing safety monitoring is required...
May 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29742699/effect-of-photobiomodulation-treatment-in-the-sublingual-radial-artery-region-and-along-the-spinal-column-in-individuals-with-multiple-sclerosis-protocol-for-a-randomized-controlled-double-blind-clinical-trial
#4
RANDOMIZED CONTROLLED TRIAL
Tamiris da Silva, Fernanda Cordeiro da Silva, Andréa Oliver Gomes, Ariane Oliveira Viana, Marcela Letícia Leal Gonçalves, Maria Fernanda Setúbal Destro Rodrigues, Anna Carolina Ratto Tempestini Horliana, Daniela de Fátima Teixeira da Silva, Maria Cristina Chavantes, Yara Dadalti Fragoso, Luciana Prats Branco, Lara Jansiski Motta, Kristianne Porta Santos Fernandes, Raquel Agnelli Mesquita-Ferrari, Sandra Kalil Bussadori
BACKGROUND: Multiple sclerosis (MS) is an autoimmune disease, for which the forms of treatment are medication and rehabilitation. However, in vitro and in vivo studies have demonstrated that photobiomodulation can be an effective treatment modality for inflammatory diseases, including MS. Photobiomodulation has a broad range of benefits, such as the avoidance of cell and tissue death, the stimulation of healing and injury repair, reductions in pain, edema and inflammation, cell proliferation, and even apoptosis...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29709026/immunophenotypic-characterization-of-csf-b-cells-in-virus-associated-neuroinflammatory-diseases
#5
Yoshimi Enose-Akahata, Shila Azodi, Bryan R Smith, Bridgette Jeanne Billioux, Ashley Vellucci, Nyater Ngouth, Yuetsu Tanaka, Joan Ohayon, Irene Cortese, Avindra Nath, Steven Jacobson
Intrathecal antibody synthesis is a well-documented phenomenon in infectious neurological diseases as well as in demyelinating diseases, but little is known about the role of B cells in the central nervous systems. We examined B cell and T cell immunophenotypes in CSF of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) compared to healthy normal donors and subjects with the other chronic virus infection and/or neuroinflammatory diseases including HIV infection, multiple sclerosis (MS) and progressive multifocal leukoencephalopathy...
April 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29708914/intrathecal-baclofen-injection-to-avoid-withdrawal-in-a-multiple-sclerosis-patient-undergoing-lumbar-spine-surgery-a-case-report
#6
Mirsad Dupanovic, Robert P Devine, Sean R Jackson, Sharon G Lynch
Spasticity of spinal or cerebral origin is frequently treated with baclofen. Treatment interruption initially results in rebound spasticity; life-threatening withdrawal symptoms may follow. Severe rebound spasticity of leg muscles occurred in a multiple sclerosis patient after a 10-hour long perioperative pause of oral baclofen intake. In a subsequent spine surgery, recurrence was prevented by substituting a cumulative 12-hour oral baclofen dose with an intraoperative intrathecal injection. Administration of intrathecal baclofen during prolonged surgery in patients dependent on oral baclofen may improve patient comfort and prevent early withdrawal symptoms...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29683408/palatability-and-oral-cavity-tolerability-of-thc-cbd-oromucosal-spray-and-possible-improvement-measures-in-multiple-sclerosis-patients-with-resistant-spasticity-a-pilot-study
#7
Giacomo Lus, Roberto Cantello, Maura Chiara Danni, Agusto Rini, Paola Sarchielli, Tiziana Tassinari, Elisabetta Signoriello
AIM: Complaints about Δ9 -tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex® ; GW Pharma Ltd, Sailsbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects. MATERIALS & METHODS: Patients with multiple sclerosis spasticity (n = 52) at six sites in Italy who were receiving THC:CBD oromucosal spray and had associated oral mucosal effects were randomized into Group A (chewing gum; n = 15); Group B (cold bottle; n = 20); and Group C (cold bottle + chewing gum; n = 17)...
April 23, 2018: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29680460/effects-of-hippotherapy-in-multiple-sclerosis-pilot-study-on-quality-of-life-spasticity-gait-pelvic-floor-depression-and-fatigue
#8
Susana Muñoz-Lasa, Carlos López de Silanes, M Ángeles Atín-Arratibel, Carmen Bravo-Llatas, Salvador Pastor-Jimeno, Nuria Máximo-Bocanegra
INTRODUCTION AND OBJECTIVE: Hippotherapy is being used as a promising method in the physical treatment of multiple sclerosis (MS). MATERIAL AND METHOD: Comparative open clinical pre-post study into hippotherapy intervention during a 6-month period in patients with MS (n=6). Not randomised and with control group (n=4). The study was performed by MHG Foundation. RESULTS: A statistically significant improvement was observed in the therapy group in: spasticity pre-post measured by the modified Ashworth scale (P=...
April 18, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29678888/bovine-spastic-syndrome-a-review
#9
REVIEW
Victoria Goeckmann, Sophie Rothammer, Ivica Medugorac
Bovine spastic syndrome (BSS) was described for the first time in 1941. The disease occurs in various-maybe even all-cattle breeds and is a chronic-progressive neuromuscular disorder that commonly affects cattle of at least three years of age. Typical clinical signs of the disease are clonic-tonic cramps of the hindlimbs that occur in attacks. Since BSS does not recover, affected animals can only be treated symptomatically by improving welfare conditions and management factors, or with physical therapy or drugs...
April 20, 2018: Veterinary Record
https://www.readbyqxmd.com/read/29651709/-cannabinoid-therapy-in-practice
#10
REVIEW
T Rasche, D Emmert, C Stieber, M Mücke, R Conrad
BACKGROUND: In recent years, the media and scientists have shown increased interest in cannabis-based drugs. OBJECTIVES: Background information about cannabis-based drugs and their mechanism of action as well as discussion of possible applications as supportive therapy or in palliative medicine, respectively, are presented. MATERIALS AND METHODS: The recent literature was examined and evaluated. RESULTS: In many medical fields, we do not have sufficient evidence for the efficacy of cannabinoids...
April 12, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29597251/-appropriate-treatment-and-therapeutic-window-in-spasticity-treatment-with-incobotulinumtoxina-from-100-to-1000-units
#11
Giancarlo Ianieri, Riccardo Marvulli, Giulia Alessia Gallo, Pietro Fiore, Marisa Megna
Many neurological diseases (ischemic and hemorrhagic stroke, multiple sclerosis, infant cerebral palsy, spinal cord injuries, traumatic brain injury, and other cerebrovascular disorders) may cause muscle spasticity. Different therapeutic strategies have been proposed for the treatment of spasticity. One of the major treatments for tone modulation is botulinum toxin type A (BTX-A), performed in addition to other rehabilitation strategies based on individualized multidisciplinary programs aimed at achieving certain goals for each patient...
March 28, 2018: Toxins
https://www.readbyqxmd.com/read/29582713/a-mixed-treatment-comparison-on-efficacy-and-safety-of-treatments-for-spasticity-caused-by-multiple-sclerosis-a-systematic-review-and-network-meta-analysis
#12
Xiying Fu, Yanqiao Wang, Can Wang, Huijie Wu, Jinyao Li, Ming Li, Qianqian Ma, Wei Yang
OBJECTIVES: This study is aimed at providing a quantitative evaluation on different therapies of spasticity caused by multiple sclerosis. DATA SOURCES: PubMed and Embase database. REVIEW METHODS: We searched for randomized controlled trials that met the requirements. Percentages of improved patients' spasticity scale, mild adverse effect and severe adverse effect were extracted as outcomes. The forest plots accompanied with surface under the cumulative ranking curves were used to reveal the efficacy and safety of these therapies...
March 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29563533/profiling-walking-dysfunction-in-multiple-sclerosis-characterisation-classification-and-progression-over-time
#13
Linard Filli, Tabea Sutter, Christopher S Easthope, Tim Killeen, Christian Meyer, Katja Reuter, Lilla Lörincz, Marc Bolliger, Michael Weller, Armin Curt, Dominik Straumann, Michael Linnebank, Björn Zörner
Gait dysfunction is a common and relevant symptom in multiple sclerosis (MS). This study aimed to profile gait pathology in gait-impaired patients with MS using comprehensive 3D gait analysis and clinical walking tests. Thirty-seven patients with MS walked on the treadmill at their individual, sustainable speed while 20 healthy control subjects walked at all the different patient's paces, allowing for comparisons independent of walking velocity. Kinematic analysis revealed pronounced restrictions in knee and ankle joint excursion, increased gait variability and asymmetry along with impaired dynamic stability in patients...
March 21, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29560966/medical-cannabis-in-the-treatment-of-cancer-pain-and-spastic-conditions-and-options-of-drug-delivery-in-clinical-practice
#14
Leos Landa, Jan Jurica, Jiri Sliva, Monika Pechackova, Regina Demlova
The use of cannabis for medical purposes has been recently legalised in many countries including the Czech Republic. As a result, there is increased interest on the part of physicians and patients in many aspects of its application. This mini review briefly covers the main active substances of the cannabis plant and mechanisms of action. It focuses on two conditions, cancer pain and spasticity in multiple sclerosis, where its effects are well-documented. A comprehensive overview of a few cannabis-based products and the basic pharmacokinetics of marijuana's constituents follows...
March 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29549004/optimization-of-%C3%AE-9-tetrahydrocannabinolic-acid-synthase-production-in-komagataella-phaffii-via-post-translational-bottleneck-identification
#15
Bastian Zirpel, Friederike Degenhardt, Chantale Zammarelli, Daniel Wibberg, Jörn Kalinowski, Felix Stehle, Oliver Kayser
Δ9 -Tetrahydrocannabinolic acid (THCA) is a secondary natural product from the plant Cannabis sativa L. with therapeutic indications like analgesics for cancer pain or reducing spasticity associated with multiple sclerosis. Here, we investigated the influence of the co-expression of 12 helper protein genes from Komagataella phaffii (formerly Pichia pastoris) on the functional expression of the Δ9 -tetrahydrocannabinolic acid synthase (THCAS) heterologously expressed in K. phaffii by screening 21 clones of each transformation...
April 20, 2018: Journal of Biotechnology
https://www.readbyqxmd.com/read/29528549/clinical-response-to-nabiximols-correlates-with-the-downregulation-of-immune-pathways-in-multiple-sclerosis
#16
M Sorosina, F Clarelli, L Ferrè, A M Osiceanu, N T Unal, E Mascia, V Martinelli, G Comi, F Benigni, F Esposito, F Martinelli Boneschi
BACKGROUND AND PURPOSE: Nabiximols (Sativex® ) is a cannabinoid-based compound used for the treatment of moderate to severe spasticity in multiple sclerosis (MS). The aim of the study was to investigate the effect of the administration of Nabiximols on blood transcriptome profile of patients with MS and to interpret it in the context of pathways and networks. METHODS: Whole-genome expression profiling was performed in whole blood of 33 subjects with MS at baseline and after 4 weeks of drug treatment...
March 12, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29497878/spasticity-treatment-ameliorates-the-efficacy-of-melatonin-therapy-in-experimental-autoimmune-encephalomyelitis-eae-mouse-model-of-multiple-sclerosis
#17
Majid Ghareghani, Kazem Zibara, Hossein Sadeghi, Naser Farhadi
Multiple sclerosis (MS) is a progressive inflammatory demyelinating disease in the central nervous system (CNS). Melatonin is an effective treatment in MS patients and experimental autoimmune encephalomyelitis (EAE), a mouse model of MS. Melatonin secretion peaks at 2 AM, concomitant with the time at which the muscles are resting and the body is exerting its antioxidant activity. The current study was designed to investigate combination treatment of baclofen, a muscle relaxant drug, and melatonin in EAE mice...
March 1, 2018: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/29449262/systematic-review-of-systematic-reviews-for-medical-cannabinoids-pain-nausea-and-vomiting-spasticity-and-harms
#18
G Michael Allan, Caitlin R Finley, Joey Ton, Danielle Perry, Jamil Ramji, Karyn Crawford, Adrienne J Lindblad, Christina Korownyk, Michael R Kolber
OBJECTIVE: To determine the effects of medical cannabinoids on pain, spasticity, and nausea and vomiting, and to identify adverse events. DATA SOURCES: MEDLINE, the Cochrane Database, and the references of included studies were searched. STUDY SELECTION: Systematic reviews with 2 or more randomized controlled trials (RCTs) that focused on medical cannabinoids for pain, spasticity, or nausea and vomiting were included. For adverse events, any meta-analysis for the conditions listed or of adverse events of cannabinoids was included...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#19
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29442178/the-use-of-cannabis-and-cannabinoids-in-treating-symptoms-of-multiple-sclerosis-a-systematic-review-of-reviews
#20
REVIEW
Suzanne Nielsen, Rada Germanos, Megan Weier, John Pollard, Louisa Degenhardt, Wayne Hall, Nicholas Buckley, Michael Farrell
PURPOSE OF REVIEW: Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects...
February 13, 2018: Current Neurology and Neuroscience Reports
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