Abstract:
:Multiple sclerosis (MS) pathology progressively affects multiple central nervous system (CNS) areas. Due to this fact, MS produces a wide array of symptoms. Symptomatic therapy of one MS symptom can cause or worsen other unwanted symptoms (anticholinergics used for bladder dysfunction produce impairment of cognition, many MS drugs produce erectile dysfunction, etc.). Appropriate symptomatic therapy is an unmet need. Several important functions/symptoms (muscle tone, sleep, bladder, pain) are mediated, in great part, in the brainstem. Cannabinoid receptors are distributed throughout the CNS irregularly: There is an accumulation of CB1 and CB2 receptors in the brainstem. Nabiximols (a combination of THC and CBD oromucosal spray) interact with both CB1 and CB2 receptors. In several clinical trials with Nabiximols for MS spasticity, the investigators report improvement not only in spasticity itself, but also in several functions/symptoms mentioned before (spasms, cramps, pain, gait, sleep, bladder function, fatigue, and possibly tremor). We can conceptualize and, therefore, hypothesize, through this indirect information, that it could be considered the existence of a broad "Spasticity-Plus Syndrome" that involves, a cluster of symptoms apart from spasticity itself, the rest of the mentioned functions/symptoms, probably because they are interlinked after the increase of muscle tone and mediated, at least in part, in the same or close areas of the brainstem. If this holds true, there exists the possibility to treat several spasticity-related symptoms induced by MS pathology with a single therapy, which would permit to avoid the unnecessary adverse effects produced by polytherapy. This would result in an important advance in the symptomatic management of MS.
journal_name
Front Neuroljournal_title
Frontiers in neurologyauthors
Fernández Ó,Costa-Frossard L,Martínez-Ginés M,Montero P,Prieto JM,Ramió Ldoi
10.3389/fneur.2020.00152subject
Has Abstractpub_date
2020-03-17 00:00:00pages
152issn
1664-2295journal_volume
11pub_type
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journal_title:Frontiers in neurology
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Frontiers in neurology
pub_type: 杂志文章,评审
doi:10.3389/fneur.2017.00331
更新日期:2017-07-10 00:00:00
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pub_type:
doi:10.3389/fneur.2020.598894
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3389/fneur.2020.00305
更新日期:2020-04-28 00:00:00
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pub_type: 杂志文章
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pub_type:
doi:10.3389/fneur.2020.540911
更新日期:2020-11-05 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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