Resting-state functional connectivity in multiple sclerosis patients receiving nabiximols for spasticity.
Cannabinoid
Functional MRI
Multiple sclerosis
Nabiximols
Spasticity
Symptomatic therapy
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
29 Mar 2023
29 Mar 2023
Historique:
received:
09
11
2021
accepted:
17
03
2023
medline:
31
3
2023
entrez:
29
3
2023
pubmed:
30
3
2023
Statut:
epublish
Résumé
Nabiximols (Sativex®) is a cannabinoid approved for multiple sclerosis (MS)-related spasticity. Its mechanism of action is partially understood, and efficacy is variable. To conduct an exploratory analysis of brain networks connectivity changes on resting state (RS) functional MRI (fMRI) of MS patients treated with nabiximols. We identified a group of MS patients treated with Sativex® at Verona University Hospital, who underwent RS brain fMRI in the 4 weeks before (T0) and 4-8 weeks after (T1) treatment start. Sativex® response was defined as ≥ 20% spasticity Numerical Rating Scale score reduction at T1 vs. T0. Connectivity changes on fMRI were compared between T0 and T1 in the whole group and according to response status. ROI-to-ROI and seed-to-voxel connectivity were evaluated. Twelve MS patients (7 males) were eligible for the study. Seven patients (58.3%) resulted Sativex® responders at T1. On fMRI analysis, Sativex® exposure was associated with global brain connectivity increase (particularly in responders), decreased connectivity of motor areas, and bidirectional connectivity changes of the left cerebellum with a number of cortical areas. Nabiximols administration is associated with brain connectivity increase of MS patients with spasticity. Modulation of sensorimotor cortical areas and cerebellum connectivity could play a role in nabiximols effect.
Sections du résumé
BACKGROUND
BACKGROUND
Nabiximols (Sativex®) is a cannabinoid approved for multiple sclerosis (MS)-related spasticity. Its mechanism of action is partially understood, and efficacy is variable.
OBJECTIVE
OBJECTIVE
To conduct an exploratory analysis of brain networks connectivity changes on resting state (RS) functional MRI (fMRI) of MS patients treated with nabiximols.
METHODS
METHODS
We identified a group of MS patients treated with Sativex® at Verona University Hospital, who underwent RS brain fMRI in the 4 weeks before (T0) and 4-8 weeks after (T1) treatment start. Sativex® response was defined as ≥ 20% spasticity Numerical Rating Scale score reduction at T1 vs. T0. Connectivity changes on fMRI were compared between T0 and T1 in the whole group and according to response status. ROI-to-ROI and seed-to-voxel connectivity were evaluated.
RESULTS
RESULTS
Twelve MS patients (7 males) were eligible for the study. Seven patients (58.3%) resulted Sativex® responders at T1. On fMRI analysis, Sativex® exposure was associated with global brain connectivity increase (particularly in responders), decreased connectivity of motor areas, and bidirectional connectivity changes of the left cerebellum with a number of cortical areas.
CONCLUSIONS
CONCLUSIONS
Nabiximols administration is associated with brain connectivity increase of MS patients with spasticity. Modulation of sensorimotor cortical areas and cerebellum connectivity could play a role in nabiximols effect.
Identifiants
pubmed: 36991352
doi: 10.1186/s12883-023-03171-0
pii: 10.1186/s12883-023-03171-0
pmc: PMC10052832
doi:
Substances chimiques
nabiximols
K4H93P747O
Cannabidiol
19GBJ60SN5
Dronabinol
7J8897W37S
Cannabinoids
0
Drug Combinations
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
128Informations de copyright
© 2023. The Author(s).
Références
J Neurol Neurosurg Psychiatry. 2016 Sep;87(9):944-51
pubmed: 27160523
Neural Plast. 2019 Jun 3;2019:5181649
pubmed: 31281342
Eur J Neurol. 2011 Sep;18(9):1122-31
pubmed: 21362108
Neurology. 2022 Nov 29;99(22):e2517-e2530
pubmed: 36096690
Neuroimage. 2012 Nov 15;63(3):1701-11
pubmed: 22885247
Ann Neurol. 2011 Feb;69(2):292-302
pubmed: 21387374
J Physiol. 2001 May 1;532(Pt 3):731-48
pubmed: 11313442
J Physiol. 2004 Feb 15;555(Pt 1):85-96
pubmed: 14673184
Mult Scler. 2018 Aug;24(9):1183-1195
pubmed: 28657428
J Neurosci Methods. 2002 Aug 30;118(2):115-28
pubmed: 12204303
Brain. 2010 Jun;133(Pt 6):1612-21
pubmed: 20356855
PLoS One. 2019 Apr 1;14(4):e0210375
pubmed: 30933977
Neuroimage Clin. 2015 Apr 09;8:140-7
pubmed: 26106538
Neurology. 2014 Jul 15;83(3):278-86
pubmed: 24871874
Schizophr Res. 2018 Apr;194:70-77
pubmed: 28823723
Mult Scler. 2018 Nov;24(13):1696-1705
pubmed: 28911257
Brain Connect. 2012;2(3):125-41
pubmed: 22642651
Neurology. 2021 Aug 24;97(8):e794-e802
pubmed: 34099528
J Nucl Med. 2010 Jan;51(1):112-20
pubmed: 20008988
Brain. 2019 Sep 1;142(9):2800-2812
pubmed: 31363742