What Are the Effects of Medical Cannabis on Multiple Sclerosis?
Multiple sclerosis is an inflammatory disease of the nervous system that affects approximately 2 million people worldwide.
The main characteristics of this disease are the multiple lesions called “plaques” that present as focal areas of inflammation and the activation of cells called “glia.”
Plaques can appear in any central nervous system region, so the symptoms depend on where the lesion is. They happen because of an alteration in the transmission of nerve impulses between neurons due to inflammation and damage to the myelin sheath in the nerve fibers (demyelination), which is necessary for this transmission.
Symptoms include: loss of some physiological functions, paresis (muscle weakness), hypoesthesia (decreased sensory perception), visual impairment, spasticity (tense and rigid muscles), diplopia (double vision), or ataxia (reduced ability to coordinate movements).
A published survey revealed that up to 47% of multiple sclerosis patients have considered using medicinal cannabis for their symptoms. It may be because the plant is helpful for various symptoms such as pain, tremors, anxiety, and sleep problems.
However, the primary use of cannabis and its derivatives is the treatment of spasticity associated with multiple sclerosis. Cannabinoids, such as THC and CBD, interact with the presynaptic CB1 receptor and regulate the release of a neurotransmitter called glutamate, thus modulating its activity during the pathophysiological phenomenon that conditions spasticity. The effectiveness demonstrated by these compounds led to the approval of the use of Sativex (medication with cannabis extracts) for spasticity in multiple sclerosis.
Nonetheless, medical cannabis is not limited to spasticity. The plant has other properties that benefit these patients, such as the neuroprotective and anti-inflammatory effects of some of the plant's compounds. CBD has prevented demyelination and inflammatory infiltrates in nervous tissue in experimental models. It also promotes the release of brain-derived neurotrophic factors, protecting against oxidative damage and decreasing oxidative markers, exerting a neuroprotective effect.
On the other hand, the analgesic effect of some cannabinoid compounds can decrease nociception and modulate pain in these patients.
To conclude, the available scientific evidence suggests that cannabis can improve a patient's quality of life with multiple sclerosis, especially with typical and difficult-to-treat symptoms such as spasticity. Although there is still a long way to go in the research field, many patients have turned to cannabis to get relief through natural and alternative medicine.
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