Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination

Longoria, Parcel, Toma, Minhas, Zeine, Victor Longoria, Hannah Parcel, Bameelia Toma, Annu Minhas, Rana Zeine

Certainty of Evidence for Medical Marijuana Effects on MS Symptom Outcomes This systematic review of the literature evaluated the evidence for benefits of medical marijuana treatment in multiple sclerosis, and examined the effects of cannabinoids in autoimmune, viral, and toxic models of demyelination, over the past 15 years. Risk of bias assessment was performed for each of the human studies using the Cochrane criteria appropriate for appraising randomized human clinical trials and cohort studies. In the three clinical trials, the mean difference in NRS spasticity scores was 0.62 (range 0.5 to 0.83) points lower in the treatment groups as compared to controls, as a placebo effect was noted in two of the trials. The total number of participants for pain studies was 573. ® (pure CBD) has been approved for the treatment of intractable epilepsy in patients with developmental epileptic encephalopathies [ A receptors; activation and desensitization of TRPV1/2 receptors; and allosteric modulation of opioid receptor types μ and δ, leading to inhibition of glutaminergic N-methyl-D-aspartate (NMDA) receptors [ Cannabis-based medicine has long been known to be useful in pain management including central pain in multiple sclerosis and post-operative pain [ 143 144 ].

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