Survey on cannabis use in Parkinson's disease: Subjective improvement of motor symptoms

Venderová, Kateřina; Růžička, Evžen; Voříšek, Viktor; Visnovský, P

doi:10.1002/mds.20111

Cited by 142 publications

(102 citation statements)

References 30 publications

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“…Venderova sent surveys to 630 patients attending a movement disorders clinic in Prague, and of the 339 respondents, 25 % had used marijuana. Of these 85 patients, 39 benefitted in rest tremor (31 %), bradykinesia (45 %), and dyskinesias (14 %), and continued its daily use [14]. A recent survey of Colorado residents with Parkinson using all types of complementary therapies found 9 using medical marijuana (4 %), reporting improvement of mood and sleep, but only 2 with improvement of motor symptoms, not specifically dyskinesias [15].…”

Section: Dyskinesias From Levodopa (In Advanced Pd)mentioning

confidence: 99%

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Koppel

2015

Neurotherapeutics

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Cannabis has been used for many medicinal purposes, including management of spasms, dystonia, and dyskinesias, with variable success. Its use for tetanus was described in the second century BCE, but the literature continues to include more case reports and surveys of its beneficial effects in managing symptoms of hyperkinetic movement disorders than randomized controlled trials, making evidence-based recommendations difficult. This paper reviews clinical research using various formulations of cannabis (botanical products, oral preparations containing Δ 9 -tetrahydrocannabinol and/or cannabidiol) and currently available preparations in the USA (nabilone and dronabinol). This has been expanded from a recent systematic review of cannabis use in several neurologic conditions to include case reports and case series and results of anonymous surveys of patients using cannabis outside of medical settings, with the original evidence classifications marked for those papers that followed research protocols. Despite overlap in some patients, dyskinesias will be treated separately from dystonia and chorea; benefit was not established beyond individual patients for these conditions. Tics, usually due to Tourettes, did respond to cannabis preparations. Side effects reported in the trials will be reviewed but those due to recreational use, including the dystonia that can be secondary to synthetic marijuana preparations, are outside the scope of this paper.

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Section: Dyskinesias From Levodopa (In Advanced Pd)mentioning

confidence: 99%

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Koppel

2015

Neurotherapeutics

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“…It acts via various mechanisms, such as inhibition of primary afferent nerve activity, decrease in neuronal response to a noxious stimulus, and inhibition of mast cell degranulation (Richardson, 2000). The effect of cannabinoid-related drugs on PD symptoms is still controversial (Sieradzan et al, 2001;Carroll et al, 2004;Venderov a et al, 2004;Chagas et al, 2014). A study from our Movement Disorders Clinic showed that treatment with medical cannabis was associated with a decrease in motor and pain scores as well as an improvement in sleep quality (Lotan et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Shohet

Khlebtovsky

Roizen

et al. 2016

European Journal of Pain

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Background: Cannabis can alleviate pain of various etiologies. This study assessed the effect of cannabis on motor symptoms and pain parameters in patients with Parkinson's disease (PD). Methods: Twenty patients with PD who were licensed to use cannabis underwent evaluation before and 30 min after cannabis consumption and again after long-term use. Motor function was assessed with the Unified PD Rating scale (UPDRS) by two raters, one blinded. Pain was assessed with the Pain Rating Index (PRI) and Visual Analogue Scale (VAS) of the short-form McGill Pain Questionnaire. Thermal quantitative sensory testing (QST) was performed in 18 patients. The two consecutive QST measurements were validated in 12 cannabis-na€ ıve patients with PD. Results: There was a significant decrease from baseline to 30 min after cannabis consumption in mean motor UPDRS score (38.1 AE 18 to 30.4 AE 15.6, p < 0.0001), total PRI (27 AE 13.5 to 9.7 AE 11, p = 0.001), and VAS score (6.4 AE 2.8 to 3.6 AE 3.1, p = 0.0005). Mean cold pain threshold decreased significantly in the more affected limb, but only after exclusion of two patients who consumed cannabis by vaporizer rather than smoking (19.5 AE 5.2 to 15.6 AE 8.7°C, p = 0.02). After longterm (median 14 weeks) exposure, mean heat pain threshold decreased significantly in the more affected limb in all treated patients (43.6 AE 3.5 to 40.9 AE 3.3°C, p = 0.05) and in cannabis smokers (43.7 AE 3.6 to 40.3 AE 2.5°C, p = 0.008). Conclusions: Cannabis improved motor scores and pain symptoms in PD patients, together with a dissociate effect on heat and cold pain thresholds. Peripheral and central pathways are probably modulated by cannabis. Significance: Quantitative sensory test results are significantly altered following cannabis consumption in patients with PD. Cannabis probably acts on pain in PD via peripheral and central pathways.

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“…Moreover, an early clinic report suggests no advantageous effects of cannabis on tremor among 5 unresponsive patients to anticholinergics and beta blockers [74]. By contrast, a questionnaire-based study revealed a 30.6 % improvement in rest tremor in tremulous [75]. A plausible argument for using cannabinoid agonists as therapeutic agents has arisen from studies describing the inhibitory effect of CB 1 R activation on glutamate release and its capability to oppose subthalamonigral neuronal overactivity and subsequently reduce tremor [64,76,77].…”

Section: Cannabinoids and Tremor In Pdmentioning

confidence: 99%

“…It has also been suggested that cannabinoid agonists and endocannabinoids can block dopamine transporters and thereby inhibit dopamine reuptake to ameliorate dyskinesia [78][79][80]. However, there are other studies asserting no beneficial effects of cannabinoid agonists in alleviation of motor symptoms [75,[81][82][83].…”

Section: Cannabinoids and Tremor In Pdmentioning

confidence: 99%

Cannabinoids and Tremor Induced by Motor-related Disorders: Friend or Foe?

et al. 2015

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Tremor arises from an involuntary, rhythmic muscle contraction/relaxation cycle and is a common disabling symptom of many motor-related diseases such as Parkinson disease, multiple sclerosis, Huntington disease, and forms of ataxia. In the wake of anecdotal, largely uncontrolled, observations claiming the amelioration of some symptoms among cannabis smokers, and the high density of cannabinoid receptors in the areas responsible for motor function, including basal ganglia and cerebellum, many researchers have pursued the question of whether cannabinoid-based compounds could be used therapeutically to alleviate tremor associated with central nervous system diseases. In this review, we focus on possible effects of cannabinoid-based medicines, in particular on Parkinsonian and multiple sclerosis-related tremors and the common probable molecular mechanisms. While, at present, inconclusive results have been obtained, future investigations should extend preclinical studies with different cannabinoids to controlled clinical trials to determine potential benefits in tremor.

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Survey on cannabis use in Parkinson's disease: Subjective improvement of motor symptoms

Abstract: An anonymous questionnaire sent to all patients attending the Prague Movement Disorder Centre revealed that 25% of 339 respondents had taken cannabis and 45.9% of these described some form of benefit.

Cited by 142 publications

References 30 publications

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Cannabinoids and Tremor Induced by Motor-related Disorders: Friend or Foe?

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