Cannabinoids and Motor Neuron Disease – A Double Blind Trial

A clinical trial of a cannabinoid oral spray that is used to treat people with multiple sclerosis (MS) suggests that the treatment could also ease the symptoms of motor neuron disease (MND).

The treatment targets spasticity, a condition caused by the permanent contraction of muscles, which impedes a person’s movement. It is a prominent symptom of both MND and MS. In 2010, after a long history of people with MS using cannabis to self-medicate, a cannabis-based treatment to manage spasticity associated with MS was approved in the United Kingdom. Giancarlo Comi at Vita-Salute San Raffaele University in Milan, Italy, and his colleagues now suggest that this same cannabinoid preparation can ease spasticity in people with MND.

In a double-blind, randomized phase II trial, 30 people received a placebo and 29 people were given the cannabinoid spray — a solution containing roughly equal amounts of tetrahydrocannabinol (THC) and cannabidiol (CBD), the main psychoactive and non-psychoactive components, respectively, of cannabis. Participants spent two weeks finding a dosage with which they were happy, and then maintained that dose for four weeks. Spasticity was measured before and after treatment.

Whereas spasticity worsened slightly in the group that received a placebo, it improved in those who received the cannabinoid treatment. Of the participants who received cannabinoids, 55% reported feeling better, compared with only 13% of those given a placebo. The cannabinoids also decreased people’s reported pain levels. Future studies might more finely distinguish the treatment’s efficacy in two forms of MND: amyotrophic lateral sclerosis, in which spasticity varies in its prevalence and intensity, and the less common primary lateral sclerosis, which is often accompanied by severe spasticity.

Read the research/clinical trial: Lancet Neurol. 18, 155–164 (2019)