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Consumption of medical cannabis in adults with dystonia improves symptoms and alleviates related pain, according to study findings presented at the International Congress of Parkinson’s Disease and Movement Disorders Society (MDS) Virtual Congress 2021, held from September 17 to 22, 2021.
Previous research has found medical cannabis may help treat involuntary muscle contractions and reduce related pain in patients with dystonia by the activation of cannabinoid receptors in the basal ganglia that release γ-aminobutyric acid (GABA). This could potentially reduce severity and improve quality of life for patients with dystonia. From 2013, the Israeli Ministry of Health (MOH) has accepted the use of medical cannabis for symptomatic treatment in patients with movement disorders and related pain.
The current study aimed to assess the effect of medical cannabis on dystonia muscle activity and related pain in patients with an MOH-approved medical cannabis license.
Patients with dystonia (n=23) with an approved medical cannabis license from the MOH were contacted via telephone by researchers from the Tel Aviv University, Israel. Using a 5-point Likert scale, participants’ demographics, medical cannabis use, and treatment effects were assessed.
A total of 11 women and 12 men, with a mean age of 52.7 years, were included in the analysis. Dystonia etiologies were generalized (n=9), focal (n=6), segmental (n=5), hemidystonia (n=2), or multifocal (n=1) caused by Parkinson disease (n=6), monogenic variants (n=4), or unknown (n=13).
Participants indicated that they had been using medical cannabis for an average of 2.5±1.0 years. Medical cannabis was consumed at a mean dose of 22.6±20.1 grams per month and at a frequency of 3.3±4.3 times per day. The medical cannabis was composed of 10.6%±6.6% tetrahydrocannabinol (THC) and 8.0%±5.7% cannabidiol. Participants also indicated that they used cannabis oil extract (47.8%), smoked dried buds (43.5%), or both (8.7%).
The subjective, self-reported efficacy of medical cannabis for dystonia was 3.3/5, pain was 3.7/5, and quality of life was 3.6/5. The majority of participants (70%) also reported an improvement in sleep.
Participants who experienced more improvements to their dystonia reported using a higher THC dose than those who showed little improvement, with a positive correlation between THC dose and dystonia symptom improvement (R2=0.012).
Participants who smoked medical cannabis vs those who consumed the oil were more likely to report dystonia symptom improvement.
Adverse effects included dry mouth (65%), worsening mood (n=3), anxiety (n=2), anxiety with hallucinations (n=1), and suicidal ideation (n=1). Three participants stopped receiving treatment with medical cannabis due to inefficacy or adverse effects.
Study limitations included its small size and the inclusion of patients with differing dystonia symptoms, using uncontrolled dosing and administration methods. Therefore, these findings should be validated in a larger, controlled study.
“[Medical cannabis] seems to improve symptoms of dystonia and related pain. Higher daily dose of THC and smoking rather than sublingual oil are significantly more efficacious,” the researchers concluded.
Anis S, Faust-Socher A, Sverdlov D, et al. A real-life study of medical cannabis effect on adults with dystonia. Presented at: MDS Virtual Congress 2021; September 17-22, 2021. Poster 93.