RESUMEN
OBJECTIVES: Cannabis has been used for medicinal purpose for thousands of years; however the positive and negative effects of cannabis use in Parkinson's disease (PD) and Multiple Sclerosis (MS) are mostly unknown. Our aim was to assess cannabis use in PD and MS and compare results of self-reported assessments of neurological disability between current cannabis users and non-users. METHODS: An anonymous web-based survey was hosted on the Michael J. Fox Foundation and the National Multiple Sclerosis Society webpages from 15 February to 15 October 2016. The survey collected demographic and cannabis use information, and used standardized questionnaires to assess neurological function, fatigue, balance, and physical activity participation. Analysis of variance and chi-square tests were used for the analysis. RESULTS: The survey was viewed 801 times, and 595 participants were in the final data set. Seventy-six percent and 24% of the respondents reported PD and MS respectively. Current users reported high efficacy of cannabis, 6.4 (SD 1.8) on a scale from 0 to 7 and 59% reported reducing prescription medication since beginning cannabis use. Current cannabis users were younger and less likely to be classified as obese (P < 0.035). Cannabis users reported lower levels of disability, specifically in domains of mood, memory, and fatigue (P<0.040). CONCLUSIONS: Cannabis may have positive impacts on mood, memory, fatigue, and obesity status in people with PD and MS. Further studies using clinically and longitudinally assessed measurements of these domains are needed to establish if these associations are causal and determine the long-term benefits and consequences of cannabis use in people with PD and MS.
Asunto(s)
Cannabis , Marihuana Medicinal/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Enfermedad de Parkinson/tratamiento farmacológico , Adulto , Afecto/efectos de los fármacos , Anciano , Personas con Discapacidad , Fatiga/etiología , Fatiga/prevención & control , Femenino , Humanos , Internet , Masculino , Fumar Marihuana , Marihuana Medicinal/farmacología , Memoria/efectos de los fármacos , Trastornos de la Memoria/etiología , Trastornos de la Memoria/prevención & control , Persona de Mediana Edad , Trastornos del Humor/etiología , Trastornos del Humor/prevención & control , Esclerosis Múltiple/complicaciones , Obesidad/etiología , Obesidad/prevención & control , Enfermedad de Parkinson/complicaciones , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To determine if sex differences in glucose uptake, a marker of brain activity, are present in brain regions that facilitate walking performance in persons with multiple sclerosis (MS). DESIGN: Cross-sectional, observational pilot. SETTING: University laboratory. PARTICIPANTS: Positron emission tomography with fluorine-18-labeled deoxyglucose (FDG) was performed on persons with MS and healthy controls (4 men and 4 women per group; N=16) after a 15-minute walking test. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Brain activity was quantified as the mean standardized uptake value (SUV). RESULTS: The mean SUV was significantly lower in the thalamus (P=.029) and cerebellum (P=.029) for men with MS compared with women with MS, but not for the prefrontal (P=.057) or frontal (P=.057) cortices. Similar nonsignificant trends were found for healthy controls. No mean SUV group × sex interaction effects were found between the MS and healthy control groups (all P>.05). CONCLUSIONS: To our knowledge, this is the first study of brain activity sex differences based on FDG uptake in persons with MS during walking. Significantly less FDG uptake in the thalamus and cerebellum brain regions important for walking performance was found in men with MS compared with women with MS; however, these comparisons were not significantly different in the healthy control group. No differences in FDG uptake were found between the MS and healthy control groups in any of the brain regions examined. Results from this study provide pilot data for larger studies aimed at identifying underlying mechanisms responsible for accelerated disability in men with MS.
Asunto(s)
Cerebelo/metabolismo , Glucosa/metabolismo , Esclerosis Múltiple/fisiopatología , Tálamo/metabolismo , Caminata/fisiología , Adulto , Estudios Transversales , Prueba de Esfuerzo , Femenino , Fluorodesoxiglucosa F18 , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Tomografía de Emisión de Positrones , Corteza Prefrontal/metabolismo , Radiofármacos , Factores SexualesRESUMEN
The purpose of the study was to determine whether pairs of motor units that discharge action potentials at different rates during isometric contractions exhibit different levels of motor unit synchronization or coherence. Twelve subjects (28.6 +/- 6.1 years) performed isometric contractions at target forces slightly above the recruitment threshold (1.02-20.9%) of an isolated motor unit. Based on audio feedback, subjects maintained a relatively constant discharge rate of the isolated unit for about 80 s. Intramuscular electrodes were used to record the discharge of 47 pairs of motor units at rates that ranged from 8.07 to 13.6 pps. Correlated discharge between pairs of motor units was quantified with the common input strength (CIS) index, k' index, and coherence spectrum. Greater discharge rates across pairs of motor units were predicted (R2 = 0.36, P < 0.001) by higher coherence from 8 to 13 Hz (r = -0.52) and lower coherence from 0 to 4 Hz (r = 0.37). Indexes of motor unit synchronization (CIS and k') were strongly associated with motor unit coherence from 16 to 32 Hz (CIS: R2 = 0.63; k': R2 = 0.4; P = 0.001). The CIS index of motor unit synchronization and the motor unit coherence from 16 to 32 Hz did not vary with discharge rate. In contrast, the k' index of motor unit synchronization declined with discharge rate (r2 = 0.20, P = 0.001). Furthermore, greater discharge rates across pairs of motor units were accompanied by higher motor unit coherence in the 8-13 Hz band and lower motor unit coherence in the 0-4 Hz band. These results demonstrate that differences in discharge rate between pairs of motor units in first dorsal interosseus during low-force, isometric contractions were associated with modulation of the correlation in the discharge times of the two motor units at frequencies less than 15 Hz.