BACKGROUND: Spasticity arises from hyperexcitability of the neural stretch reflex arc secondary to injury of the corticospinal tract. In response to injury, the density of glutamatergic inputs from afferent 1A fibers to motor neurons increases dramatically and adaptive changes occur in the morphology of microglia cells in the spinal cord. SUMMARY: Involvement of the endocannabinoid system in pathophysiological mechanisms responsible for @entity508 has been demonstrated in animal models of @entity15 . Stimulation of cannabinoid (CB)1 receptors reduces the hyperglutamatergic drive from sensory afferents to spinal cord motor neurons and blocks the synaptic effects of activated microglia and pro-inflammatory mediators (e.g. @entity310 ) on glutamatergic transmission. Enhancing corticospinal tract excitability through intermittent theta burst stimulation inhibits the stretch reflex and @entity508 by promoting long-term potentiation, a form of synaptic plasticity that requires stimulation of @entity6510 receptors. Evidence indicates that the antispasticity effects of @entity839 :CBD oromucosal spray (Sativex  ) are associated with enhanced cortical long-term potentiation. Key Messages: Glutamatergic and GABAergic pathways are involved in the regulation of muscle tone. @entity6510 receptors, which are associated with movement, postural control, and @entity158 and sensory perception, influence glutamatergic pathways. @entity839 :CBD oromucosal spray was shown to reverse motor cortex plasticity from long-term @entity308 through long-term potentiation of synaptic transmission, thereby restoring, at least in part, effective corticospinal inputs to spinal circuits.    2014 S. Karger AG, Basel.

Advances in the management of @entity15 @entity508 : XXXX @entity508 nervous pathways.

@entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity839 :: ('MESH:D013759', 'Chemical') :: ['THC'] @entity310 :: ('7124', 'Gene') :: ['TNF-a'] @entity6510 :: ('1268', 'Gene') :: ['CB1'] @entity508 :: ('MESH:D009128', 'Disease') :: ['spasticity'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity15 :: ('MESH:D009103', 'Disease') :: ['MS']
@entity15 :: (MESH:D009103,Disease) :: ['multiple sclerosis']
