title: Cannabis-based treatment induces polarity-reversing plasticity assessed by theta burst stimulation in humans.
abstract: BACKGROUND
  In animal models, the cannabinoid system has been convincingly implicated in the regulation of long-lasting synaptic plasticity. Both long-term potentiation (LTP) and depression (LTD) phenomena can be induced in the human motor cortex by transcranial magnetic theta burst stimulation (TBS).
  
  
  OBJECTIVE
  Here, we explored the potential involvement of the cannabinoid system in TBS-induced synaptic plasticity in humans.
  
  
  METHODS
  We tested the effects of a cannabis-based preparation (Sativex) on continuous TBS (cTBS) and intermittent TBS (iTBS) protocols in subjects with multiple sclerosis.
  
  
  RESULTS
  We observed a shift in the polarity of synaptic plasticity induced by cTBS. In these subjects, in fact, cTBS induced the expected inhibition of motor-evoked potentials (MEPs) before Sativex exposure, whereas it caused a persisting enhancement of MEP amplitude 4 weeks after. The LTP-like phenomenon induced by iTBS was conversely unaffected by Sativex.
  
  
  CONCLUSIONS
  Our results indicate that cannabis ingredients have metaplastic effects on the motor cortex, and strongly suggest that the cannabinoid system is involved in the modulation of synaptic plasticity not only in rodents but also in humans.
authors.affiliation: Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy. giakoch@libero.it; g.koch@hsantalucia.it
authors.forename: Giacomo
authors.initials: G
authors.lastname: Koch
authors.forename: Francesco
authors.initials: F
authors.lastname: Mori
authors.forename: Claudia
authors.initials: C
authors.lastname: Codecà
authors.forename: Hajime
authors.initials: H
authors.lastname: Kusayanagi
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Monteleone
authors.forename: Fabio
authors.initials: F
authors.lastname: Buttari
authors.forename: Stefania
authors.initials: S
authors.lastname: Fiore
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bernardi
authors.forename: Diego
authors.initials: D
authors.lastname: Centonze
mesh_terms: D000328:Adult; D000818:Animals; D002185:Cannabidiol; D002186:Cannabinoids / Q000494:pharmacology / Q000627:therapeutic use; D013759:Dronabinol; D004338:Drug Combinations; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D017774:Long-Term Potentiation / Q000187:drug effects / Q000502:physiology; D036881:Long-Term Synaptic Depression / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000187:drug effects / Q000502:physiology; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000503:physiopathology; D009473:Neuronal Plasticity / Q000187:drug effects / Q000502:physiology; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use; D013826:Theta Rhythm; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
chemical_list: D002186:Cannabinoids; D004338:Drug Combinations; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols