{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:08:26Z","timestamp":1785769706601,"version":"3.56.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Government Pharmaceutical Organization (GPO) of Thailand","award":["06\/2565"],"award-info":[{"award-number":["06\/2565"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Previous studies demonstrated that cannabinoids may reduce spasticity in patients with spinal cord injury (SCI); however, the effect of naturally extracted THC:CBD oil, the most commonly used naturally extracted cannabinoids, has yet to be elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess the effect of a 1:1 THC:CBD oil on reducing spasticity in chronic SCI patients<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A single-center, placebo-controlled, double-blind crossover clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixteen chronic SCI patients with intractable spasticity were randomly assigned to either the intervention (1:1 THC:CBD oil) or control (placebo) phase for 1 month, then crossed over. The primary outcome (combined Ashworth Scale [AS] of all involved muscle groups) and the secondary outcomes, including patient-rated visual analog scale (VAS) of spasticity, were assessed before and after both phases and analyzed using a multilevel mixed-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All participants completed the study. The average (SD) dose of THC:CBD oil was 11.6 (1.3) mg. No significant difference in the total AS score for all involved muscle groups was found between the pre- and post-treatment phases, or between the experimental and control phases (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). A significant reduction was observed in the patient rating VAS (effect size\u2004=\u2004\u221213.9 [95% CI: \u221225.5 to \u22122.3;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In people with chronic SCI who had intractable spasticity, there was no statistically significant effect of 1:1 THC:CBD oil on spasticity-related outcomes, except for patient rating VAS reduction. Further studies are needed to evaluate the efficacy of higher doses of THC (&gt;12\u2009mg\/day) and to use patient-reported spasticity scores as the primary outcome measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>The study was registered with the Thai Clinical Trials Registry (TCTR identification number: TCTR20220329001).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864261468464","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:33:52Z","timestamp":1785584032000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Medical cannabis improved self-reported spasticity rating in patients with chronic spinal cord injury: a placebo-controlled, double-blind, crossover pilot clinical trial"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6978-415X","authenticated-orcid":false,"given":"Nattha","family":"Boonthanakorn","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"},{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2568-5897","authenticated-orcid":false,"given":"Sintip","family":"Pattanakuhar","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"},{"name":"Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Woftson Building, 106 Rottenrow East, Glasgow G4 0NW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratchayapon","family":"Kammuang-lue","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0497-4585","authenticated-orcid":false,"given":"Siam","family":"Tongprasert","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apichana","family":"Kovindha","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101757"},{"key":"e_1_3_4_3_2","first-page":"1","volume-title":"Spinal cord injury rehabilitation evidence","author":"Hsieh JTC","year":"2016","unstructured":"Hsieh JTC, Connolly SJ, McIntyre A, et al. Spasticity following spinal cord injury. In Eng JJ, Teasell RW, Miller WC, et al (eds) Spinal cord injury rehabilitation evidence. version 6.0. SCIRE \u2013 Spinal Cord Injury Research Evidence, 2016, pp. 1\u2013135."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101982"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2009.12.025"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.35755\/jmedassocthai.2021.03.11919"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10030539"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.4018\/978-1-6684-5652-1.ch008"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2022.12.022"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.4097\/kja.21165"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(00)00352-7"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2002.0090s1010.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2015.230"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.29.3.201"},{"key":"e_1_3_4_15_2","first-page":"63","volume-title":"Sample size calculations in clinical research","author":"Chow SC","year":"2003","unstructured":"Chow SC, Wang H, Shao J. 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