Study register / Neurology / ALS

ALS

2 curated studies · 2 key studies · mechoulam.de

In amyotrophic lateral sclerosis (ALS), the evidence is limited and mainly concerns accompanying symptoms such as muscle cramps. Controlled analyses suggest that tetrahydrocannabinol probably offers no substantial benefit here.

Rating scheme

The letter rates the quality of a study, independently of its type. Every study type can receive any grade: a review can be B or C when it is small or weak, and an RCT can be S. The grade is a synthesis of study design, journal authority and clinical bindingness:

S
Highest evidence, large, methodologically first-rate studies or S3 guidelines
A
Strong evidence, solid, meaningful studies with a clear result
B
Moderate evidence, smaller or methodologically limited studies
C
Weak evidence, preliminary, indirect or contradictory findings
D
Lowest evidence, exploratory hints, single cases or expert opinion

Quality profile per study

To the left of each study there is a profile of four features, it shows the differences within a letter class.

Sample size ★
Number of participants (RCT) or included studies (review).
Blinding
Double-blind, single-blind or open-label.
Effect size
Clear benefit, mixed, no benefit or harm.
Citations / year ★
Age-adjusted citation frequency.

Key studies

2
  1. 01
    S
    Symptomatic treatments for amyotrophic lateral sclerosis/motor neuron disease.
    Ng et al. ·2017 ·The Cochrane database of systematic reviews
    Read
  2. 02
    A
    A Systematic Review of Management of Cramping Pain in Patients with Amyotrophic Lateral Sclerosis.
    Hall et al. ·2025 ·European neurology
    Read

Systematic Reviews and Meta-Analyses

Syntheses of RCT evidence following Cochrane and PRISMA standards.

2
S
Sample size ★★★★★
Blinding —
Effect size —
Citations / year —
● Key study
Ng et al. ·2017 ·The Cochrane database of systematic reviews

Symptomatic treatments for amyotrophic lateral sclerosis/motor neuron disease.

Design
Systematic Review
Sample
k = 9 Studien
n = 4.012 Pat.
Summary

Cochrane overview of k=9 Cochrane Systematic Reviews on symptomatic treatment in ALS/MND (3 empty reviews without RCTs). For cramp treatment: 13 RCTs (n=4.012 pooled number of participants across all reviews). Tetrahydrocannabinol (THC) probably ineffective for cramps (moderate-quality evidence). Memantine also probably ineffective. Vitamin E possibly without effect (low-quality evidence). Effect of L-threonine, gabapentin, xaliproden, riluzole, baclofen uncertain (very low quality evidence). For spasticity: evidence on endurance-based training programme uncertain.

DOI 10.1002/14651858.cd011776.pub2 ↗
A
Sample size ★★★★★
Blinding —
Effect size —
Citations / year —
● Key study
Hall et al. ·2025 ·European neurology

A Systematic Review of Management of Cramping Pain in Patients with Amyotrophic Lateral Sclerosis.

Design
Systematic Review
Sample
k = 9 Studien
Summary

Systematic review on cramp-pain management in ALS (PRISMA-compliant, PROSPERO CRD42024521649), k=9 included studies. Mexiletine showed significant reduction in cramp frequency and intensity in several trials (dose-dependent variation in efficacy). Dronabinol and levetiracetam with limited efficacy. Among non-pharmacological options: supervised exercise programs (stretching, functional mobility) effective for reducing cramp-pain intensity; unsupervised home exercise programs without significant improvement. Review emphasizes lack of high-quality research on cramp-pain in ALS.

DOI 10.1159/000548820 ↗