Parkinson’s disease is the second most common neurodegenerative disease, after Alzheimer’s disease. There is currently no cure for the disease. Could cannabis be useful to protect the brain of these patients or to alleviate their symptoms?
Parkinson’s disease is a chronic degenerative disease of the central nervous system that mainly affects the areas of the brain responsible for controlling movement. It generally appears in people over 60 years old (although there are cases of the so-called juvenile Parkinson that appear in people under 40 years old) and more in men than in women. Buy CBD cigarettes – regular
Parkinson’s disease is defined by the death of neurons in an area of the brain called the substantia nigra, responsible for the production of dopamine, one of the neurotransmitter molecules necessary for signals to travel properly through the brain. This lack of dopamine alters the signaling of that area, the basal ganglia, in charge of movement control. That is why the main symptoms of the disease are motor. To the characteristic tremor at rest, which everyone associates with the disease, we must add rigidity, postural instability and bradykinesia (slowing down of movements). Sensory, sleep, affective problems (depression or anxiety) and, in the later stages, dementia may also appear in later stages of the disease.
In approximately 5% of cases, the disease appears as a consequence of mutation in certain genes. However, in the vast majority of patients the cause is unknown, probably being a mixture of genetic susceptibility and environmental factors.
Currently, there is no cure for the disease and only its symptoms are treated. In addition, one of the main treatments, levodopa, which is used to supply dopamine deficiency, ceases to be useful after a few years and causes uncontrolled movements (dyskinesias) in patients. This makes it necessary to investigate new compounds that can protect neurons from death caused by this disease and / or alleviate its symptoms. Buy CBD cigarettes – menthol online
Against this background, could cannabis be useful in the treatment of Parkinson’s disease? Already in the late 19th century, the use of cannabis for the treatment of Parkinson’s disease was described for the first time in Europe by William Richard Gowers in his “Manual of Diseases of the Nervous System”. Philadelphia, Pa, USA: P. Blakiston’s Son & Co; 1888). Let’s see what the scientific evidence is 130 years later.
Cannabis compounds called cannabinoids (of which more than 100 have been described) act in our brain by binding to structures called the CB1 receptor, mainly present in neurons and responsible for the psychoactive effect of some of these cannabinoids, and CB2 receptor, present mainly in glial cells, responsible among other things for the inflammatory response. These receptors, together with the endogenous molecules that activate them (endocannabinoids) are part of the endocannabinoid system, an intercellular communication system present in our body. Buy CBD flower online
Many of the cannabinoids have great neuroprotective potential. By binding to the CB1 receptor in neurons, they can protect them from various harmful stimuli. They also have the anti-inflammatory capacity, mediated by the binding to the CB2 receptor of glial cells. And last but not least, cannabinoids are important antioxidant compounds, protecting neurons from damage caused by oxidative stress (very important in Parkinson’s disease) independently of their receptor binding, due to their own molecular structure. , or by binding to other non-cannabinoid receptors, such as PPAR nuclear receptors that have antioxidant activity. This has been shown in numerous preclinical studies (in vitro and in laboratory animal models) for different diseases such as Alzheimer’s disease,
The basal ganglia area, affected in Parkinson’s disease, has a high density of CB1 cannabinoid receptors, which makes sense since the endocannabinoid system has, among its functions, that of movement control, generally inhibiting it. The importance of the endocannabinoid system in this structure suggested the potential that its manipulation would have in Parkinson’s disease. It has been seen both in experimental animal models and in patients with Parkinson’s disease that this endocannabinoid system is altered in the disease. An increase in the CB1 receptor has been reported in the neurons of the basal ganglia, an increase in the CB2 receptor in the glial cells responsible for inflammation, and an increase in the level of endocannabinoids. This has been interpreted as a response of the organism to the damage caused by the disease. Some have considered the endocannabinoid system as an innate brain defense mechanism. Buy CBD prerolls online
Pharmacological studies carried out in animal models have seen the neuroprotective potential of those compounds with antioxidant capacities, such as Δ9-tetrahydrocannabinol (Δ9-THC, the main psychoactive compound in cannabis), cannabidiol (CBD, the other most important cannabinoid, without psychoactive activity) and Δ9-tetrahydrocannabivarine (Δ9-THCV) and those with anti-inflammatory capacity by binding to the CB2 receptor (such as Δ9-THCV). The activation of the CB1 receptor, although it is a neuroprotective strategy that is used in other diseases, would be contraindicated in the case of Parkinson’s disease since it would worsen the motor symptoms by enhancing the immobility of the patients.
Despite the large accumulated preclinical evidence, clinical research to date has not yielded positive results. Buy marijuana online
Observational studies seem to suggest that cannabis may improve motor symptoms. In some of these studies, patients who used cannabis have indicated that they had experienced an improvement in some of the different symptoms of the disease: tremor at rest, bradykinesia, uncontrolled movements caused by treatment, sleep problems, or pain. There are also studies, however, in which patients did not experience any improvement in tremor after consuming a single dose of smoked cannabis. In another study in which CBD was administered to Parkinson’s patients, they reported improvements in some psychotic symptoms and in their sleep problems. This type of observational study presents numerous problems since researchers cannot control the variables of the experiment, there is no control group with which to compare the effect, the measures are indirectly based on what the patient reports, … all this means that these studies present many variables that can confuse the result. Chief among them is the placebo effect. Patients, aware that they are using cannabis, can report that they feel better by being convinced that this use will make them feel better. Although this is not negligible, of course, it would be desirable to see a “real” effect. This is accomplished by conducting “double-blind” randomized clinical trials in which neither the patient nor the investigator knows whether the patient is taking the treatment or a control substance.
Unfortunately, few randomized, double-blind clinical trials have been conducted with cannabis in Parkinson’s patients, and there are also a few recruited patients. In these few clinical trials, the results have not been promising. Recent studies have seen that using both Δ9-THC isolate and a cannabis extract with Δ9-THC and CBD, no beneficial effects on motor symptoms are observed. Nor have any benefits been reported in quality of life or sleep problems. In another study in which CBD was administered for 6 weeks, no effect was seen on either motor symptoms or neuroprotection, although an improvement in patients’ quality of life was seen. Although these studies have been carried out with few patients, it seems to indicate that cannabis is not beneficial in treating the motor symptoms of the disease, although it could help in treating secondary symptoms. It would be necessary to carry out studies with a larger number of patients and with other types of compounds that have demonstrated their efficacy in preclinical studies, such as Δ9-THCV. For this, a change in the legislation would be necessary to change the current status of cannabis as a drug of abuse in many countries, which would facilitate its use in research. Buy hemp online
In view of these results, it appears that cannabis use, due to its ability to activate the CB1 receptor by compounds such as Δ9-THC and others, would not be the best strategy for the treatment of Parkinson’s disease. However, treatment with those compounds with the best pharmacological profile, such as Δ9-THCV combined with CBD, either in its pure state or as botanical extracts of plants enriched in these compounds, could be useful.