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Central nervous system disorders are a group of diseases and conditions that affect the health and functioning of the spinal cord and brain. Studies have shown cannabis can limit the progression of many central nervous system disorders and help manage symptoms like pain, seizures and spasms.
Overview of Central Nervous System Disorders
Central nervous system disorders are a broad category of conditions or diseases that affect the spinal cord or brain. There are many different types of central nervous system disorders, some of which include epilepsy, migraine, Huntington’s disease, Alzheimer’s disease, Parkinson’s disease, Tourette syndrome, dystonia, multiple sclerosis, meningitis, lupus, fibromyalgia, and bipolar disorder. While central nervous system disorders can vary greatly from each other, all the disorders cause a loss of sufficient, intact nervous system circuits that orchestrate particular functions.
The damage that leads to or causes central nervous system disorders can include trauma, infections, degeneration, congenital problems, structural defects, tumors, blood flow disruption and autoimmune disorders.
Symptoms associated with central nervous system disorders vary depending on the specific condition, but can include headaches, tingling or loss of feeling, muscle weakness, muscle wasting, loss of sight or double vision, memory loss, impaired mental ability, lack or coordination, tremors and seizures, muscle rigidity, and back pain.
Most central nervous system disorders cannot be cured, but medications, therapy, surgery and other treatment options can help limit their progression and manage associated symptoms.
Findings: Effects of Cannabis on Central Nervous System Disorders
Studies have shown that cannabis has neuroprotective effects, and in turn supports the health of the brain and spinal cord and helps in the treatment of a variety of central nervous system disorders. The cannabinoids found in cannabis, including cannabidiol (CBD) and tetrahydrocannabinol (THC), have shown they effectively protect neurons and astrocytes from damage, modulate inflammatory reaction and assist in neuroregeneration (Lafuente, et al., 2011) (Kubajewska & Constantinescu, 2010) (Croxford, et al., 2008).
CBD and THC activate the cannabinoid receptors (CB1 and CB2) of the endocannabinoid system, which plays a significant regulatory role in health and disease (Pacher, Batkai & Kunos, 2006) (Di Marzo, Bifulco & De Petrocellis, 2004). The upregulation of the endocannabinoid system has shown to reduce the severity of symptoms like neuropathic pain and muscle spasms and slow the progression of central nervous system disorders like multiple sclerosis, epilepsy, Parkinson’s disease, Alzheimer’s disease and others (Di Marzo, Bifulco & De Petrocellis, 2004) (Pertwee, 2006) (Pacher, Batkai & Kunos, 2006). Studies also show that cannabinoids reduce the debilitating seizures caused by epilepsy and reduce spasms experienced by those with multiple sclerosis, and minimize the neurological damage caused by spinal cord and traumatic brain injuries (Iuvone, et al., 2004) (More & Choi, 2015) (Blair, Deshpande & DeLorenzo, 2015) (Lakhan & Rowland, 2009).
Cannabis slows the progression of Alzheimer’s disease by slowing the production of beta-amyloid proteins, considered the key contributor to the disease’s progression (Iuvone, et al., 2004). It also protects brain cells from the deleterious effects of amyloid-beta, reduces inflammation, and supports the brain’s repair process by enhancing the birth of new cells (Campbell & Gowran, 2007).
Cannabis reduces the involuntary muscle contractions associated with dystonia (Consroe, Sandyk & Snider, 1986).
CBD has been shown to effectively and significantly decrease the frequency of seizures and in some cases has even shown to produce complete seizure freedom (Blair, Deshpande & DeLorenzo, 2015).
Studies have found that cannabis is effective at improving sleep disruption, pain, depression, joint stiffness, anxiety, physical function and quality of life in individuals with fibromyalgia (de Souza Nascimento, et al., 2013) (Russo, 2004).
Cannabis reduces inflammation, thus potentially offering therapeutic benefit to those with lupus, and can reduce pain associated with the disorder (Nagarkatti, et al., 2009) (Clayton, Marshall, Bountra & O’Shaughnessy, 2002).
Through activation of the cannabinoid receptors, cannabis inhibits the pain response caused by migraines (Akerman, Holland, Lasalandra & Goardsby, 2013) (Baron, 2015) (Greco, et al., 2014).
Cannabis reduces pain and muscle spasms associated with multiple sclerosis and helps slow the disease’s progression (Lakhan & Rowland, 2009) (Pacher, Batkai & Kunos, 2006). One animal study found that cannabinoids reduced damage to myelin caused from inflammation, thereby providing neuroprotection (Pryce, et al., 2003).
Cannabis’ neuroprotective effects and ability to encourage cell health reduces the progression of Parkinson’s disease (More & Choi, 2015). It has also shown to help manage the tremors, rigidity, bradykinesia, motor disability and impairments, sleep problems and pain associated with the disorder (Lotan, Treves, Roditi & Djaldetti, 2014).
Cannabis safely reduces the frequency of tics caused by Tourette syndrome (Muller-Vahl, 2013).
States That Have Approved Medical Marijuana for Central Nervous System Disorders
No states include central nervous system disorders on their list of approved conditions for medical marijuana. However, many do allow medical marijuana for the treatment of specific central nervous system disorders.
For example, Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Iowa, Maine, Mississippi, Missouri, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, South Carolina, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming have approved medical marijuana for the treatment of either epilepsy or seizure disorders. California and Illinois have specifically approved medical marijuana for the treatment of migraines. Arizona, Arkansas, Delaware, Illinois, Maine, Michigan, North Dakota, New Hampshire, Oregon, and Rhode Island have approved medical marijuana for Alzheimer’s disease. Arkansas, Illinois and North Dakota have approved medical marijuana specifically for the treatment of fibromyalgia. Illinois and New Mexico has approved medical marijuana for the treatment of dystonia. Illinois and New Hampshire have approved medical marijuana specifically for the treatment of lupus. Arkansas, Illinois and Minnesota have approved medical marijuana specifically for the treatment of Tourette syndrome. Connecticut, Florida, Georgia, Illinois, Maine, Massachusetts, New Hampshire, New Mexico, New York, and West Virginia have approved medical marijuana for the treatment of Parkinson’s disease. Alaska, Connecticut, Florida, Georgia, Illinois, Maine, Massachusetts, New Hampshire, New Jersey, New Mexico, New York, Vermont, and West Virginia allow medical marijuana for the treatment of multiple sclerosis.
In addition, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. Plus, various other states will consider allowing medical marijuana to be used for the treatment of central nervous system disorders with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Recent Studies on Cannabis’ Effect on Central Nervous System Disorders
- Akerman, S., Holland, P.R., Lasalandra, M.P. and Goadsby, P.J. (2013, September). Endocannabinoids in the brainstem modulate dural trigeminovascular nociceptive traffic via CB1 and “triptan” receptors: implications in migraine. Journal of Neuroscience, 33(37), 14869-77. Retrieved from http://www.jneurosci.org/content/33/37/14869.
- Baron, E.P. (2015, June). Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It’s Been. Headache, 55(6), 885-916. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/head.12570/full.
- Blair, R.E., Deshpande, L.S., and DeLorenzo, R.J. (2015, September). Cannabinoids: is there a potential treatment role in epilepsy? Expert Opinion on Pharmacology, 16(13), 1911-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845642/.
- Campbell, V.A., and Gowran, A. (2007). Alzheimer’s disease; taking the edge off with cannabinoids? British Journal of Pharmacology, 152(5), 655–662. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190031/.
- Cao, C., Li, Y., Liu, H., Bai, G., Mayl, J., Lin, X., Sutherland, K., Nabar, N., and Cai, J. (2014). The potential therapeutic effects of THC on Alzheimer’s disease. Journal of Alzheimer’s Disease, 42(3), 973-4. Retrieved from http://content.iospress.com/articles/journal-of-alzheimers-disease/jad140093.
- Central Nervous System Disease. (2013, October 27). International Neuromodulation Society. Retrieved from http://www.neuromodulation.com/central-nervous-system-disease-definition.
- Chagas, M.H., Zuardi, A.W., Tumas, V., Pena-Pereira, M.A., Sobreira, E.T., Bergamashi, M.M., dos Santos, A.C., Teixeira, A.L., Hallak, J.E., and Crippa, J.A. (2014, November). Effects of cannabidiol in the treatment of patients with Parkinson’s disease: an exploratory double-blind trial. Journal of Psychopharmacology, 28(11), 1088-98. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/0269881114550355.
- Clayton, N., Marshall, F.H., Bountra, C., and O’Shaughnessy, C.T. (2002, April). CB1 and CB2 cannabinoid receptors are implicated in inflammatory pain. Pain, 96(3), 253-60. Retrieved from http://journals.lww.com/pain/pages/articleviewer.aspx?year=2002&issue=04000&article=00005&type=abstract.
- Consroe, P., Sandyk, R., and Snider, S.R. (1986). Open label evaluation of cannabidiol in dystonic movement disorders. International Journal of Neuroscience, 30(4), 277-282. Retrieved from http://www.tandfonline.com/doi/abs/10.3109/00207458608985678?journalCode=ines20.
- Croxford, J.L., Pryce, G., Jackson, S.J., Ledent, C., Giovannoni, G., Pertwee, R.G., Yamamura, T., and Baker, D. (2008, January). Cannabinoid-mediated neuroprotection, not immunosuppression, may be more relevant to multiple sclerosis. Journal of Neuroimmunology, 193(1-2), 120-9. Retrieved from http://www.jni-journal.com/article/S0165-5728(07)00396-7/fulltext.
- de Lago, E., Moreno-Martet, M., Cabranes, A., Ramos, J.A., and Fernandez-Ruiz, J. (2012, June). Cannabinoids ameliorate disease progression in a model of multiple sclerosis in mice, acting preferentially through CB1 receptor-mediated anti-inflammatory effects. Neuropharmacology, (62)7, 2299-308. Retrieved from http://www.sciencedirect.com/science/article/pii/S0028390812000500.
- de Souza Nascimento, S., Desantana, J.M., Nampo, F.K., Ribeiro, E.A., da Silva, D.L., Araujo-Junior, J.X., da Silva Almeida, J.R., Bonjardim, L.R., de Souza Araujo, A.A., and Quintans-Junior, L.J. (2013). Efficacy and safety of medicinal plants or related natural products for fibromyalgia: a systematic review. Evidence-Based Complementary and Alternative Medicine, 2013. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687718/.
- Di Marzo, V., Bifulco, M., and De Petrocellis, L. (2004, September). The endocannabinoid system and its therapeutic exploitation. Nature Reviews, 3(9), 771-84. Retrieved from http://www.nature.com/nrd/journal/v3/n9/full/nrd1495.html.
- Greco, R., Mangione, A.S., Sandrini, G., Nappi, G. and Tassorelli, C. (2014, March). Activation of CB2 receptors as a potential therapeutic target for migraine: evaluation in an animal model. The Journal of Headache and Pain, 15, 14. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995520/.
- Iuvone, T., Esposito, G., Esposito, R., Santamaria, R., Di Rosa, M., and Izzo, A.A. (2004, April). Neuroprotective effect of cannabidiol, a non-psychoactive component from Cannabis sativa, on beta-amyloid-induced toxicity in PC12 cells. Journal of Neurochemistry, 89(1), 134-41. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1471-4159.2003.02327.x/full.
- Kubajewska, I., and Constantinescu, C.S. (2010, August). Cannabinoids and experimental models of multiple sclerosis. Immunobiology, 215(8), 647-57. Retrieved from http://www.sciencedirect.com/science/article/pii/S0171298509001442.
- Lafuente, H., Alvarez, F.J., Pazos, M.R., Alvarez, A., Rey-Santano, M.C., Mielgo, V., Murgia-Esteve, X., Hilario, E., and Martinez-Orgado, J. (2011, September). Cannabidiol reduces brain damage and improves functional recovery after acute hypoxia-ischemia in newborn pigs. Pediatric Research, 70(3), 272-7. Retrieved from http://www.nature.com/pr/journal/v70/n3/full/pr2011171a.html.
- Lakhan, S.E., and Rowland, M. (2009). Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. BMC Neurology, 9(59), doi:10.1186/1471-2377-9-59. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793241/.
- Lotan, I., Treves, T.A., Roditi, Y., and Djaldetti, R. (2014, March-April). Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study. Clinical Neuropharmacology, 37(2), 41-4. Retrieved from http://journals.lww.com/clinicalneuropharm/pages/articleviewer.aspx?year=2014&issue=03000&article=00001&type=abstract.
- More, S.V., and Choi, D.K. (2015, April). Promising cannabinoid-based therapies for Parkinson’s disease: motor symptoms to neuroprotection. Molecular Neurodegeneration, 10, 17. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404240/.
- Muller-Vahl, K.R. (2013). Treatment of Tourette syndrome with cannabinoids. Behavioral Neurology, 27(1), 119-24. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215298/.
- Nagarkatti, P., Pandey, R., Rieder, S.A., Hegde, V.L., and Nagarkatti, M. (2009, October). Cannabinoids as novel anti-inflammatory drugs. Future Medicinal Chemistry, 1(7), 1333-49. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/.
- Overview of Nervous System Disorders. (n.d.). John Hopkins Medicine. Retrieved from http://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/overview_of_nervous_system_disorders_85,P00799/.
- Pacher, P., Batkai, S., and Kunos, G. (2006, September). The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacological Reviews, 58(3), 389-462. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2241751/.
- Pertwee, R.G. (2006, January). Cannabinoid pharmacology: the first 66 years. British Journal of Pharmacology, 147(Suppl 1), S163-S171. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1760722/.
- Pryce, G., Ahmed, Z., Hankey, D.J., Jackson, S.J., Croxford, J.L. Pocock, J.M., Ledent, C., Petzold, A., Thompson, A.J., Giovannoni, G., Cuzner, M.L., and Baker, D. (2003, October). Cannabinoids inhibit neurodegeneration in models of multiple sclerosis. Brain, 126(Pt 10), 2191-202. Retrieved from https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/awg224.
- Russo, E.B. (2004, February-April). Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinology Letters, 25(1-2), 31-9. Retrieved from http://www.nel.edu/pdf_/25_12/NEL251204R02_Russo_.pdf.
- Tripp, D.A., Nickel, J.C., Katz, L., Krsmanovic, A., Ware, M.A., and Santor, D. (2014). A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome. Canadian Urological Association Journal, 8(11-12), E901–E905. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277530/.