Medical Marijuana Strains for Traumatic Brain Injury:
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Cannabidiol (CBD) is known to have anti-inflammatory, antioxidative, and antiepileptic properties. The neuroprotective advantages of CBD have sparked interest in its therapeutic potential against the secondary injury cascade resulting from traumatic brain injury (TBI). Presently, there is a lack of effective broad treatment strategies to counteract the damaging mechanisms that ensue after the primary injury, often leading to lasting neurological consequences or death [1].
However, CBD’s impact on various neurotransmitter systems, the blood-brain barrier, oxidative stress mechanisms, and the inflammatory response offers support for its clinical utility in the context of TBI.
What is Traumatic Brain Injury?
Traumatic brain injury is caused by an external force, such as a blow, jolt, or penetrating head injury, resulting in temporary or permanent impairment of brain functions [3].
In addition to the immediate primary injury, a secondary injury follows, activating biochemical cascades that induce metabolic and cellular changes. Both primary and secondary injuries are linked to elevated levels of glutamatergic neurotransmitters.
Persistently high extracellular glutamate levels in the brain (up to 120 hours post-TBI) are indicative of an unfavorable prognosis in TBI patients [3]. At elevated concentrations, glutamate contributes to excitotoxicity, neuroinflammation, oxidative stress, and cell death.
Sustained increased glutamatergic neurotransmission following severe TBI poses a risk factor for the development of disorders such as Parkinson’s disease, Alzheimer’s disease, and post-traumatic epilepsy.
It is crucial to note that, to date, there are no therapeutic strategies preventing the long-term consequences of TBI [3]. Approximately 40% of individuals with moderate to severe TBI may experience lasting health impacts and disabilities. TBI is the primary cause of death in individuals under 45 years, necessitating hospitalization and rehabilitation, leading to substantial medical costs.
Medical Marijuana for Traumatic Brain Injury
Preclinical data indicates the potential usefulness of CBD in immediate TBI treatment [1]. However, CBD’s broader potential lies in aiding TBI recovery by mitigating the effects of the secondary injury cascade. If CBD proves effective in ameliorating these symptoms, anticipated long-term benefits extend to survival, neurocognitive function, neurodegenerative outcomes, and neuropsychiatric aspects.
A 2022 study observed that CBD administered orally has been shown to mitigate both short and long-term excitotoxicity induced by traumatic brain injury and facilitate functional recovery [3]. Notably, pretreatment with CBD proved effective in reducing the negative consequences associated with TBI.
The available data on tetrahydrocannabinol (THC) treatment in TBI models are more nuanced than that of CBD [2]. Animal models have shown that gender may make a difference in the possible benefits of THC to TBI, with more benefits being seen in male mouse models.
The cannabis pharmaceutical Sativex (a 1:1 THC:CBD formula) is typically well tolerated in studies of epilepsy and pain, but high-THC marijuana products have not been part of formal TBI research.
Indeed, much research still needs to be done to evaluate the clinical utility of THC for traumatic brain injury [2]. Cannabis terpenes are also a point of interest in future studies.
The cannabis terpene beta-caryophyllene is known to have analgesic benefits and is thought to help reduce neuroinflammation. Limonene, pinene, linalool, terpinene, and citral are also thought to have antioxidant and pain-relieving benefits that could support TBI recovery.
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