The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Neurological disorders are a group of diseases and conditions that affect
the brain, spinal cord and nervous system. Studies have shown cannabis can
delay the onset or limit the progression of various disorders as well as
manage their associated spasms, seizures, tics, pain and other symptoms.
Overview of Neurological Disorders
Neurological disorders are disorders of the body’s nervous system, which
consists of the brain, spinal cord, and nerves. According to the University
of California San Francisco Medical Center, there are more than 600 nervous
system diseases. The most common types include Parkinson’s
disease, epilepsy, stroke, multiple
sclerosis, migraine, tumors of
the brain and spinal cord, Tourette
cord injury, and amyotrophic
lateral sclerosis (ALS).
Damage to the body’s nervous system can be caused by a genetic disorder, a
trauma event that causes a brain or spinal cord injury, tumors,
degeneration, autoimmune disorders or blood flow disruptions. The cause of
some neurological disorders, like Parkinson’s disease, remains unknown.
While symptoms of neurological disorders vary significantly depending on the
specific type of disorder, they can include muscle weakness, loss of muscle
control or poor coordination, paralysis, loss of sensation, spasms,
seizures, loss of mental control, loss of consciousness, confusion and pain.
There is no cure for most neurological disorders, so the focus of treatment
is on limiting the progression of the disorder and managing symptoms.
Medications can be used to control pain, spasms and seizures.
Findings: Effects of Cannabis on Neurological Disorders
Research has shown that cannabis possesses neuroprotective effects, which in
turn support the health of the brain, spinal cord and nerves, and help in
preventing and limiting the progression of various neurological disorders.
The major cannabinoids found in cannabis, including cannabidiol (CBD) and
tetrahydrocannabinol (THC), have both shown they can help protect neurons,
modulate the inflammatory response and encourage neuroregeneration (Lafuente,
et al., 2011) (Kubajewska & Constantinescu, 2010) (Croxford, et al., 2008).
Amyotrophic Lateral Sclerosis (ALS)
The cannabinoids in cannabis have shown they are capable of delaying the
onset of ALS, prolonging neuron survival and slowing the progression of the
disease (Bilsland, et al., 2006) (Carter, Abood, Aggarwal & Weiss, 2010)
(Raman, et al., 2004). CBD specifically has been found to significantly slow
the onset of ALS (Weydt, et al., 2005). Cannabis can also help with managing
the pain, appetite loss, depression, sleeping problems, spasticity and
drooling associated with ALS (Amtmann, et al., 2004) (Carter, Abood,
Aggarwal & Weiss, 2010).
In numerous studies, CBE has demonstrated the ability to reduce or even
eliminate seizures (Blair, Deshpande & DeLorenzo, 2015) (Rosenberg, Tsien,
Whalley & Devinsky, 2015) (Szaflarski & Bebin, 2014) (Devinsky, et al.,
Through their activation of the CB1 and CB2, cannabinoids effectively
inhibits the pain response caused by migraines (Akerman, Holland, Lasalandra
& Goardsby, 2013) (Baron, 2015) (Greco, et al., 2014).
Multiple Sclerosis (MS)
Cannabis’ cannabinoids slow the neurodegenerative process of multiple
sclerosis by helping to regulate the body’s immune system, modulating its
inflammatory response and encouraging neuroregeneration (Kubajewska &
Constantinescu, 2010) (Croxford, et al., 2008). One study showed that
cannabinoids reduced the damage to myelin caused from inflammation, thereby
offering neuroprotection (Pryce, et al., 2003). Another found that
cannabinoids reduced neurological disability, improved motor coordination
and limited the progression of the MS in animals with a model of multiple
sclerosis (de Lago, et al., 2012).
Studies show that cannabis’ neuroprotective effects can slow the progression
of Parkinson’s. Its cannabinoids suppress excitotoxicity, glial activation
and oxidative injury that lead to neuron degeneration. They improve the
mitochondria function and the clearance of cellular debris, which also
supports neuron health (More & Choi, 2015) (Garcia-Arencibia, Garcia &
Fernandez-Ruiz, 2009) (Lastres-Becker & Fernandez-Ruiz, 2006) (Zeissler, et
al., 2013). THC specifically prevents neuron damage caused by free radicals
and activates a receptor that encourages the formation of new mitochondria
(Zeissler, et al., 2013). CBD has also shown to support the health of neural
cells mitochondria (da Silva, et al., 2014) (Zuardi, 2008).
Cannabis effectively reduces neuropathic pain (Jensen, Chen, Furnish &
Wallace, 2015) (Baron, 2015) (McDonough, McKenna, McCreary & Downer, 2014).
Cannabis-based medicines have even shown they can reduce chronic neuropathic
pain that had previously proven refractory to other treatments (Boychuk,
Goddard, Mauro & Orellana, 2015).
CBD has shown to protect neurons against prion toxicity and therefore
reduced the risk of prion diseases, a group of rare degenerative brain
disorders (Dirikoc, et al., 2007).
Spinal Cord Injury
Cannabis’ cannabinoids limit neurological damage caused by a spinal cord
injury if administered shortly after the traumatic event. The cannabinoids
reduce the proinflammatory cytokines and delay the atrophy and degeneration
of neurons and thereby protect the white matter and myelin sheath
surrounding the cord and nerves (Arevalo-Martin, Garcia-Ovejero &
Molina-Holgado, 2010) (Latini, et al., 2014) (Arevalo-Martin, Garcia-Ovejero
& Molina-Holgado, 2010) (Arevalo-Martin, et al., 2012). An animal trial have
found the administration of cannabinoids shortly after a spinal cord injury
caused an improvement in locomotor functional recovery (Kwiatkoski,
Guimaraes & Del-Bel, 2012). In addition, cannabis has found to be among the
most effective pain relief treatments for people with spinal cord injuries
(Wilsey, et al., 2013) (Heutink, Post, Wollaars & van Asbeck, 2011).
Cannabinoids reduce infarct volume and improving functional outcome
following strokes (England, Hind, Rasid & O’Sullivan, 2015). When
administered shortly after a stroke, CBD specifically protects neurons and
astrocytes from damage, and therefore leads to improved functional,
histological, biochemical, and neurobehavior recovery (Lafuente, et al.,
Cannabis effectively suppresses tics and improves behavioral problems
associated with Tourette syndrome (Muller-Vahl, 2013) (Muller-Vahl, et al.,
Tumors of the Brain and Spinal Cord
CBD has shown it has anti-tumor properties, with one study showing it
significantly inhibited the growth of cancer cells (Massi, et al., 2004).
States That Have Approved Medical Marijuana for Neurological Disorders
No states include “neurological disorders” on their list of approved
conditions for medical marijuana, although Pennsylvania allows
medicinal cannabis for “damage to the nervous tissue of the spinal cord with
objective neurological indication of intractable spasticity.” Additionally,
many other states allow medical marijuana for the treatment of specific
For example, Arizona, Arkansas, Connecticut, Delaware, Florida, Georgia, Maine, Massachusetts, Michigan, Minnesota, New
Dakota, Ohio and Pennsylvania have
approved medical marijuana for the treatment of ALS. Alabama, Connecticut, Delaware, Florida, Georgia, Iowa, Louisiana, Maine, Mississippi, Missouri, New
Dakota, Ohio, Oklahoma, Pennsylvania, South
Carolina, Texas, Utah, 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. Arkansas, Montana, New
York and Pennsylvania have
approved medical marijuana for the treatment of neuropathy. New
Dakota, Ohio and Pennsylvania have
approved medical marijuana specifically for the treatment of spinal
cord injuries. Arkansas, Illinois, Minnesota and Ohio have
approved medical marijuana specifically for the treatment of Tourette
syndrome. Connecticut, Florida, Georgia, Illinois, Maine, Massachusetts, New
York, Ohio and Pennsylvania have
approved medical marijuana for the treatment of Parkinson’s
disease. Alaska, Connecticut, Florida, Georgia, Illinois, Maine, Massachusetts, New
York, Ohio, Pennsylvania and Vermont allow
medical marijuana for the treatment of multiple
sclerosis. Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New
Dakota, Ohio, Oregon, Pennsylvania, Rhode
and Washington legally
allow medical marijuana for the treatment of cancer, including tumors.
Currently, no states have approved medical marijuana specifically for the
treatment of stroke.
However, 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
neurological 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”).
In addition, various states have approved medical marijuana for symptoms
commonly associated with neurological disorders. Many states have approved
medical marijuana specifically to treat chronic
pain. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Dakota, Montana, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.” Alaska, Arizona, Arkansas, California, Colorado, Delaware, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Dakota, Ohio, Oregon, Pennsylvania (intractable
Island, Tennessee (intractable
seizures), Vermont and Washington have
approved medical marijuana to treat seizures. Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oregon, Rhode
Island and Washington have
approved medical marijuana for the treatment of spasms.
Recent Studies on Cannabis’ Effect on Neurological Disorders
Cannabis delays the onset of ALS and slow the progression of the
and amyotrophic lateral sclerosis: hypothetical and practical
applications, and a call for clinical trials.(http://www.ncbi.nlm.nih.gov/pubmed/20439484)
CBD-enriched cannabis reduced seizure frequency in 85% of
children and caused complete seizure freedom in 14% of children.Perceived
efficacy of cannabidiol-enriched cannabis extracts for treatment
of pediatric epilepsy: A potential role for infantile spasms and
Lennox-Gastaut syndrome. (http://www.ncbi.nlm.nih.gov/pubmed/25935511)
Cannabinoids administered shortly following spinal cord injury
endogenous activation of CB1 and CB2 receptors after spinal cord
injury is a protective response involved in spontaneous
cannabis significantly improved tremors, rigidity and
bradykinesia in Parkinson’s disease patients.Cannabis
(medical marijuana) treatment for motor and non-motor symptoms
of Parkinson disease: an open-label observational study.(http://www.ncbi.nlm.nih.gov/pubmed/24614667)
CBD administered shortly following an ischemic event increased
the recovery of electrical activity in the brain by about 50%
and reduced seizures by 50%.Neuroprotective
effects of the nonpsychoactive cannabinodi cannabidiol in
hypoxic-ischemic newborn piglets. (http://www.ncbi.nlm.nih.gov/pubmed/18679164)Cannabinoids
reduced neurological disability and the progression of multiple
sclerosis in mice.Cannabinoids
ameliorate disease progression in a model of multiple sclerosis
in mice, acting preferentially through CB1 receptor-mediated
anti-inflammatory effects. (http://www.ncbi.nlm.nih.gov/pubmed/22342378)
Four weeks of cannabis treatment significantly improved spasms
in MS patients.A
randomized double-blind-placebo-controlled, parallel-group,
enriched-design study of nabiximols* (Sativex(®)), as add-on
therapy, in subjects with refractory spasticity caused by
multiple sclerosis. (http://www.ncbi.nlm.nih.gov/pubmed/21362108)
Cannabis significantly improves neuropathic pain that was
refractory to other treatments.The
effectiveness of cannabinoids in the management of chronic
nonmalignant neuropathic pain: a systematic review.(http://www.ncbi.nlm.nih.gov/pubmed/25635955)
Six weeks of cannabis treatment reduced tics in patients with
reduce symptoms of Tourette’s syndrome. (http://www.ncbi.nlm.nih.gov/pubmed/14521482)
Akerman, S., Holland, P.R., Lasalandra, M.P. and Goadsby, PJ. (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.
Amtmann, D., Weydt, P., Johnson, K.L., Jensen, M.P., and Carter, G.T.
(2004). Survey of cannabis use in patients with amyotrophic lateral
American Journal of Hospice and Palliative Care, 21(2), 94-104.
Arevalo-Martin, A., Garcia-Ovejero, D., and Molina-Holgado, E. (2010, May).
The endocannabinoid 2-arachidonoylglycerol reduces lesion expansion and
white matter damage after spinal cord injury. Neurobiology
of Disease, 38(2), 304-12.
Arevalo-Martin, A., Garcia-Ovejero, D., Sierra, Palomares, Y.,
Paniagua-Torija, B., Gonzalez-Gil, I., Oretega-Gutierrez, S., and
Molina-Holgado, E. (2012). Early endogenous activation of CB1 and CB2
receptors after spinal cord injury is a protective response involved in
spontaneous recovery. PLos
One, 7(11), e49057.
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,
Bilsland, L.G., Dick, J.R., Pryce, G., Petrosino, S., Di Marzo, V., Baker,
D., and Greensmith, L. (2006). Increasing cannabinoid levels by
pharmacological and genetic manipulation delay disease progression in SOD1
FASEB Journal, 20(7),
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.
Boychuk, D.G., Goddard, G., Mauro, G., and Orellana, M.R. (2015, Winter).
The effectiveness of cannabinoids in the management of chronic nonmalignant
neuropathic pain: a systematic review. Journal
of Oral & Facial Pain and Headache, 29(1), 7-14.
Carter, G.T., Abood, M.E., Aggarwal, S.K and Weiss, M.D. (2010). Cannabis
and amyotrophic lateral sclerosis: hypothetical and practical applications,
and a call for clinical trials. American
Journal of Hospice & Palliative Medicine, 27(5), 347-356.
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.
da Silva, V.K., de Freitas, B.S., da Silva Dornelles, A., Nery, L.R.,
Falavigna, L., Ferreira, R.D., Bogo, M.R., Hallak, J.E., Zuardi, A.W.,
Crippa, J.A., and Schroder, N. (2014, February). Cannabidiol normalizes
caspase 3, synaptophysin, and mitochondrial fission protein DNM1L expression
levels in rats with brain iron overload: implications for neuroprotection. Molecular
Neurobiology, 49(1), 222-33.
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,
Devinsky, O., Cilio, M.R., Cross, H., Fernandez-Ruiz, J., French, J., Hill,
C., Katz, R., Di Marzo, V., Jutras-Aswad, D., Notcutt, W.G.,
Martinez-Orgado, J., Robson, P.J., Rohrback, B.G., Thiele, E., Whalley, B.,
and Friedman, D. (2014, June). Cannabidiol: pharmacology and potential
therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia,
Dirikoc, S., Priola, S.A., Marella, M., Zsurger, N., and Chabry, J. (2007,
September 5). Nonpsychoactive cannabidiol prevents prion accumulation and
protects neurons against prion toxicity. Journal
of Neuroscience, 27(36), 9537-44.
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England, T.J., Hind, W.H., Rasid, N.A., and O’Sullivan, S.E. (2015, March).
Cannabinoids in experimental stroke: a systematic review and meta-analysis. Journal
of Cerebral Blood Flow and Metabolism, 35(3), 348-58.
Garcia-Arencibia, M., Garcia, C., and Fernandez-Ruiz, J. (2009, December).
Cannabinoids and Parkinson’s disease. CNS
& Neurological Disorders Drug Targets, 8(6), 432-9.
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.
Heutink, M., Post, M.W., Wollaars, M.M., and van Asbeck, F.W. (2011).
Chronic spinal cord injury pain: pharmacological and non-pharmacological
treatments and treatment effectiveness. Disability
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Jensen, B., Chen, J., Furnish, T., and Wallace, M. (2015, October). Medical
Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence. Current
Pain and Headache Reports, 19(10),
Kubajewska, I., and Constantinescu, C.S. (2010, August). Cannabinoids and
experimental models of multiple sclerosis. Immunobiology,
Kwiatkoski, M., Guimaraes, F.S., and Del-Bel, E. (2012, April).
Cannabidiol-treated rats exhibited higher motor score after cryogenic spinal
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Lafuente, H., Alvarez, F.J., Pazos, M.R., Alvarez, A., Rey-Santano, M.C.,
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Lastres-Becker, I., and Fernandez-Ruiz, J. (2006). An overview of
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Cannabinoid CB2 receptor (CB2R). stimulation delays rubrospinal
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Massi, P., Vaccani, A., Ceruti, S., Colombo, A. Abbracchio, M.P., and
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McDonough, P., McKenna, J.P., McCreary, C., and Downer, E.J. (2014,
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