Spinocerebellar ataxia is a group of inherited genetic disorders that cause
the degeneration of the brain’s cerebellum. Studies have shown cannabis
offers neuroprotective effects, therefore potentially limiting the
progression of the disorder, and can help patients manage pain and spasms.
Overview of Spinocerebellar Ataxia
Spinocerebellar ataxia (SCA) is a group of progressive and degenerative
genetic diseases that cause movement problems. There are many different
types of spinocerebellar ataxia, each of which causes the cerebellum to
degenerate that in turn causes a loss in muscle coordination. Most cases of
spinocerebellar ataxia are hereditary.
Spinocerebellar ataxia can develop in people of all ages. Symptoms usually
begin with coordination and balance problems. As the disease progresses,
speech and swallowing difficulties, muscle spasms and stiffness, eye muscle
weakness and involuntary movement and cognitive impairment often occur.
Those with SCA will also often experience numbness, tingling or pain in
their limbs, uncontrolled muscle tensing, muscle wasting and muscle
twitching. People with SCA live about 10 to 20 years after symptoms first
There is no cure for spinocerebellar ataxia and the disorder is often fatal.
Treatment efforts typically focus on managing symptoms associated with the
disorder and physical therapy to strengthen and reduce atrophy in muscles.
Findings: Effects of Cannabis on Spinocerebellar Ataxia
While research on cannabis’ direct effect on spinocerebellar ataxia is
limited, studies have shown that cannabis has neuroprotective effects,
suggesting that it could potentially limit the progression of the disease.
Cannabinoids suppress excitotoxicity, glial activation and oxidative injury
that cause the degeneration of the neurons. They improve the function of
cell’s mitochondria and activation of cellular debris clearance, further
encouraging neuron health (More & Choi, 2015) (Garcia-Arencibia, Garcia &
Fernandez-Ruiz, 2009) (Lastres-Becker & Fernandez-Ruiz, 2006) (Zeissler, et
al., 2013). A major cannabinoid found in cannabis, tetrahydrocannabinol
(THC), has been shown to help in the treatment of Parkinson’s disease by
preventing free radical damage and encouraging the formation of new
mitochondria (Zeissler, et al., 2013). Cannabidiol (CBD), another major
cannabinoid found in cannabis, has also demonstrated its ability to support
the health of neural cells mitochondria, causing the researchers concluded
that CBD should be considered as a potential therapeutic option in
neurodegenerative disorders (da Silva, et al., 2014) (Zuardi, 2008).
Cannabinoids have also shown to protect the brain in patients with
Alzheimer’s disease by reducing the deleterious effects of amyloid-beta,
reduce inflammation, and support the brain’s repair process by enhancing
neurogenesis, or the birth of new cells (Campbell & Gowran, 2007).
Cannabis can also help spinocerebellar ataxia patients manage the muscle
spasms and pain associated with their disease. Medical cannabis has been
shown to significantly improve muscle spasticity, both in mice and clinical
trials (Borgelt, Franson, Nussbaum & Wang, 2013) (Baker, et al., 2000). THC
and CBD, through their activation of the CB1 and CB2 cannabinoid receptors,
help regulate the excitatory and inhibitory neurotransmitters necessary to
curtail spasms (Syed, McKeage & Scott, 2014) (Smith, 2002). Their activation
of the CB1 and CB2 receptors also helps in the management of pain. These
receptors regulate the release of neurotransmitter and central nervous
system immune cells to manage pain levels (Woodhams, Sagar, Burston &
Chapman, 2015). Studies reveal that THC and CBD effectively reduce pain
associated with some cancer, neuropathy, spasticity, headache, migraines,
and other acute pain and chronic pain conditions (Jensen, Chen, Furnish &
Wallace, 2015) (Baron, 2015). They are effective against both neuropathic
and nociceptive pain, and have shown to help manage pain that had previously
proven refractory to other treatments (Boychuck, Goddard, Mauro & Orellana,
2015) (Wallace, et al., 2015) (Lynch & Campbell, 2011). One study found that
94% of HIV-positive patients reported an improvement in muscle pain and 90%
reported an improvement in nerve pain after cannabis use (Woolridge, et al.,
States That Have Approved Medical Marijuana for Spinocerebellar Ataxia
Currently, only the state of Illinois has
approved medical marijuana for the treatment of spinocerebellar ataxia.
However, in Washington
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment. In addition, various other
states will consider allowing medical marijuana to be used for the treatment
of spinocerebellar ataxia 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”).
Seventeen states have approved medical marijuana for the treatment of
spasms, which are commonly associated with spinocerebellar ataxia. These
states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oregon, Rhode
Island and Washington.
Several states have approved medical marijuana specifically to treat
“chronic pain,” a symptom associated with spinocerebellar ataxia. 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, 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.”
Recent Studies on Cannabis’ Effect on Spinocerebellar Ataxia
CBD restored brain protein levels after damage, showing it
offers memory-rescuing and neuroprotective properties.Cannabidiol
normalizes caspase 3, synaptophysin, and mitochondrial fission
protein DNM1L expression levels in rats with brain iron
overload: implications for neuroprotection. (http://www.ncbi.nlm.nih.gov/pubmed/23893294)
Smoking cannabis significantly reduced tremors, rigidity and
(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)
Baker, D., Pryce, G., Croxford, J.L., Brown, P., Pertwee, R.G., Huffman,
J.W., and Layward, L. (2000, March 2). Cannabinoids control spasticity and
tremor in a multiple sclerosis model. Nature,
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,
Borgelt, L.M., Franson, K.L., Nussbaum, A.M., and Wang, G.S. (2013,
February). The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy,
Boychuck, D.G., Goddard, G., Mauro, G., and Orellana, M.F. (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.
Campbell, V. A., & Gowran, A. (2007). Alzheimer’s disease; taking the edge
off with cannabinoids? British
Journal of Pharmacology, 152(5),
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), 973-84.
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.
Eubanks, L.M., Rogers, C.J., Beuscher, A.E. 4th, Koob, G.F., Olson, A.J.,
Dickerson, T.J., and Janda, K.D. (2006, November-December). A molecular link
between the active component of marijuana and Alzheimer’s disease pathology. Molecular
Pharmaceuticals, 3(6), 773-7.
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.
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),
Lastres-Becker, I., and Fernandez-Ruiz, J. (2006). An overview of
Parkinson’s disease and the cannabinoid system and possible benefits of
cannabinoid-based treatments. Current
Medicinal Chemistry, 13(30< 3705-18.
Lynch, M.E., and Campbell, F. (2011, November). Cannabinoids for treatment
of chronic non-cancer pain; a systematic review of randomized trials. British
Journal of Clinical Pharmacology, 72(5), 735-744.
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.
NINDA Ataxias and Cerebellar or Spinocerebellar Degeneration Information
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Institute of Neurological Disorders and Stroke. Retrieved from
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& Therapeutics, 95(2), 165-74.
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Syed, Y.Y., McKeage, K., and Scott, L.J. (2014, April).
Delta-9-tetrahydrocannabinol-cannabidiol (Sativex): a review of its use in
patients with moderate to severe spasticity due to multiple sclerosis. Drugs,
Wallace, M.S., Marcotte, T.D., Umlauf, A., Gouaux, B., and Atkinson, J.H.
(2015, July). Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. Journal
of Pain, 16(7), 616-27.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role
of the endocannabinoid system in pain. Handbook
of Experimental Pharmacology, 227, 119-43.
Woolridge, E., Barton, S., Samuel, J., Osario, J., Dougherty, A., and
Holdcroft, A. (2005, April). Cannabis use in HIV for pain and other medical
of Pain and Symptom Management, 29(4), 358-67.
Zeissler, M.L., Eastwood, J., Hanemann, C.O., Zajicek,J., and Carroll, C.,
(2013). 9-Tetrahydrocannabinol is protective through PPARy dependent
mitochondrial biogenesis in a cell culture model of Parkinson’s disease. Journal
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