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A concussion is a head trauma or traumatic brain injury (TBI) which affects your brain. It occurs when a blow to the head causes the brain to suddenly accelerate within the skull. This results in brain swelling and can lead to serious brain damage when there is enough force that the fluid between the brain and the skull are insufficient to protect the brain from injury.
Concussion injuries can range from mild traumatic brain injury to severe traumatic brain injury. Both singular and repeated concussive events can result in long term effects and even death. This is why concussion is a very high risk for those who play contact sports such as American Football or Hockey, where head injury is common. It’s also why there is always a medical team on hand so that injured players can be quickly evaluated by a health care professional and treated rapidly if they lose consciousness.
Common signs and symptoms of concussion include:
1. a feeling of pressure in the head
3. amnesia around the event that caused the injury
5. ringing in the ears
7. slurring of speech
8. delayed responses
9. being ‘dazed’
12. loss of consciousness
While these symptoms are typically seen immediately after the event, other symptoms may be delayed. They include:
1. loss of concentration
2. memory complaints
4. personality changes
5. sensitivity to noise or light
6. sleep disturbances
Symptoms may appear differently in young children, who may become listless, irritable and lose their balance easily. Children may also lose interest in food and their favorite toys and may cry for no reason.
If concussion symptoms are not noticed and treated quickly, other significant health problems associated with post concussion syndrome, and even death can occur. It’s not uncommon for a TBI to cause very extreme lifelong side effects, or even death. Catching the symptoms quickly is of the utmost importance.
Cannabinoids, including THC and CBD
Cannabinoids are the chemicals found in the cannabis plant which give it its medicinal properties. They contain 5 of the more than 60 active ingredients that are found in the marijuana plant. Cannabinoids include THC, the intoxicating agent which is associated with recreational drug use, and CBD or cannabinol. In recent years CBD and THC have received a lot of public attention for their potential health benefits. These substances have multiple biological effects and therapeutic applications in both the central and peripheral nervous systems.
One of the biological effects of cannabinoids is the regulation of neuronal homeostasis. Neuronal Homeostasis is the body’s ability to preserve, rescue, repair and replace neurons and cells against injury, like concussion. Interestingly, the brain has its own built in cannabinoid receptors. When the brain is injured, it produces increased levels of endocannabinoids. This suggests that these substances play an important role in the ability of the body to repair itself.
Studies of Concussion (TBI) and CBD
Many studies have demonstrated that cannabinoids have a neuroprotective effect. Below are briefly described some of the most interesting in relation to concussion.
A 2014 study tried to determine whether there was a link between the presence of THC and mortality rates after a TBI. They divided the patients into two groups, a THC+ group and a THC- group and compared how each group recovered from their TBIs. Strict criteria were set in order to make sure that the data was reliable. Altogether 446 cases met all the criteria for the study. Overall mortality was 9.9% for the entire group but the mortality rate for the THC+ group was much lower at just 2.4%. This suggests that the cannabinoids present in one group of the study had significantly helped them to recover from their concussions.
A review of preclinical studies conducted in 2017 attempted to assess the therapeutic potential of cannabinoids, including CBD, to minimise the effects of concussion. Specifically the review wanted to know how these molecules interact in the brain and whether or not they are helpful in controlling or modulating the damaging effects of concussion.
The review found that certain TBI induced behavioural changes responded positively to the increased levels of cannabinoid in the system. These include learning and memory, neurological motor impairment, post-traumatic seizures and anxiety. This means that the endocannabinoid system is potentially “druggable” for the treatment of TBI symptoms. This is extremely positive given that there are currently very few medications which are helpful in the treatment of TBI side effects.
The review recommended further study of the changes in the endocannabinoid system that take place during a TBI in order to understand the role that the entire system plays in TBI symptoms and pathology. This review further suggests continued and more specific study of cannabinoids, their neuroprotective properties, and how they may be used to further treat TBIs.
A further study researched what is happening in the brain when a TBI happens. It found that harmful mediators are introduced into the brain environment. Glutamate, ROS and cytokines cause vasoconstriction, excitotoxicity, neuronal cell death and neuroinflammation, all very harmful effects. In turn these processes cause secondary damage and in the case of concussion, are responsible for most concussion symptoms. When endocannabinoids (part of the brain’s repair system) are present via the cannabinoid receptors, they encourage the production of stem cells which can repair or replace other cells, and minimise the harmful effects of concussion.
What does this mean?
All of this means that cannabinoids like CBD appear to have a neuroprotective function when it comes to concussion injuries and other TBIs. More than this though, cannabinoids may well show potential as an effective treatment for the effects that people experience after a TBI.
These studies indicate that cannabinoid-based drugs could be an effective therapeutic solution for concussion and other types of TBI. Importantly, they appear to be able to significantly reduce the impact of a traumatic brain injury, including concussion symptoms but more importantly, they may significantly reduce the mortality rates post TBI.
Other Neurological Conditions and Cannabinoids
The potential neuroprotective qualities of cannabinoids on brain structures (neurons, glial cells and neural progenitor cells) shows promise for both acute and chronic neurodegenerative conditions. A review of studies in this area conducted in 2015 collected all of the experimental evidence available that support the idea that different cannabinoids may be neuroprotective in conditions like adult and neonatal ischemia, brain trauma, Alzheimer’s disease, Parkinson’s disease, Huntington’s chorea and ALS. This collective review concluded that prompt clinical validations were required to validate cannabinoid-based medication for the treatment of all such conditions. The study noted that currently these conditions suffer from a lack of effective treatments to delay or stop the progression of the disease or condition.
In the case of ischemia (bleeding in the brain), studies have found that cannabinoids have a beneficial and neuroprotective effect not only in cases of localized bleeding but in cases of wider spread or global bleeding. Importantly, studies have shown that cannabinoids ameliorate the psychological symptoms of ischemia as well as the physiological symptoms.
The study suggested that cannabinoid-based medications might serve as a new therapy to delay or arrest neurodegeneration in acute and chronic conditions. They do this by normalizing glutamate homeostasis, reducing injury caused by oxidation, and/or reducing localized swelling. They also are possibly capable of activating certain responses in cells in order to control the toxicity of protein aggregates.
The outcomes of concussions are significant and can cause lifelong damage. However, it seems they can be minimised with the provision of a cannabinoid treatment post injury. Concussion symptoms can therefore be significantly improved with appropriate cannabinoid-based medicines. There are countless studies which suggest this. However, most of the studies have been conducted on either animals or cellular models. Even the clinical trials on humans have focused on alleviating specific symptoms rather than fighting disease and injury.
This is why more research is needed into the effects of CBD on not only concussion, but on other illnesses, diseases and conditions too. CBD in particular should be studied in much greater depth for its neuroprotective, anti-inflammatory and antioxidant effects. Given the results of current research, the push should be to approve THC and CBD based medications for use in clinical trials for acute and chronic neurodegenerative disease and injury and to take advantage of its neuroprotective properties in the treatment of such disease and injury in leading institutions such as the American Academy of Neurology. Hopefully as the public’s interest in the use of CBD for medical purposes increases, so too will the research resources given to it.
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