Researchers have been on the hunt for a treatment that can slow the progression of Parkinson’s Disease while managing the often-debilitating symptoms that come with it for decades. And it looks like they may be in luck. Recent studies have shown that cannabinoids or CBD could be a significant front-runner when it comes to therapeutic remedies for the treatment of Parkinson’s.
Parkinson’s Disease is a neurodegenerative disease that affects the central nervous system. There are more than 10 million people living with the disease worldwide, most of whom are over the age of 50. The cause still remains largely unknown, but some researchers believe that a genetic predisposition could be the reason, while others think it could have been caused by exposure to pesticides or from serious head injuries. One theory that is gaining traction among medical scientists traces early signs of PD to the gut, the brainstem, and the olfactory bulb in the brain, which operates the sense of smell. New research has shown that the quality of bacteria in the gut – the microbiome – is strongly implicated in the advancement of Parkinson’s, the severity of symptoms, and related mitochondrial dysfunction.
Researchers are currently looking for ways to identify biomarkers for Parkinson’s that can potentially diagnose the disease in its early stages and other treatments that will slow the progression of the disease. Medications that are currently on the market for Parkinson’s that improve symptoms but do not slow the development of the disease. The most common treatment (Levodopa) targets dopamine depletion, but neural damage eventually worsens, the drug becomes ineffective and can even worsen the uncontrolled movements in patients.
The Parkinson’s Foundation defines the disease as a “neurodegenerative disorder that affects predominantly dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.”
It is important to note that patients with PD don’t start to experience symptoms until later in the course of the disease because a tremendous amount of the substantia nigra neurons have already been lost or impaired. Lewy bodies (or the accumulation of abnormal alpha-synuclein) are found in substantia nigra neurons of PD patients.
Here’s how Project CBD describes this phenomenon, “Within the P.D. brain there is an inordinate number of Lewy bodies – intracellular aggregates of difficult to break down protein clusters – that cause dysfunction and demise of neurons. This pathological process results in difficulties with thinking, movement, mood, and behavior. The excessive presence of Lewy bodies, coupled with the deterioration of dopaminergic neurons, are considered to be hallmarks of Parkinson’s. But mounting evidence suggests that these aberrations are advanced-stage manifestations of a slowly evolving pathology.”
It appears that non-motor symptoms occur for years before Parkinson’s progresses to the brain and that P.D. is a multi-system disorder, not just a neurological ailment, which develops over a long period. According to the National Parkinson’s Foundation, motor symptoms of PD only begin to manifest when most of the brain’s dopamine-producing cells are already damaged.
Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. According to the Parkinson’s Foundation, people with PD may experience:
The cause of the disease remains largely unknown. Although there is no cure, treatment options vary and include medications and surgery. While Parkinson’s itself is not fatal, disease complications can be severe. The Centers for Disease Control and Prevention (CDC) rated complications from PD as the 14th cause of death in the United States.
In addition to movement-related (“motor”) symptoms, Parkinson’s symptoms may be unrelated to movement (“non-motor”). People with PD are often more impacted by their non-motor symptoms than motor symptoms. Examples of non-motor symptoms include apathy, depression, constipation, sleep behavior disorders, loss of sense of smell, and cognitive impairment.
If the Parkinson’s is diagnosed early enough, the patient has a better chance of slowing the progression of the disease. Currently, the most common method for treating P.D. is by orally taking L-dopa, the chemical precursor to dopamine. The drawback is that long-term use of the drug will exacerbate Parkinson’s symptoms in some patients. Unfortunately, there is no cure for P.D. yet, but scientists remain hopeful.
Parkinson’s Disease Stages
Parkinson’s affects people differently. Not everyone experiences the same symptoms, and if they do, they won’t necessarily experience them in the same order or intensity. But there are 5 distinct patterns of progression in Parkinson’s Disease, as defined by The Parkinson’s Foundation.
During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. Changes in posture, walking, and facial expressions occur.
Symptoms start getting worse. Tremor, rigidity and other movement symptoms affect both sides of the body. Walking problems and poor posture may be apparent. The person is still able to live alone, but daily tasks are more difficult and lengthy.
Considered mid-stage, loss of balance and slowness of movements are hallmarks. Falls are more common. The person is still fully independent, but symptoms significantly impair activities such as dressing and eating.
At this point, symptoms are severe and limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and is unable to live alone.
This is the most advanced and debilitating stage. Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is required for all activities. The person may experience hallucinations and delusions. The Parkinson’s community acknowledges that there are many important non-motor symptoms as well as motor symptoms.
If you’d like more information on the stages of Parkinson’s, watch this video
CBD and Parkinson’s
Now let’s get into the effects of CBD and Parkinson’s, as explained by Rachel Dolhun, MD via the Michael J. Fox Foundation.
“Marijuana is derived from the plant Cannabis sativa, which contains more than 60 different compounds referred to as cannabinoids. One of these is the major ‘psychoactive’ component — Delta-9-tetrahydrocannabinol (THC) — which causes alterations in perception, mood and behavior. The ratio of THC to the other cannabinoid compounds, which do not have these psychoactive effects, varies from plant to plant and among the various formulations of medical marijuana.
We naturally make our own cannabinoids that bind to receptors found throughout the body and brain — this is called the “endocannabinoid system.” When these cannabinoids bind to receptors, they can impact brain chemicals, including dopamine, which decreases in Parkinson’s. One area of the brain that contains a high number of these receptors is the basal ganglia — the complex of cells that controls movement and is affected in PD. Because the cannabinoids in marijuana work in some of the same sites and ways as those made by the body, researchers have looked into what role they could play in modifying PD and in treating motor and non-motor symptoms.”
Research on Cannabinoids and Parkinson’s
Although clinical and preclinical studies focusing specifically on the use of plant cannabinoids to treat PD are limited, (because of Federal red tape) they do provide insight into how the compound may aid those with the disease. Cannabidiol, THC, and THCV have all shown promise as a therapeutic remedy for PD, enough to warrant further exploration. Further research is needed to reveal which plant cannabinoids or combination of plant cannabinoids is most appropriate for the different stages of Parkinson’s. But the evidence so far suggests that THCA and CBDA have powerful medicinal properties, including anti-inflammatory, anti-nausea, anti-cancer and anti-seizure properties.
A study in the Journal of Molecular Neurobiology has also shown that cannabinoids possess neuroprotective components that help protect the brain cells and reduce injury.
Another study, done by Scientists at the University of Louisville School of Medicine has identified a previously unknown target of cannabidiol, which may have a significant impact on the management of Parkinson’s Disease. According to the research, “CBD activates a G-coupled protein receptor called “GPR6” that is highly expressed in the basal ganglia region of the brain. GPR6 is considered an “orphan receptor” because researchers have yet to find the primary endogenous compound that binds to this receptor.
It has been shown that depletion of GPR6 causes an increase of dopamine, a critical neurotransmitter, in the brain. This finding suggests GPR6 could have a role in the treatment of Parkinson’s, a chronic, neurodegenerative disease that entails the progressive loss of dopaminergic (dopamine-producing) neurons and consequent impairment of motor control. By acting as an ‘inverse agonist’ at the GPR6 receptor, CBD boosts dopamine levels in preclinical studies.”
Another study carried out on animal models of Parkinson’s disease at the Complutense University in Madrid, found that administering THCV lessened motor inhibition, reduced brain cell damage from toxins and protected certain neurons. The authors concluded that “THCV has a promising pharmacological profile for delaying disease progression in PD and also for ameliorating parkinsonian symptoms.”
Learn more about how CBD Hemp Oil can Help Treat Parkinson’s
Using CBD to Treat Parkinson’s
Dosage for patients with P.D. varies quite a bit, so it may be necessary to consult a physician. Dr. Bonni Goldstein, in her book, Cannabis Revealed (2016) discussed how a patient’s response to cannabis therapeutics can vary.
“A number of my patients with PD have reported the benefits of using different methods of delivery and different cannabinoid profiles. Some patients have found relief of tremors with inhaled THC, and other have not. A few patients have found relief with high doses of CBD-rich cannabis taken sublingually. Some patients are using a combination of CBD and THC … Trial and error are needed to find what cannabinoid profile and method will work best. Starting a low-dose and titrating up is recommended, particularly with THC-rich cannabis. Unfortunately, THCV-rich varieties are not readily available.”
Juan Sanchez-Ramos, M.D., Ph.D, Medical Director for the Parkinson’s Research Foundation, encourages his patients to begin with a 1:1 THC:CBD ratio product if they can get it. In his book, “Cannabinoids for the Treatment of Movement Disorders, he and coauthor Briony Catlow, Ph.D, along with Dr. Ethan Russo, compiled that data and described the dosage that provided positive results for patients with P.D.
It’s important to remember that each patient is different and may require personalized medicine and dosage. Speaking in general terms, the most optimal therapy found for Parkinson’s will include a combination of varying amounts of CBD and THC.
Dr. Russo goes on to give general advice for patients with P.D. who are considering cannabis therapy, “2.5 mg of THC is a threshold dose for most patients without prior tolerance to its effects, while 5 mg is a dose that may be clinically effective at a single administration and is generally acceptable, and 10 mg is a prominent dose, that may be too high for naïve and even some experienced subjects. These figures may be revised upward slightly if the preparation contains significant CBD content … It is always advisable to start at a very low dose and titrate upwards slowly.”
For information about other nutritional supplementation to help manage Parkinson’s visit the Life Extension Foundation’s Parkinson’s Page.