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The potential role of cannabis in managing Chronic Traumatic Encephalopathy (CTE) is an area of ongoing research, and findings are not conclusive. Cannabis contains compounds known as cannabinoids, and some studies suggest that these compounds may have neuroprotective and anti-inflammatory properties, which could potentially be relevant in the context of CTE. Researchers are hopeful that cannabis may help relieve pain, anxiety, and sleep disturbances in CTE patients. However, individual responses can vary.
What is Chronic Traumatic Encephalopathy?
Chronic Traumatic Encephalopathy (CTE) is a type of traumatic brain injury that was first recognized in boxers [1]. Because of this, it was first called being “punch drunk” or “boxer’s dementia (dementia pugilistica).” Chronic Traumatic Encephalopathy is believed to be caused by repeated head injuries, particularly concussions or subconcussive blows to the head. Repeated closed-head injuries and repeated concussions occur most often in athletes who participate in sports like boxing, rugby, football, and hockey. However, military veterans and domestic abuse survivors have also been diagnosed with CTE.
Approximately 17% of people with a repetitive concussion or mild traumatic brain injury develop CTE [1]. The exact mechanism is not fully understood, but the accumulation of an abnormal protein called tau and the development of neurofibrillary tangles in specific brain regions are key characteristics. An inflammatory cascade causes tau to accumulate and form neurofibrillary tangles, which can disrupt normal brain cell function and lead to the degeneration of brain tissue over time. Symptoms of CTE may vary and may not appear until decades after the initial head injuries. Common symptoms include:
Memory Loss: Progressive loss of memory and cognitive function
Impaired Judgment: Difficulty making sound decisions and assessing situations
Confusion and Disorientation: Feeling disoriented and having trouble understanding one’s surroundings
Mood and Behavioral Changes: Aggression, irritability, impulsivity, depression, and anxiety are common
Motor Impairments: Problems with coordination, tremors, and difficulty with movements
Speech and Language Difficulties: Communication problems, including slurred speech
Dementia: Advanced stages may involve severe cognitive decline and dementia
There is no specific cure for Chronic Traumatic Encephalopathy, and treatment primarily focuses on managing symptoms. Supportive care and strategies to address specific cognitive and behavioral issues can include cognitive rehabilitation, behavioral therapy, and medications to relieve depression or anxiety.
Medical Cannabis for Chronic Traumatic Encephalopathy
Cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD), along with cannabis terpenes (caryophyllene) can have direct activity on the cannabinoid receptors CB1 and CB2 (tetrahydrocannabinol, THC, caryophyllene) [3]. They can also indirectly modulate the body through other receptors like peroxisome proliferator-activated receptor-gamma (PPAR) and 5-HT1A serotonin receptors (CBD, CBDA). THC and CBD have been used in combination for the relief of headaches, nausea, insomnia, dizziness, agitation, substance abuse, and psychotic symptoms associated with CTE. However, these studies have mostly been anecdotal/informal, or performed in cell or animal models. It is thought that the neuroprotective properties of CBD may be especially beneficial to CTE patients, but the use of high-THC marijuana is less common.
Researchers have examined the use of cannabinoids more broadly in traumatic brain injury and have found that the endocannabinoid system may be a mechanism for alleviating symptoms and preventing conditions from worsening. In mild cases of traumatic brain injury, early treatment (within 24 hours) to elevate endocannabinoid levels has been shown to reduce neuroinflammation and improve recovery [2]. While little research exists on the treatment of CTE with cannabinoids, early treatment of the initial traumatic brain injury may help prevent CTE development. Ultimately, patients looking to treat Chronic Traumatic Encephalopathy with cannabis will need to work closely with a medical cannabis doctor to determine the most appropriate course of action.
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