Cannabis Treatment for Parkinsons

1.0 Introduction

Emerging as a neurodegenerative disorder, Parkinson’s disease has been associated with progressive deterioration of patients’ motor function. According to Shi, Cai, and Zhang et al. (2017), this degeneration is attributed to a significant loss in the individuals’ dopamine-producing brain cells. Some of the symptoms associated with the condition include a shuffling gait and impaired balance. Similarly, Finseth, Hedeman, and Binder at al. (2015) documented that Parkinson's disease exhibits additional secondary conditions such as dementia, depression, and anxiety. Whereas most diagnoses have been done when patients are aged 60, and above, early-onset cases have been reported. With patients losing their muscle control progressively, their heads and limbs tremble while at rest, leading to slowness and even stiffness. From the treatment perspective, most of the existing scholarly contributions affirm that Parkinson’s disease is yet to receive a specific treatment approach. However, a number of therapies have been established in a quest to delay the condition’s onset of motor symptoms and even ameliorate them. As observed by Rodriguez, Gorriti, and Bilbao et al. (2001), most therapies seeking to address this condition aim to increase the brain's dopamine amount via mechanisms such as prolonging dopamine’s effect, mimicking it, or replacing the dopamine. To prolong its effect, the therapies inhibit its breakdown.

Indeed, from this premise of the emergence of therapies that seek to delay the onset of symptoms of Parkinson's disease, recent studies have focused on the use of cannabis. Given the difference in the contexts and demographic or environmental conditions in which these studies are conducted, varying outcomes have been reported. Hence, it becomes imperative to review these studies and results to determine whether parallels can be drawn between their findings. In this paper, the main aim is to review the evidence accruing from studies that have sought to determine the extent to which the adoption and implementation of cannabis treatment alter the severity of Parkinson's disease.

2.0 Review of Evidence

In the study by Finseth, Hedeman, and Binder at al. (2015), the main aim was to establish the self-reported efficacy of cannabis in relation to complementary therapies among Parkinson's disease patients. The study was conducted in the context of Colorado. Therefore, the leading objective or motivation was to examine the efficacy and use of complementary and alternative medicine in shaping the nature of symptoms among patients in the selected context, with particular attention directed to cannabis. Imperative to highlight is that the authors noted that medical cannabis is legal in Colorado upon authorization from physicians. From the methodological perspective, self-administered surveys targeted the Denver metro area's Parkinson's disease support groups, as well as patients at the University of Colorado Hospital Movement Disorders Clinics. From the sampling perspective, 217 patients participated, and the inclusion criterion was that they were supposed to be Parkinson's syndrome patients. From the findings, it was established that a smaller number of participants had opted for cannabis. The latter group, benefits included improvements in the quality of life at 22 percent, motor symptoms also at 22 percent, sleep at 56 percent, and mood benefits at 56 percent. However, the usage rate was lower, and the motor response was lower. Hence, the role of cannabis in Parkinson’s disease could not be delineated clearly. It was also established that education levels, income levels, and the age of onset of Parkinson’s disease play a moderating role in determining the effectiveness of cannabis as a treatment modality. Despite these insightful outcomes, the study was limited by a failure to track refusal rates, suggesting a biased estimate in the prevalence of the use of cannabis in the rest of the Parkinson’s disease’s population. Additionally, highly educated patients and predominantly white men were typical of the selected sample, failing to be representative.

Another study was conducted by Babayeva, Assefa, and Basu et al. (2016) regarding the use of marijuana compounds as a non-conventional intervention or therapy in patients diagnosed with Parkinson's disease. The review aimed at investigating the scientific evidence suggesting that marijuana and its components aid in treating Parkinson's disease. The authors noted that most treatment approaches in existence only relieve motor symptoms associated with the condition. It was also asserted that these treatment approaches exhibit several side effects, including dyskinesia (p. 9). Similarly, it was observed that the therapies in existence fail to slow the condition's progression, prompting an urgent need for drugs that are deemed safer. Findings indicated that the use of medical marijuana and its associated components imply that cannabinoids act in a similar fashion as the neurological pathway that undergoes disruption in Parkinson's disease. It was concluded that cannabinoids play a crucial role in treating movement disorders in several ways. Some of these mechanisms include the effect on motor activity, the localization of its receptors in areas perceived to be responsible for controlling movement, and motor behavior regulation. Specific beneficial effects were noted to include improvements in non-motor symptoms such as anxiety, sleep, pain, and depression, besides antiexcitotoxic, antioxidative, and anti-inflammatory properties. Despite the criticality of the results, the authors failed to account for differences in physical environments in which patients are found and how such differences could shape the degree of the impact of cannabis treatment of Parkinson’s disease.

Rodriguez, Gorriti, and Bilbao et al. (2001) examined the endogenous cannabinoid system's impact in modulating dopamine transmission. The experiment conducted on rats indicated that the endogenous cannabinoid system forms a target for developing new strategies through which dopamine-related diseases can be treated, including Parkinson's disease. Indeed, it was noted that dopaminergic agonists help reduce unwanted effects arising from Parkinson's disease. It was also observed that the endogenous cannabinoid system plays the crucial role of protecting neurons from a number of forms of injury arising from glutamate overstimulation. The injuries were also asserted as those that could arise from the release of dopamine in the central synapse. Hence, the study was critical because it established a direct relationship between the use of the endogenous cannabinoid system and the treatment of dopamine-related diseases, including Parkinson’s disease. However, the findings faltered in such a way that the environment to which rats are exposed, which formed the central focal point of the experiment, differs from that which characterizes human interactions—as such, generalizing the outcomes to the contexts of humans or patients with Parkinson’s disease prompts a consideration of such variations in environmental experiences between rats and human beings.

In the study by Bega, Gonzalez-Latapi, Zadikoff, and Simuni (2014), the supreme objective was to review the clinical evidence regarding the use of alternative and complementary therapies in treating Parkinson's disease. The study used secondary data sources in which electronic databases such as Cochrane Library and Medline were accessed via search terms linked to the topic. From the review, the authors noted that in the majority of the previous literature and experiments, patients who have opted for the use of cannabis and its associated components to treat Parkinson's disease tend to be younger. Dominant groups that were noted to use this therapy were found to include those with poorer statuses and more severe symptoms, longer disease duration, and higher levels of education and income. Regarding the study's specific objective, it was noted that cannabis treatment increases brain connectivity via the release of neurotrophic factors and through neuroplasticity, improves oxidative stress and mitochondrial dysfunction, provides anti-inflammatory effects, and shapes the nature of neurogenesis (p. 15). Imperative to highlight is that this impact was perceived to be present in patients with the aforementioned socio-economic and physical status. For patients who could exhibit unrelated statuses, the authors failed to document the manner in which cannabis treatment could alter their disease outcomes.

Lastly, Shi, Cai, and Zhang et al. (2017) affirmed that in the substantia nigra, a loss in dopaminergic neurons forms the leading pathological feature. As such, the authors sought to investigate the impact of cannabinoid receptor two agonists in treating Parkinson's disease (with a mouse model on focus). Hence, an experimental approach was used to obtain first-hand information. Specific activities included behavioral tests, brain and blood distribution of AM1241, real-time PCR, and immunohistochemistry. Findings suggested that with AM1241 treatment, significant therapeutic effects would be felt in Parkinson's disease mice. Specifically, AM1241 was found to foster DA neuron degeneration (upon MPTP-induced neurotoxicity). Hence, it was observed that AM1241 accounts for the promotion of DA neuron regeneration and the resultant alleviation of MPTP-induced Parkinson’s disease. However, this experiment was conducted with Parkinson’s disease mice, failing to explain possible differences in the impact, if any, for the case of humans.

3.0 Conclusion

In summary, most of the existing studies point to the beneficial role of cannabis treatment in addressing Parkinson’s disease. Specific effects of this treatment include improvements in the quality of life, motor symptoms, sleep, mood benefits, and the localization of its receptors in areas perceived to be responsible for controlling movement (as well as the regulation of motor behavior). However, these studies are conducted in different socio-cultural and physical environments. Similarly, some of the studies rely on animal experiments. Therefore, the possible effect of these differences in the settings and demographic factors on the degree to which cannabis treatment aids in addressing the selected disorder remains unaddressed. Overall, the existing evidence is worth acknowledging because it points out the relationship between cannabis treatment and symptom alleviation, proceeding to highlight potential side effects. In the future, there is a need for studies to account for the potential role of environmental and demographic conditions in shaping the degree of success of this therapy.