Cannabinoids in the management of behavioral, psychological, and motor symptoms of neurocognitive disorders: a mixed studies systematic review

Abstract

Aim We undertook this systematic review to determine the efficacy and safety of cannabis-based medicine as a treatment for behavioral, psychological, and motor symptoms associated with neurocognitive disorders. Methods We conducted a PRISMA-guided systematic review to identify studies using cannabis-based medicine to treat behavioral, psychological, and motor symptoms among individuals with Alzheimer's disease (AD) dementia, Parkinson’s disease (PD), and Huntington’s disease (HD). We considered English-language articles providing original data on three or more participants, regardless of design. Findings We identified 25 studies spanning 1991 to 2021 comprised of 14 controlled trials, 5 pilot studies, 5 observational studies, and 1 case series. In most cases, the cannabinoids tested were dronabinol, whole cannabis, and cannabidiol, and the diagnoses included AD (n = 11), PD (n = 11), and HD (n = 3). Primary outcomes were motor symptoms (e.g., dyskinesia), sleep disturbance, cognition, balance, body weight, and the occurrence of treatment-emergent adverse events. Conclusions A narrative summary of the findings from the limited number of studies in the area highlights an apparent association between cannabidiol-based products and relief from motor symptoms in HD and PD and an apparent association between synthetic cannabinoids and relief from behavioral and psychological symptoms of dementia across AD, PD, and HD. These preliminary conclusions could guide using plant-based versus synthetic cannabinoids as safe, alternative treatments for managing neuropsychiatric symptoms in neurocognitive vulnerable patient populations.

Circulating endocannabinoid levels in pregnant women with gestational diabetes mellitus: a case–control study

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Cys-loop receptors on cannabinoids: All high?

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The Antimicrobial Properties of Cannabis and Cannabis-Derived Compounds and Relevance to CB2-Targeted Neurodegenerative Therapeutics

“…In the brain, CB2 is expressed by microglia, astrocytes and neurons, while CB2-agonism may induce cell-specific events [ 1 ]. CB2-engaging molecules, including cannabinoids, have received considerable attention as potential therapeutic and/or preventive agents for neuropathic pain, neuroinflammation, variant dementias, and other neuropathies [ 1 , 2 , 3 , 4 ]. As reviewed elsewhere, CB2 manipulation has shown preclinical promise in treating Alzheimer’s disease (e.g., reduced Tao phosphorylation; protection against Aβ-induced injury and suppressed microglia activation), Parkinson’s disease (e.g., prevention of neurodegradation; reduced neuroinflammation), Huntington’s disease (protection of striatal neurons; suppression of CNS inflammation) and other neurodegenerative disorders [ 3 ].…”

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