By Jennifer Freeman, MD, Doctor of Medicine (M.D.) from UT Health San Antonio in 2008 – Dr. Freeman practices surgery in Dallas TX
Every year in the United States, approximately 60,000 individuals are newly diagnosed with Parkinson’s disease according to the Parkinson’s Foundation (PF).
The PF adds that, by the year 2020, the number of people living with this medical condition is expected to near one million in total, making it more prevalent than multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease combined.
What is Parkinson’s disease?
The American Parkinson Disease Association (APDA) defines Parkinson’s as “a type of movement disorder that can affect the ability to perform common, daily activities.”
Unlike other movement disorders, Parkinson’s disease is characterized by a loss of brain cells, specifically those in the substantia nigra region. This lowers dopamine levels which causes issues related to movement regulation, thus impacting the patients’ quality of life.
Parkinson’s disease is both chronic and progressive, making this movement disorder one that is long-lasting, while also worsening as time progresses.
Also, though it typically appears after the age of 50, roughly one in ten Parkinson’s disease patients are diagnosed at a younger age. This is called Early Onset Parkinson’s.
Symptoms of Parkinson’s tend to vary from person to person and fall into one of two categories: motor symptoms and non-motor symptoms.
The APDA shares that it is the motor symptoms of Parkinson’s that typically make these typical daily movements more difficult, some of which include experiencing tremors, having stiff or rigid muscles, walking difficulties, slowness of movement (also known as bradykinesia), and postural instability.
Another motor symptom Parkinson’s disease patients tend to notice is a change in their voice. Changes in volume are common in the early stages, whereas speaking fast, crowding words, and stuttering are more prevalent in advanced stages of this disease.
Parkinson’s symptoms that don’t involve movement and are therefore sometimes missed, include:
- Reduced sensitivity to smells
- Trouble staying asleep
- Increased depression and anxiety
- Psychotic symptoms such as hallucinations and delusions
- Weight loss
- Excessive sweating
- Difficulty multi-tasking
- Harder time with organization
- Increase in urinary frequency and urgency
- Reduced libido
- Slower blinking and dry eyes
Currently, there is no cure for Parkinson’s. However, patients do have a few treatment options that can help manage this particular medical condition.
One is taking a medication to help better manage motor function. Two well-known options include Levodopa and Carbidopa, both of which can be prescribed in varying strengths and formulations.
Another common Parkinson’s treatment is therapy. For instance, physical therapy may be pursued to aid in walking and occupational therapy can help enhance fine motor skills. Speech therapy may also be required to assist with vocal issues.
Deep brain stimulation is an option as well. Approved by the U.S. Food and Drug Administration (FDA) several years ago, this treatment method is a form of surgical therapy in which an electrode is implanted in the brain, then stimulated via a device that is placed in the chest area under the skin.
The APDA further indicates that complementary medicine such as yoga and massage can also provide relief from symptoms of PD as well. Research is also finding that CBD oil can potentially help too.
CBD is different than other cannabinoids found in the marijuana plant that are known for producing the high commonly associated with medical marijuana use. This includes tetrahydrocannabinol (THC) and a similar cannabinoid, tetrahydrocannabivarin (THCV). Both THC and THCV can produce this high effect, whereas CBD does not.
Additionally, our bodies do produce some cannabinoids on its own. These are called endogenous cannabinoids because they are so similar to cannabis plant compounds. CBD works by mimicking and augmenting these natural cannabinoids, providing a more therapeutic effect.
Admittedly, information in this field is still emerging, primarily because the endocannabinoid system is a relatively new finding due to the first endocannabinoid not being discovered until 1992.
After the second one was identified three years later, researchers began to realize that the human body has an entire endocannabinoid system that offers positive effects related to bone density and diabetes prevention.
Since that time, research has also connected CBD with providing benefits for Parkinson’s disease.
For instance, one 2018 study published by Frontiers in Pharmacology shares that CBD helps by increasing levels of the endocannabinoid anandamide, an agonist of cannabinoid receptors. It is also thought to aid in other processes found helpful for Parkinson’s patients, such as those related to serotonin receptors like 5-HT1A, peroxisome proliferator-activated receptors, and more.
Other studies shared by the National Institute of Health (NIH) have found similar results. Specifically, they indicate that the study of CBD in relation to Parkinson’s disease is especially interesting because of the direct relationship between endocannabinoids, cannabinoid receptors, and the neurons associated with this neurodegenerative disease that impacts the central nervous system.
Another piece of research, this one published in the journal Cannabis and Cannabinoid Research, indicates that many clinical trials have been conducted in this area.  Though some have been inconclusive or controversial, others have found that CBD has positive effects on some of Parkinson’s motor symptoms.
One such study looked at 22 patients who engaged in the medical use of cannabis, which contains CBD. In this case, improvements were noted in regard to tremor, rigidity, and bradykinesia 30 minutes after using medical marijuana.
Other pieces of Parkinson’s research have found that CBD can also help relieve non-motor symptoms. For instance, an open-label study—meaning that there is no placebo group, so the subjects know that they’re receiving active treatment—found that, after being taken for four weeks, CBD helped reduce psychotic symptoms.
Another double-blind trial involved 119 Parkinson’s patients who were treated with either 75 mg of CBD per day, 300 mg CBD daily, or a placebo. Although researchers could not establish a statistically significant difference in motor and general symptoms scores, there were significantly different means in relation to their well-being and quality of life.
The Michael J. Fox Foundation for Parkinson’s Research adds that research in this area is somewhat limited due to governmental regulations, with interpretation of results also impacted due to no standardization of CBD doses or use of products containing CBD and THC combined. Therefore, it can be difficult to determine the specific effect CBD can provide to Parkinson’s patients.
Healthline reports that CBD oil has a number of scientifically-proven benefits that extend beyond those related to Parkinson’s. Among them are:
- Pain relief
- Decreased feelings of anxiety and depression
- Greater heart health
- Fewer issues with acne
- Protection of the nervous system
One of the major concerns patients have with the use of CBD oil is whether or not it is legal. Psychology Today stresses that, while many people think that the passing of the 2018 Farm Bill legalized CBD federally, this isn’t exactly the case.
Instead, the Farm Bill only legalized hemp, which is the fibrous stalk of the marijuana plant. Technically, all other parts of the plant are still illegal under the Controlled Substances Act.
What confuses the issue even more is that each state has set its own statutes regarding hemp, medical marijuana, and CBD. For instance, in New York, patients can smoke cannabis, but they aren’t banned from accessing it as a dried flower. However, if you live in Colorado, not only can individuals use medical cannabis, but children can even legally possess it on school campuses if they have status as a medical cannabis patient.
Because of these variations, it is always recommended that Parkinson’s patients check the legality of cannabis use or CBD oil in their individual states before utilizing this option for treatment purposes.
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Source: Drug Science