Neuroprotection Following Concussion: The Potential Role for Cannabidiol

Can J Neurol Sci. 2020 May;47(3):289-300. doi: 10.1017/cjn.2020.23.

Abstract

Cannabidiol (CBD) has been generating increasing interest in medicine due to its therapeutic properties and an apparent lack of negative side effects. Research has suggested that high dosages of CBD can be taken acutely and chronically with little to no risk. This review focuses on the neuroprotective effects of a CBD, with an emphasis on its implications for recovering from a mild traumatic brain injury (TBI) or concussion. CBD has been shown to influence the endocannabinoid system, both by affecting cannabinoid receptors and other receptors involved in the endocannabinoid system such as vanilloid receptor 1, adenosine receptors, and 5-hydroxytryptamine via cannabinoid receptor-independent mechanisms. Concussions can result in many physiological consequences, potentially resulting in post-concussion syndrome. While impairments in cerebrovascular and cardiovascular physiology following concussion have been shown, there is unfortunately still no single treatment available to enhance recovery. CBD has been shown to influence the blood brain barrier, brain-derived neurotrophic factors, cognitive capacity, the cerebrovasculature, cardiovascular physiology, and neurogenesis, all of which have been shown to be altered by concussion. CBD can therefore potentially provide treatment to enhance neuroprotection by reducing inflammation, regulating cerebral blood flow, enhancing neurogenesis, and protecting the brain against reactive oxygen species. Double-blind randomized controlled trials are still required to validate the use of CBD as medication following mild TBIs, such as concussion.

Keywords: Cannabidiol; Cerebrovasculature; Concussion; Endocannabinoid; Neuroprotection.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / therapeutic use
  • Blood-Brain Barrier / metabolism
  • Brain Concussion / drug therapy*
  • Brain Concussion / immunology
  • Brain Concussion / metabolism
  • Brain Concussion / physiopathology
  • Brain-Derived Neurotrophic Factor / metabolism
  • Cannabidiol / therapeutic use*
  • Cerebrovascular Circulation
  • Cognition
  • Endocannabinoids / metabolism
  • Humans
  • Inflammation
  • Neurogenesis
  • Neuroprotection
  • Neuroprotective Agents / therapeutic use*
  • Oxidative Stress
  • PPAR gamma / metabolism
  • Post-Concussion Syndrome / drug therapy*
  • Post-Concussion Syndrome / immunology
  • Post-Concussion Syndrome / metabolism
  • Post-Concussion Syndrome / physiopathology
  • Receptor, Cannabinoid, CB1 / metabolism
  • Receptor, Cannabinoid, CB2 / metabolism
  • Receptor, Serotonin, 5-HT1A / metabolism
  • Receptors, Purinergic P1 / metabolism
  • TRPV Cation Channels / metabolism

Substances

  • Anticonvulsants
  • Brain-Derived Neurotrophic Factor
  • Endocannabinoids
  • Neuroprotective Agents
  • PPAR gamma
  • Receptor, Cannabinoid, CB1
  • Receptor, Cannabinoid, CB2
  • Receptors, Purinergic P1
  • TRPV Cation Channels
  • Receptor, Serotonin, 5-HT1A
  • Cannabidiol