Cannabidiol (CBD) oil is manufactured by the dilution of CBD extracts with carrier oils such as hemp seed oil.
CBD is a cannabinoid obtained from Cannabis sativa and has the ability to modulate a variety of physiological responses by binding to specific receptors of the endocannabinoid system (ECS).
CBD is not psychoactive and has been proven to confer several health benefits. [1]
Overview of Parkinson’s Disease
Parkinson’s disease (PD) is a gradually degenerative disorder of the central nervous system (CNS). It mainly affects the motor system i.e., system concerned with movement.
The initial signs of the disorder include shaking, rigidity, and slowness of bodily movements. Patients also experience behavioural changes and encounter difficulties in thinking. [2]
PD also leads to the development of anxiety and depression. Dementia is inevitable in the end stage of the disease. [3]
Benefits of CBD in Parkinson’s Disease
The major benefits of CBD in Parkinson’s disease are linked with its neuroprotective nature. It prevents the motor neurons from being damaged under the conditions of neurodegeneration.
CBD also helps in reducing the incidence of movement disorders such as bradykinesia.
It helps in lowering the frequency and intensity of refractory seizures by supporting the action of the anticonvulsant medication.
It also improves motor function in patients who suffer from movement disorders. Having a calming effect, CBD also helps in promoting peaceful sleep.
1. CBD Is A Neuroprotective Agent
Nerve cells, also known as neurons, are involved in sending and receiving messages referred to as nerve impulses between the body and the central nervous system which includes the brain.
Neurons are constituted by a cell body with branching arms, known as dendrites, which act like antennae responsible for detecting the nerve impulses. [4]
The ‘tail’ of the neurons, known as axon or nerve fibre, is a slender projection that carries the nerve impulses away from the cell body.
These impulses travel from neuron to neighboring neurons by getting transmitted via the axon of one cell and received by the dendrite of the other.
They cross over a tiny gap between the two neurons known as a synapse. Chemical messengers, known as neurotransmitters, allowing the impulse to cross the synapse. [5]
As per the discoveries of neuroscience, humans have around 100 billion neurons and several neighbouring cells referred to as the neuroglia which is involved in providing nourishment and protection to the neurons. [6]
Parkinson’s disease (PD) is a gradually degenerative, progressive disorder that affects the neurons embedded in the deep parts of the brain, such as the basal ganglia and the substantia nigra.
Neurons of the substantia nigra yield the neurotransmitter dopamine, which is responsible for transmitting impulses that mediate and control body movement. [7]
In Parkinson’s, the functional and structural integrities of the dopamine-producing neurons, found in the substantia nigra, become affected and they gradually begin to die off in some individuals. When around 80% of the dopamine is lost, symptoms such as tremor, slowness of movement, rigidity, stiffness, and problems with balance occur. [8]
PD has no definite cure as the exact cause of the neurodegeneration remains to be deciphered. However, the priorities that should get addressed in Parkinson’s therapy is the need to protect the nerve cells from accelerated damage. [9]
A 2016 review by the University of São Paulo evaluated the role of CBD as a neuroprotective agent. It was revealed that CBD weakens the damage caused by neurodegenerative conditions and enhances synaptic (nerve ending) plasticity. [10]
Summary -As CBD helps in protecting the nerve cells from damage, it can be used in the management of PD symptoms.
2. CBD Oil Treats Movement Disorders
Parkinson’s disease (PD) is one of the chief reasons behind the development of parkinsonism and is also known as primary parkinsonism.
It is different from secondary parkinsonism, such as drug-induced parkinsonism and post-encephalitic parkinsonism that occurs after a viral infection. [11]
The term ‘parkinsonism’ denotes a clinical syndrome constituted by a combination of motor (movement) problems, such as bradykinesia (slowness of movement), tremors even at rest, muscular rigidity, gradual loss of postural reflexes (automatic movements that control posture), and ‘freezing’, wherein the feet get temporarily stuck to the ground. [12]
For patients with PD, movements take much more time and the frequency of spontaneous movements is lowered. For instance, blinking, grimacing and even smiling take more time giving the face and expressionless appearance. [13]
One of the most prominent symptoms of Parkinson’s is bradykinesia or movement slowing.
In case of this symptom, when a patient reaches for a cup on a table, the movement takes longer to complete than for a person without PD. Furthermore, the initial movement is often inadequate. [14]
Movement disorders that are caused by PD are often diagnosed by a simple examination.
The patient is asked to tap their fingers ‘big and fast’ and if they suffer from a disorder, the movement will slower which can be seen as fewer taps per second than a healthy individual. [15]
Treating the symptoms of PD is a major area of research as, in the long run, it will help in delaying the progression of the disease.
Cannabinoids have emerged as popular alternative lines of medication in the field of movement disorders. [16]
A 2015 review by the University of Colorado School of Medicine recognized that CBD oil helps in treating movement disorders such as bradykinesia and muscular rigidity via the endocannabinoid system (ECS) which improves motor function. [17]
In a study reviewed by the National Academy of Sciences, CBD oil was revealed to be a muscle relaxant. [18]
Summary – As CBD oil helps in reducing movement disorders, it will help in managing the symptoms of PD.
3. CBD Treats Refractory Epileptic Seizures
Sometimes, seizures (the sudden disorder in nerve cell activity) cannot be controlled by medication and therapies.
Such repetitive seizures are known as ‘drug-resistant’ or ‘refractory’ seizures.
Research has shown that epilepsy often fails to get managed in about one-third of the cases but, in order to be refractory, the condition rests on the actual frequency and intensity of the episodes. [19]
Epilepsy researchers agree with the fact that unrestrained seizures denote attacks which are frequent and severe.
In fact, such episodic seizures often require therapies which are draining and seriously degrade the quality of daily life. In the case of Parkinson’s, the seizures often result in status epilepticus. [20]
Status epilepticus denotes an episode that lasts for half an hour or longer. It can continue even when the individual has not regained consciousness following the primary seizure.
Many studies have shown that both localized and generalized seizures can lead to status epilepticus. In fact, any episode that occurs for more than 5 minutes needs emergency treatment. [21]
The medications usually recommended for status epilepticus are anticonvulsants.
However, if the incidence fails to decrease, non-drug therapies such as responsive neurostimulation, surgery, vagus nerve stimulation, and even dietary therapies need to be followed.
Recently, CBD products are being used to treat seizures. [22]
A 2017 study at the University of Pavia assessed the role of CBD oil in treating refractory epileptic seizures.
The results showed that CBD helped in reducing convulsions to a much higher degree than other anticonvulsants. It also supports anticonvulsant medication and provided effective seizure management. [23]
Summary – CBD helps in reducing refractory seizures and provides relief to patients suffering from PD.
4. CBD Improves Motor Function
The motor system is involved with the task of controlling various facets of the movement, as and when needed by specific tasks.
Certain movement features require tight control whereas others may be controlled more lightly. In some other elaborate tasks, numerous features may be needed to be tightly coordinated. [24]
The motor system also regulates movement characteristics outside the body. Controlling several features of movement is not easy, given that the central nervous system cannot directly affect the position of the limbs.
It can only result in muscle contractions, which build up the forces required to carry out the complete movement, such as joint rotation. [25]
Parkinson’s leads to the development of motor dysfunction. Many typical symptoms appear in most patients at some point or the other in the course of the illness.
The most common ones include bradykinesia, akinesia (loss of voluntary movement), and hypokinesia (decreased bodily movement) and they inevitably appear in almost every patient. [26]
‘Postural instability’ is another form of motor dysfunction and denotes an impaired reaction that disturbs the balance.
For instance, tripping on an uneven sidewalk might cause a patient to fall because their response is inadequate for the quick recovery of balance. Rigidity caused increased resistance when a foot/hand is lightly moved. [27]
Therefore, enhancing motor function and preventing the development of further symptoms are necessary to provide relief.
Cannabinoids have shown great potential in this aspect and several studies have shown that CBD can be used to halt the further progression of motor dysfunction. [28]
A 2015 study published in the journal, Movement Disorders, established that CBD usage helps in reducing motor dysfunction.
Pre-clinical research has proved the potential of phytocannabinoids like CBD in protecting motor neurons from progressive damage and preserving their functional integrities via the receptors of the endocannabinoid system present in the nervous system. [29]
Summary – As CBD helps in improving motor function, it can be used to provide relief to PD patients suffering from motor-related problems.
5. CBD Promotes Peaceful Sleep
About 96% of patients with Parkinson’s disease suffer from several sleep-related disorders.
These disturbances, as evaluated by validated scales, such as the Parkinson’s disease sleep scale (PDSS) usually reflect the severity of the disease. [30]
The chief reasons behind the onset of sleep disturbances in PD have been categorized into four types.
The first reason for disturbed sleep is PD-related motor symptoms, such as nocturnal akinesia, early-morning dystonia (repetitive movements), painful cramps, tremors, and difficulty turning in bed. [31]
The next category is treatment-related nocturnal disturbances, particularly with drugs like levodopa and antidepressants.
Psychiatric symptoms like hallucinations, depression, dementia, vivid dreams, and psychosis can also disturb sleep in PD.
Finally, the presence of other sleep disorders like insomnia, restless leg syndrome, and rapid eye movement behavioural disorder (REM-BD) can affect patients. [32]
Sleep disorders can lead to new complications such as the development of anxiety disorders. They also increase stress levels and aggravate other symptoms of PD.
Rest is important for the patients as they are usually exhausted due to motor problems. CBD has a calming effect which helps in promoting sound sleep. [33]
A 2017 review by the Palo Alto Health Care System acknowledged the potential of CBD in treating sleep-related disorders.
The review stated that CBD helps in promoting REM sleep and, thus, can help Parkinson’s patients who are particularly affected due to REM sleep disruption. [34]
Summary – As CBD helps in promoting peaceful sleep, it can manage the sleep-related disorders caused by Parkinson’s.
Dosage
It is advisable to consult a health care provider before consuming medications containing THC. The dosage depends on the mode of delivery as the CBD products can be orally ingested or inhaled by a vaporizer.
There is no prescribed dosage for using CBD oil to treat PD completely. However, the symptoms can be managed.
Patients should begin with doses of 25-30mg and the optimum dose should be decided as per the individual’s tolerance level.
Vaporizers containing CBD oil can be used to promote sleep. 6-8mg should be inhaled.
Precautions
The plant-derived cannabinoid, CBD, has very few side-effects. In fact, daily oral doses of up to 500mg can be had for up to half a year. [35]
CBD products usually contain varying amounts of the psychotropic agent, tetrahydrocannabinol (THC), which is responsible for the side-effects.
While the quantity of THC permitted in medicinal products is quite inadequate but sensitive individuals might still experience the hallucinatory effect. [36]
CBD inhibits the activity of cytochrome p450, a class of liver enzymes responsible for metabolizing drugs and therefore, CBD usage reduces efficacies of certain medications.
Medicines containing an excess of THC might cause confusion, dizziness, disorientation, nausea, fatigue, impaired balance, unsteady gait hallucinations, and paranoia. [37]
They might also cause tachycardia, a condition wherein the heart rate gets rapidly raised for a short duration. Cannabis products which have a moderate amount of THC should not be accompanied by alcohol. [38]
Pregnant and lactating women should consult a gynecologist before consuming CBD-containing medicines.
Caution should also be maintained while administering THC-containing products to children and adolescents as it might affect their CNS differently. [39]
Summary
To summarize, it can be said that CBD provides several benefits to people suffering from Parkinson’s. It is a neuroprotectant and hence, delays the progression of nerve damage.
It helps in reducing the occurrence of movement disorders which degrade the quality of daily life.
CBD acts as an anticonvulsant and helps in reducing both the incidence and intensity of epileptic seizures.
It helps in improving motor function and also helps in promoting peaceful sleep which aids in improving the health of PD patients.