Alzheimer's Disease, and it's disruptive cousin dementia, are some of the saddest ailments of all. The agitation, aggression and forgetfulness often associated with the diseases rob loved ones of their most precious asset; their personality. Frustration and confusion abound for not only the victim, but also for loved ones and caregivers alike. Most often, the symptoms increase over time as they slowly take over the life of the unsuspecting victim.
Over the past few years, there has been growing interest in medications that target the endocannabinoid system (ECS). According to research published in the U.S. National Library of Medicine, "The behavioral effects of ECS medications, as well as their ability to modulate neuroinflammation and oxidative stress, make targeting this system particularly relevant in Alzheimer's Disease." (1)
This article will delve deeper into the dark recesses of Alzheimer's Disease (AD) and uncover a valuable new weapon in managing its debilitating symptoms, particularly effective in moderate to severe stages of the disease.
The National Institutes on Aging define Alzheimer's disease as "an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks." (2)
The sobering statistics around Alzheimer's elevate managing this disease to a high national priority: (3)
AD typically progresses slowly in three stages. Stage one is an early, pre-clinical stage with no symptoms (however changes are taking place within the brain). There is a second stage of mild cognitive impairment, and a final stage which is categorized as dementia. The time from diagnosis to death can be as short as 3-4 years, or as long as 10 years or more if the person is younger when diagnosed. (4)
As in all brain disorders, fully understanding and documenting this disease is still an area of emerging science. But research does show some key cause and effect interactions that physicians know impact the progression of the disease.
Inflammation in the brain has long been known to be a key reason for the changes in brain function that occur with AD. Both beta-amyloid plaques and tau tangles cause an immune response in the brain, and the microglia cells act as the first line of defense. However, microglia can become overactive in the presence of brain plaques and produce compounds that damage nearby cells. (5)
Another key indicator for AD has to do with the 5HT6 receptors. These receptors lock in chemicals called neurotransmitters, and this decrease in neurotransmitters impacts neuron-to-neuron (nerve cell) communications, which is what causes the brain to think and function normally.
The endocannabinoid system is composed of a number of cannabinoid receptors, including well-characterized CB1 and CB2 receptors, with their endogenous ligands and enzymes related the synthesis and degradation of these essential compounds.
Over the past few years, there has been growing interest in the therapeutic potential of medications that target the endocannabinoid system. The behavioral effect of ECS mediations, as well as their ability to modulate neuroinflammation and oxidative stress, make targeting this system highly relevant in the treatment of Alzheimer's. (6)
For Alzheimer's patients, CBD is one treatment option that is slowing the progression of this disease. CBD works directly within the endocannabinoid system (ECS) within the brain in some of the key neurotransmitter reactions that control the cognitive skills relative to AD. Since it was discovered in the 1960s, the chemicals in this all natural product have been widely explored and researched for its wide-reaching impacts on the neurotransmission system within the brain, with positive results. (7)
Recently, scientists discovered a direct link between ECS and the progression of Alzheimer's. Cannabiniods (CBD) possess the ability to protect the neurotransmitters within the brain against toxicity. They serve as signaling molecules which regulate downstream events implicated in Alzheimer's disease pathology.
Science also shows that CBD has anti-emetic, anti-convulsive, anti-inflammatory and analgesic properties. Because all of these come into play with Alzheimer's, particularly brain inflammation, CBD is a viable option for minimizing these effects within the brain. The agitation activities, and even violence and anger outbursts, that are often associated with AD can often be minimized because of calming effect CBD has on how rapidly the neurons fire within the brain.
One of the primary neuropathic hallmarks of Alzheimer's is the deposition of plaques that obstruct the areas of the brain important for memory and cognition. With the use of CBD, there is the possible prevention of downstream neurotoxic events associated with plaque deposition. The therapeutic impacts of CBD manifested in both biochemical and neurobiological studies.
CBDs effectiveness is, in part, because CBD relaxes the blood vessels and allows toxins and plaques to pass through, rather than become lodged. (8)
Additionally, CBD acts as a molecular chaperone, accelerating the formation of amyloid fibrils in the brain, which form stable complexes that bind together key neurotransmitters. (9)
As it relates to CB1 and CB2 receptors, there is strong evidence indicating that the activation of both of these receptors by natural antagonists, including CBD. Activating these receptors ignites the brain's intrinsic repair mechanisms, and also reduces the harmful production of amyloid peptide action and tau phosphorylation, which are players in the acceleration of AD symptoms. Though much about brain function is not known, this is one area where there is considerable supportive research of CBD's positive effects.
CB1 receptors are widely distributed in the brain regions such as the cerebellum, cortex, hippocampus, and basal ganglia. These are the areas associated with learning and memory, and also the brain regions most compromised in the early stages of AD. CB2 is sparsely expressed in the brainstem, cerebellum and microglia.
Autopsy studies have reported increased expression of CB1 and CB2 receptors on microglia an in the senile plaques. Additionally, fatty acid amid hydrolase (a key endocannabinoid metabolizing enzyme) is also upgraded in the senile plaque that may increase the events leading to increased plaque deposits which worsen the disease. (10)
Research evidence has demonstrated the antioxidant, neuroprotective, and anti-inflammatory potentials of the endocannabinoid system hold major potential in alleviating the symptoms of Alzheimer's.
According to a white paper issued in 2014, "endocannabinoid signaling has been demonstrated to modulate numerous concomitant pathological processes, including neuroinflammation, excitotoxicity, mitochondrial dysfunction and oxidative stress." (11) In a general sense, these functions smooth out the interactions between neurotransmitters, reduce stress in neurological function, and keep nerve signals from misfiring, that impact cognitive function.
A notable 2016 study sets the stage for a future of positive developments utilizing CBD to treat Alzheimer's. Though it is a small study by medical standards, a group of ten Alzheimer's patients were recruited to measure the results of CBD in a four week study. (12) The study showed significant NPI score reductions from 44.4 to 12.8 noting domains of significant decrease in delusions, agitation/aggression, irritability, apathy, sleep and caregiver distress. The results were so significant, and the benefits of using CBD so broad-reaching, that a more extensive study is certainly warranted.
Alzheimer's can only be characterized as a vicious criminal that robs its victims of their most valuable asset, the efficient function of their brain. With the debilitating symptoms of the loss of cognitive functions - thinking, remembering and reasoning - victims and caregivers alike come to dread each passing day. The disease simply does not get any better with the passage of time.
For those people, CBD represents an opportunity to alleviate the symptoms of this horrific disease. It can help neutralize the depression, psychosis, and aggressive behavior that are hallmarks of Alzheimer's. For anyone who has watched a loved one battle the adverse effects of this intruder into the brain, CBD is a treatment option that gives hope.
1 - Liu, C.S., Chau, S.A. Ruthirikuhan, M et al. "Cannabinoids for the Treatment of Agitation and Aggression in Alzheimer's Disease," CSN Drugs (August 2015).
2 - "Alzheimer's Disease Fact Sheet" National Institute on Aging (www.nia.nih.gov).
3 - "Alzheimer's Disease Fact Sheet" National Institute on Aging (www.nia.nih.gov).
4 - "About Alzheimer's Disease: Alzheimer's Basics," National Institute on Aging (www.nia.nih.gov)
5 - "Treatment Horizon," Alzheimer's Association, alz.org/research.
6 - Liu, C.S., Chau, S.A. Ruthirikuhan, M et al. "Cannabinoids for the Treatment of Agitation and Aggression in Alzheimer's Disease," CSN Drugs (August 2015).
7 - Eubanks, L, Rogers, C, Beuscher, A et al. "A Molecular Link Between the Active Component in CBD and Alzheimer's Disease Pathology," National Institutes of Health (Oct 6, 2008).
8 - Eubanks, L, Rogers, C, Beuscher, A et al. "A Molecular Link Between the Active Component in CBD and Alzheimer's Disease Pathology," National Institutes of Health (Oct 6, 2008).
9 - Eubanks, L, Rogers, C, Beuscher, A et al. "A Molecular Link Between the Active Component in CBD and Alzheimer's Disease Pathology," National Institutes of Health (Oct 6, 2008).
10 - "CBD, A Better and Safer Treatment Option for Alzheimer's," www.solcbd.com.
11 - Aso, E, and Ferrer, I. "Cannabinoids for Treatment of Alzheimer's disease: Moving Toward the Clinic," U.S. National Library of Medicine (March 5, 2014).
12 - Shelef, A, Barak, Y, et al. "Safety and Efficacy of Medical CBD for Behavioral and Psychological Symptoms of Dementia" U.S. National Library of Medicine (2016).