A Prospective Observational Study on Therapeutic and Adverse Effects of Medical Cannabis for Chronic Traumatic Brain Injury
Abstract
Traumatic brain injury (TBI) represents a large public health burden for civilians, Service Members, and Veterans. Particularly concerning are the chronic symptoms of TBI, which include emotional problems (depression, anxiety, post-traumatic stress disorder PTSD), physical problems (sleep and pain), and problems with cognitive functioning. These problems prevent most TBI survivors from returning to a normal life with their families and at work. Currently, there are very few treatments for the chronic symptoms of TBI. As a result, a growing number of medical providers and patients are considering medical cannabis (MC) to treat chronic symptoms related to TBI. MC is now legal in New Mexico as well as 32 additional U.S. states. Our and others’ research suggest that cannabis use may be 4-9 times higher in younger Veterans with a history of trauma relative to the general population. Although there is anecdotal evidence that MC is effective for treating emotional problems, as well as pain and sleep disorders, recent systematic reviews have concluded that the actual scientific evidence for MC has not been established. This is primarily because it is illegal to do studies to examine the effects of cannabis on health-related disorders in a careful and controlled fashion. While there are certain ways to do this research with federal funding (using cannabis strains from the government), this type of research has very low validity and does not generalize to the types of cannabis products that are regularly used in state-regulated markets. Moreover, TBI results in complex pathophysiological processes that involve slow but steady changes to brain function, brain vasculature, and the structure of the brain. These processes have been shown to go on for many years post-injury. Therefore, even if cannabis products were relatively safe for healthy individuals to consume, it does not mean that they would be safe for TBI survivors to consume. The primary objectives of the current study are therefore to determine whether MC has potential therapeutic or adverse effects on TBI-related symptoms (emotional, physical, and cognitive) as well as overall brain health. Symptoms are measured using standard clinical tests, whereas brain health is measured using advanced brain scans and blood-based biomarkers. Based on our preliminary data in chronic TBI survivors, we predict that MC will not have any therapeutic effects on emotional or physical symptoms and will have detrimental effects on cognition and overall brain health. Our application therefore addresses two FY21 TBIPHRP Areas of Encouragement. First, we will identify objective biomarkers that can be used for monitoring TBI progression and how different therapies affect the progression of TBI pathology for better or worse. Second, we will examine how a treatment that is growing in popularity, but has little scientific evidence (MC), affects emotional, physical, and cognitive symptoms in chronic TBI. This is in direct response to Focus Area 3 Interventions that promote sustained functional recovery … or during the chronic phase of injury). The collective team has extensive preliminary data and real-world experience on the emotional, physical, and cognitive symptoms associated with TBI (Mayer, Quinn and Arciniegas), objective characterization of TBI-related pathology through imaging (Mayer, Quinn and Arciniegas), and blood-based biomarkers (Zetterberg), and clinical trials with TBI (Arciniegas, Quinn and Mayer), measuring post-traumatic symptoms in military populations (Sadek, Quinn and Arciniegas), cognitive and brain effects associated with recreational marijuana (Hutchinson), and putative therapeutic effects associated with MC (Hutchison, as well as two funded studies from the National Institutes of Health). We have conducted systematic reviews of MC for the treatment of TBI and the relationship between TBI pathophysiology and other common disorders like depression and
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2211054
Entities
People
- Andrew R Mayer
Organizations
- Lovelace Foundation
- United States Army