CBD, Traumatic Brain Injury, & Post-Concussion Syndrome

There is a growing body of evidence indicating that CBD may have potential applications for treating brain injuries, including traumatic brain injuries, and concussion syndrome. Due to the evidence, some athletes and athletic organizations are beginning to encourage research into CBD's potential benefits for athletes recovering from concussion syndrome or brain injuries.

CBD Patented for Neurological Protection after Trauma

A report published in Proceedings of the National Academy of Sciences in 1998 is credited as one of the first to connect CBD and THC to neuroprotective properties. This groundbreaking study led to a patent confirming that cannabinoids are neuroprotectants and antioxidants.

This study and the patent together further suggest that THC and CBD may act neuroprotectants that could limit the neurological damage that patients experience after trauma, stroke, or other problems that reduce blood flow to the brain.

This is applicable for externally caused Traumatic Brain Injuries (TBI) as well. Given that strokes and TBI share many features, the potential benefit is strong.

Marijuana Users Have Better TBI Outcomes

A 2014 study reported in American Surgeon found that people who consume marijuana and have a traumatic brain injury experience better outcomes than those with a TBI who do not consume marijuana. The results came from a retrospective study that looked at TBI patients who were tested for THC with their symptoms. To avoid skewed results, the study did not look at those with injuries that were unlikely to allow survival. It also ignored patients under 15. The study found that the rate of mortality from the TBIs was significantly lower for those who tested positive for THC.

In other words, those who had THC in their systems at the time of the traumatic brain injury had a lower chance of dying from their brain injuries. This supports the previously mentioned research and patent that THC likely has some neuroprotective properties or at least healing properties in general.

A Potential Explanation of the Protection

An article from the British Journal of Pharmacology in 2011 offered an explanation of how marijuana may protect patients who suffer from brain injuries. According to this report, the endocannabinoid system is “self-protective” and will react to major events like TBI and strokes. Damage from such events causes the accumulation of harmful mediators that induce further damage. However, endogenous production of cannabinoid molecules is triggered in response to the injury and these molecules provide protection and repair, potentially blunting the damage from something such as a head injury. The study found increased endocannabinoid levels within the brain both during and immediately after a TBI. Interestingly, the CB1 and CB2 receptors activated by the endocannabinoid compounds are the same ones that THC activates. Amazingly, the human body’s endocannabinoid system produces these important compounds in response to injury. These cannabinoids activate a cascade of events that may reduce or even reverse the damage caused by a brain injury. While it is clear the CBD and other cannabinoids are the primary components of the cascade and mediate their activity primarily through CB1 and CB2 receptors, the role of THC is not yet well understood in this protection and repair phenomenon.

A 2018 study on mice looked specifically at the CB1 receptor and the response to a TBI or stroke and reinforced the idea that the receptor responds to these traumatic events. It showed that when the CB1 receptor is activated, theoretically by compounds released from injured cells, it will dilate the blood vessels by activating the release of specific cytokines responsible for that mechanism. This increases the blood flow to the brain, which increases the supply of nutrients and oxygen. That type of reaction did not occur in mice that do not have CB1 receptors, confirming that the receptor indeed creates the reaction that is critical for this specific response.

Timing May Matter

Interestingly, research in 2013 found that the extent to which activated CB1 receptors can protect against a TBI depends on the time of the day. This reporting came from a study in rats that found that the survival rate for TBI was higher at times when the CB1 receptors are naturally the least robust.

Activating the CB2 Receptor Is Also Relevant

Other research has shown that the CB2 receptor also plays a role in the potential protection that CBD provides against TBIs. A 2012 report found that activating this receptor reduces the damage to the blood-brain barrier following TBIs in rats. This was followed up by a 2014 report indicating that the CB2 receptor helps regulate the neurovascular response and inflammation in brains that suffered from TBIs.

Sports Organizations Have Started Considering CBD

As mentioned, some of the research into CBD and its potential in treating injuries and pain management has led to increased acceptance. In May 2019, the NFL Players Association and the NFL agreed to study the possibility of using marijuana for pain management for players.

Although this particular application is not directly related to the potential of CBD in treating TBIs, it is relevant given the limited number of effective options proven to effectively mediate the problems associated with brain injury. This is particularly true given the high level of concussions and TBIs associated with football, an elementary reason why an organizations like the National Football League and the NFL Players Association are so interested in the emerging clinical research on CBD and cannabis products.