Cannabidiol (CBD) is known to have anti-inflammatory, antioxidative, and antiepileptic properties. The neuroprotective advantages of CBD have sparked interest in its therapeutic potential against the secondary injury cascade resulting from traumatic brain injury (TBI). Presently, there is a lack of effective broad treatment strategies to counteract the damaging mechanisms that ensue after the primary injury, often leading to lasting neurological consequences or death .
However, CBD’s impact on various neurotransmitter systems, the blood-brain barrier, oxidative stress mechanisms, and the inflammatory response offers support for its clinical utility in the context of TBI.
What is Traumatic Brain Injury?
Traumatic brain injury is caused by an external force, such as a blow, jolt, or penetrating head injury, resulting in temporary or permanent impairment of brain functions .
In addition to the immediate primary injury, a secondary injury follows, activating biochemical cascades that induce metabolic and cellular changes. Both primary and secondary injuries are linked to elevated levels of glutamatergic neurotransmitters.
Persistently high extracellular glutamate levels in the brain (up to 120 hours post-TBI) are indicative of an unfavorable prognosis in TBI patients . At elevated concentrations, glutamate contributes to excitotoxicity, neuroinflammation, oxidative stress, and cell death.
Sustained increased glutamatergic neurotransmission following severe TBI poses a risk factor for the development of disorders such as Parkinson’s disease, Alzheimer’s disease, and post-traumatic epilepsy.
It is crucial to note that, to date, there are no therapeutic strategies preventing the long-term consequences of TBI . Approximately 40% of individuals with moderate to severe TBI may experience lasting health impacts and disabilities. TBI is the primary cause of death in individuals under 45 years, necessitating hospitalization and rehabilitation, leading to substantial medical costs.
Medical Marijuana for Traumatic Brain Injury
Preclinical data indicates the potential usefulness of CBD in immediate TBI treatment . However, CBD’s broader potential lies in aiding TBI recovery by mitigating the effects of the secondary injury cascade. If CBD proves effective in ameliorating these symptoms, anticipated long-term benefits extend to survival, neurocognitive function, neurodegenerative outcomes, and neuropsychiatric aspects.
A 2022 study observed that CBD administered orally has been shown to mitigate both short and long-term excitotoxicity induced by traumatic brain injury and facilitate functional recovery . Notably, pretreatment with CBD proved effective in reducing the negative consequences associated with TBI.
The available data on tetrahydrocannabinol (THC) treatment in TBI models are more nuanced than that of CBD . Animal models have shown that gender may make a difference in the possible benefits of THC to TBI, with more benefits being seen in male mouse models.
The cannabis pharmaceutical Sativex (a 1:1 THC:CBD formula) is typically well tolerated in studies of epilepsy and pain, but high-THC marijuana products have not been part of formal TBI research.
Indeed, much research still needs to be done to evaluate the clinical utility of THC for traumatic brain injury . Cannabis terpenes are also a point of interest in future studies.
The cannabis terpene beta-caryophyllene is known to have analgesic benefits and is thought to help reduce neuroinflammation. Limonene, pinene, linalool, terpinene, and citral are also thought to have antioxidant and pain-relieving benefits that could support TBI recovery.
Best Cannabis Strains for Traumatic Brain Injury
When shopping for medical marijuana products, it is important to follow the guidance of your medical marijuana doctor. While research suggests CBD products present the most benefit, your doctor may offer different insights and guidance specific to your health condition. You may also find more CBD options available in the form of hemp flower as opposed to marijuana. With that in mind, here are some cannabis strains to consider.
Remedy, a CBD-rich hemp strain, is the product of crossing Cannatonic with Afghan Skunk. This tranquil strain delivers a range of calming effects, inducing relaxation in both the body and mind, all without inducing any psychoactive sensations. Dominated by terpenes such as caryophyllene, myrcene, and pinene, it provides therapeutic advantages, accompanied by a sensory profile marked by a sweet and floral essence, accentuated with subtle notes of citrus and juniper. For medical cannabis patients desiring relaxation without the possible disturbances linked to THC, Remedy stands as an excellent choice.
ACDC, a CBD-dominant cannabis strain originating from a Cannatonic phenotype, stands as a versatile choice suitable for individuals at all experience levels. With an exceptionally low THC content, ACDC ensures that even beginners can engage without fear of experiencing intoxicating effects. Recognized for its capacity to alleviate anxiety, stress, and pain, ACDC is the preferred selection for individuals seeking relief without the typical euphoric sensations. Particularly valued among medical cannabis patients, ACDC exhibits the potential to alleviate symptoms of anxiety, inflammation, and chronic pain. The primary terpenes present in the ACDC strain include myrcene, pinene, and caryophyllene. These terpenes contribute to the strain’s nuanced flavor profile, featuring subtle earthy, woody, herbal, and citrus notes.
Cannatonic, a CBD-dominant hemp strain resulting from the meticulous crossing of MK Ultra and G13 Haze genetics, offers users an initial experience of a mild and serene buzz, creating a foundation for relaxation. Renowned for its remarkable ability to alleviate stress, Cannatonic has gained recognition among medical marijuana patients who suffer from the symptoms of migraines, pain, muscle spasms, and anxiety. The strain presents an earthy aromatic profile that evolves into a woody citrus flavor upon smoking. Distinguished by its terpene composition, prominently featuring myrcene, pinene, and caryophyllene, Cannatonic offers therapeutic benefits without an overwhelming psychoactive impact.
- Charlotte’s Web
Charlotte’s Web, a hemp strain renowned for its high CBD and low THC levels, has a touching and impactful origin story. The strain’s name and fame are attributed to Charlotte Figi, a young girl grappling with Dravet syndrome. Charlotte’s parents, after exploring various treatments with limited success, turned to cannabis oil as a potential solution. However, their search for a product with minimal THC proved challenging.
In their time of need, the Stanley Brothers of Colorado stepped in, introducing a strain initially named “Hippie’s Disappointment.” This strain boasted an extraordinary 30:1 CBD-to-THC ratio, ensuring an absence of intoxicating effects. Later rightfully rebranded as “Charlotte’s Web,” the strain’s journey gained national attention, partly due to endorsements from Dr. Sanjay Gupta. His shift from skepticism to acknowledging the efficacy of low-THC strains like Charlotte’s Web contributed to the strain’s prominence. Success stories from both young patients and adults underscored its ability to mitigate seizures and offer therapeutic benefits.
One of Charlotte’s Web’s most notable features is its versatility in addressing various conditions such as anxiety, stress, pain, inflammation, and seizures, thanks to its abundant CBD content. It is particularly valued for inducing tranquility and relaxation without the typical intoxicating effects of THC. Charlotte’s Web also presents a flavor profile marked by earthy and herbal notes, reflecting its aroma. When consumed, it delivers a gentle and pleasant taste, appreciated by those seeking a straightforward and uncomplicated experience. Dominated by myrcene, pinene, and caryophyllene, the strain’s terpenes contribute to its distinct characteristics.
Dancehall, a sativa-dominant hybrid, emerges from the crossbreeding of Juanita La Lagrimosa and Kalijah strains. This unique “1:1” variety stands out with an exceptionally low THC content, hovering around 1%, paired with a CBD level of approximately 15%. The distinctive equilibrium it presents induces clear-headed effects, uplifting mood, and fostering creativity and sociability. Users often depict their Dancehall experience as a refreshing surge of energy, accompanied by a gentle body relaxation. The primary terpenes—myrcene, caryophyllene, and limonene—contribute to its flavor profile, introducing spicy and herbal notes with sweet citrus undertones.
Pennywise, a hybrid cannabis strain rich in CBD, is a cross between Harlequin and Jack the Ripper. Notably, Pennywise exhibits four distinct phenotype variations, showcasing diverse bud shapes, spanning from elongated to rounded. With a CBD-to-THC ratio of 1:1, this strain holds particular appeal for medical marijuana patients seeking relief from the symptoms of arthritis, PTSD, epilepsy, neurological disorders, and cancer. The balanced interplay of these cannabinoids results in a gentler, more relaxed psychoactive encounter, delivering a cerebral and focused high accompanied by a revitalizing sense of invigoration. The Pennywise strain’s terpene profile is predominantly composed of myrcene, terpinolene, and pinene, contributing to its flavor profile characterized by woody and herbal notes, complemented by subtle hints of citrus and spice.
- Royal Highness
Royal Highness, a sativa-dominant hybrid marijuana strain, was meticulously crafted through the thoughtful combination of the strains Dancehall and Respect. This strain achieves a near-even balance between THC and CBD content, resulting in effects that are notably less psychoactive when compared to THC-dominant counterparts. The Royal Highness encounter begins with a cerebral surge, brimming with motivation and focused energy, encouraging a proactive mindset. It is defined by a clear-headed and functional cerebral euphoria, complemented by a gentle, soothing body sensation. Royal Highness delights the senses with its smooth and pleasant flavor profile, marked by fruity, spicy, and subtly skunky notes. Medical marijuana patients often choose this strain to alleviate symptoms associated with anxiety and pain. The dominant terpenes, myrcene, pinene, and caryophyllene, contribute to both the strain’s flavors and its therapeutic effects.
- Aychman, M. M., Goldman, D. L., & Kaplan, J. S. (2023). Cannabidiol’s neuroprotective properties and potential treatment of traumatic brain injuries. Frontiers in neurology, 14, 1087011. https://www.frontiersin.org/articles/10.3389/fneur.2023.1087011/full
- Lins, B. R., Anyaegbu, C. C., Hellewell, S. C., Papini, M., McGonigle, T., De Prato, L., … & Fitzgerald, M. (2023). Cannabinoids in traumatic brain injury and related neuropathologies: preclinical and clinical research on endogenous, plant-derived, and synthetic compounds. Journal of neuroinflammation, 20(1), 77. https://link.springer.com/content/pdf/10.1186/s12974-023-02734-9.pdf
- Santiago-Castañeda, C., Huerta de la Cruz, S., Martínez-Aguirre, C., Orozco-Suárez, S. A., & Rocha, L. (2022). Cannabidiol reduces short-and long-term high glutamate release after severe traumatic brain injury and improves functional recovery. Pharmaceutics, 14(8), 1609. https://www.mdpi.com/1999-4923/14/8/1609