CBD helps improve migraine symptoms.
1. Description of migraine.
It is a neurological disease characterized by hemicrania (unilateral headache) always lasting more than 4 hours, present at least 4 times per month. Migraine is pulsatile , of moderate or severe intensity, worsened by movement . It is generally accompanied by nausea and/or vomiting, as well as photophobia and phonophobia .
There are 2 types of migraines: migraines with or without aura. In 20 to 30% of migraine sufferers, the headache is preceded by an aura, a transient and reversible neurological disorder, such as visual disturbances (vision of dots, shiny spots), sensory and/or language disturbances which last less than a year. hour.
Migraine is caused by abnormal neuronal excitability, but it is still unclear how the attack is triggered. The aura is likely caused by a transient dysfunction of the cortex that results in a slow wave of depolarization of neurons, from the back of the brain to the front. The headache is linked to the activation of the trigeminovascular system (trigeminal nerves which innervate the meninges and intracranial vessels). The activation of this system releases neuropeptides causing vasodilation in the meninges and neuronal inflammation. It also triggers central pain transmission via the brainstem. An imbalance between neurotransmitters (including serotonin which helps regulate pain in the nervous system) could be involved. Studies have looked at the role of serotonin in migraine as they noted that serotonin expression was decreased during attacks . (174)
2. Action of CBD to improve migraine symptoms.
However, recent studies support that the endocannabinoid system may also be involved in the onset of migraines. Experimental and clinical data indeed suggest a link between the deregulation of this signaling complex and migraines. (175)
Accumulating evidence has demonstrated a role for the CB1 receptor in antinociception, and recent research suggests that CB2 receptors also play a role in pain perception. Researchers in this study pre-treated rats with nitroglycerin (which induces migraine) and then treated them with a CB2 receptor agonist. They demonstrated a significant analgesic effect . (176)
Another study published in 2018 specifies, based on clinical observations, that levels of anandamide (endocannabinoid) are reduced in the CSF (cerebrospinal fluid) and plasma of patients suffering from chronic migraine, and that this reduction would be associated with relief of pain in the spinal cord. As previously stated, anandamide is produced under inflammatory conditions and is rapidly degraded by the enzyme FAAH . Anandamide levels in the CNS (central nervous system) and PNS (peripheral nervous system) can therefore easily be modulated by FAAH inhibitors. Inhibition of anandamide degradation is therefore a promising therapeutic target for migraine because it is accompanied by increased availability of the endocannabinoid at the site where its formation is stimulated, thus prolonging its action. CBD is an inhibitor of the FAAH enzyme and would therefore be a promising therapeutic target through this mechanism of action . (177,178)
A Spanish study published in 2016 concludes that CBD improves cortical serotonergic and glutamate signaling through a 5-HT1A receptor-dependent mechanism . The increase in serotonin induced by CBD would therefore be a potential target for the treatment of migraine. (95)
An Italian team studied the use of cannabinoids for the prevention of migraine and acute headaches. They administered different doses of THC/CBD mixtures and observed a 55% reduction in pain at doses above 200 mg. Secondly, they recruited 79 patients suffering from chronic migraine who received 25 mg of amitriptyline daily (tricyclic antidepressant used to treat migraine) or 200 mg of THC/CBD combination for 3 months. The researchers demonstrated a 40.4% reduction in migraine attacks in the THC/CBD group and a 40.1% reduction in the amitriptyline group. Cannabinoids also reduced pain intensity in migraine patients by 43.5% . (179).
Quotes:
71. Inserm. Information files | Inserm - Science for health [Internet]. [cited Oct 30, 2020]. Available at: https://www.inserm.fr/information-en-sante/dossiers-information
174. Launay JM. The letter from the neurologist - headache supplement - Serotonin and migraine. June 2003; Available at: https://www.edimark.fr/Front/frontpost/getfiles/7497.pdf
175. Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016;1(1):154‐65.
95. Linge R, Jiménez-Sánchez L, Campa L, Pilar-Cuéllar F, Vidal R, Pazos A, et al. Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors. Neuropharmacology. Apr 2016;103:16‐26.176. Greco R, Mangione AS, Sandrini G, Nappi G, Tassorelli C. Activation of CB2 receptors as a potential therapeutic target for migraine: evaluation in an animal model. J Headache Pain. 2014;15(1):14.
177. Greco R, Demartini C, Zanaboni AM, Piomelli D, Tassorelli C. Endocannabinoid System and Migraine Pain: An Update. Front Neurosci. 2018;12:172.
178. Greco R, Demartini C, Zanaboni AM, Tumelero E, Reggiani A, Misto A, et al. FAAH inhibition as a preventive treatment for migraine: A pre-clinical study. Neurobiol Dis. 2020;134:104624.
179. Pulling L. EAN 2017: Cannabinoids suitable for migraine prophylaxis - Neuro Central [Internet]. 2017 [cited Oct 30, 2020]. Available at: https://www.neuro-central.com/ean-2017-cannabinoids-suitable-migraine-prophylaxis/
1 comment
Super article ! La fleur cbd gold rock est ma préférée !