Multiple Sclerosis (MS) is a neurological disease that affects about 2.8 million people worldwide (Atlas of MS, 2020). MS is an inflammatory disease affecting the brain, spinal cord and optic nerves. It is the most common autoimmune disease affecting the central nervous system. Non-fatal, it affects mostly women. Let's discover what research says about cannabis and more specifically CBD in multiple sclerosis.
Multiple Sclerosis
Multiple sclerosis (MS) is an inflammatory disease that will affect genetically predisposed people, but can also be favoured by environmental elements. This disease is called autoimmune, because it causes the immune system to attack the myelin. The body therefore attacks itself, no longer differentiating between the "self" and the "non-self". In the case of MS, it is the Central Nervous System (CNS) that is affected. The CNS includes:
- The brain
- The spinal cord
- The optic nerve
Neurons
The brain is the conductor of our body. It regulates all vital functions, receiving and sending information throughout the body via the nerves. Its weight varies from one adult to another from 1300 to 1400 grams in humans. The brain contains about 86 billion neurons, and it is precisely these neurons that are affected by multiple sclerosis (MS). A neuron is a nerve cell whose job is to transmit a signal. It is composed of a cell body and two extensions, the axon and the dendrites. The axon is surrounded by a whitish protective sheath made of myelin, which also promotes better conductivity of information.
The disease
Multiple sclerosis causes the destruction of the myelin that surrounds the axons of each neuron. Once exposed, the axon loses its effectiveness in transmitting nerve impulses. Generally, the disease begins with an attack during which symptoms appear, the myelin is attacked by an inflammatory phenomenon causing its destruction. The axon is no longer protected by its sheath and is damaged. Most of the time, this inflammatory flare-up is brief, and a process of re-myelination begins. The neurons function optimally again in the best of cases. However, over the course of the disease, the successive repairs may be incomplete, and symptoms may then persist:
- Motor disturbances
- Sensory disorders
- Vision problems
- Pain
- Severe fatigue
- Sleep Disorders
Multiple sclerosis is a disease with no cure at present, but it reduces patients' life expectancy little or not at all.
Treatments
MS relapses are treated with high-dose corticosteroids for several days. Because symptoms are not always the same from one person to another, treatments may be different. Symptoms can also vary in intensity depending on several parameters such as fatigue, morale and activity.
- Motor disorders: Physiotherapy is essential to maintain the patient's autonomy and improve his quality of life.
- Sensory disorders: they are treated with symptomatic treatments that can improve these sometimes extremely unpleasant sensations.
- Vision disorders: they affect about 75% of patients during the course of their illness, and are regressive. Orthoptic rehabilitation gives good results.
- Fatigue: MS causes great fatigue that does not help the other symptoms of the disease. It is therefore important to promote good sleep in affected patients, to ensure that they have an adapted physical activity, and possibly an organization of working hours.
- Pain: common in most patients, it is partly relieved by antiepileptic drugs and antidepressants for neuropathic pain. Neuralgic pain is treated with antiepileptics, thermocoagulation or radiosurgery. Other pains are treated with analgesics or local anesthetics.
CBD and MS: what research says
CBD is extracted from Sativa cannabis, more commonly known as industrial hemp. CBD (cannabidiol) is one of the most studied cannabinoids. Some studies, mostly preclinical or on small groups, explore its possible effects on symptoms of multiple sclerosis; their results do not allow any conclusion.
- A 2016 laboratory study reported that CBD (cannabidiol) increased concentrations of the anti-inflammatory cytokine IL-10, and other possible anti-inflammatory mechanisms have been described. (Kozela et al. 2016)
- In 2012, the MUSEC trial (Zajicek et al., 279 patients) tested an oral medicinal cannabis extract, under medical supervision, on muscle stiffness and related pain; this extract was a medicinal product, not CBD sold to the public.
CBD is not a medicine and does not replace the treatment of multiple sclerosis. Ask your doctor or neurologist for advice before any use, especially since CBD may interact with some medicines. Another neurological disease is covered in our page on CBD and amyotrophic lateral sclerosis.
