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CTE and Cannabis Treatment

   The purpose of the skull is to protect the brain against any trauma or blunt force that may occur to the head. The brain is cushioned inside the skull and is surrounded by cerebrospinal fluid which provides the brain with additional protection and nutrients. When a strong blow to the head occurs, the brain will make contact with the inner side of the skull causing a variety of issues including tearing of blood vessels, swelling, inflammation, and bruising of the brain resulting in alteration of brain function. This series of actions is called a concussion or traumatic brain injury. When repeated traumatic brain injuries occur this can result in chronic traumatic encephalopathy (CTE) which is a progressive and fatal neurodegenerative disease.

   Athletes that play contact sports such as football, hockey, boxing, wrestling, rugby, and even soccer, are at a greater risk of developing CTE because they are more likely to endure repeated hits to the head. CTE can affect an individual’s memory, judgment, speech, reflexes, balance, and muscle coordination. The most common symptoms include confusion, headache, dizziness, memory loss, sensitivity to light or noise, insomnia, double vision, nausea, and changes in personality and behavior.

   When an individual is suspected of having CTE, many mental and neurological tests will occur. Additionally, a doctor will take a thorough medical history and have images taken of the brain. All of this information will be used to rule out other neurological diseases as CTE can only be diagnosed after the death of the individual. An autopsy of the brain would be performed and it would be determined whether known biological markers of CTE were present. One of the biological markers present is a protein found in nerve cells called tau. Interestingly, abnormal tau protein levels have also been associated with both dementia and Alzheimer’s disease. But, the unique pattern of abnormal tau buildup around the brain blood vessels is what differentiates CTE from Alzheimer’s and dementia. More research is necessary to fully understand the brain changes that occur in CTE and how they are related to and different from other neurological diseases including dementia.

   Unfortunately, concussions and traumatic brain injuries are very common and widespread injuries in the NFL. Scientists at Boston University recently completed a study showing that out of 376 former NFL players, 345, or 91.7% were diagnosed with CTE. This study doesn’t suggest that 91.7% of all current and former players have CTE as the prevalence rate among NFL players is unknown. However, given the nature of the sport, the rate of occurrence is significantly higher than would normally be seen in those individuals who do not play professional football. While there is no cure for CTE, researchers are interested in what treatment options are available. Very recently, researchers are starting to investigate whether medical marijuana will help reduce the symptoms associated with CTE. Some studies have suggested that compounds within medical marijuana, for example, CBD, can serve as a neuroprotective antioxidant meaning it may reduce the brain’s neurological impairment and swelling that occur during a traumatic brain injury. Furthermore, CBD may reduce inflammation, regulate blood flow, and enhance the generation of new brain cells. Overall, this would reduce brain damage and facilitate recovery.

   Additionally, more and more NFL players are turning to cannabis to manage pain both on and off the field. According to a study completed at Washington University School of Medicine, over half of the retired players used opioids during their NFL career. Because of the dangerous side effects including sedation of opioids, players are looking to cannabis as a safer more effective alternative to managing their chronic pain issues. While the NFL still prohibits players from using cannabis, they have softened their stance on cannabis. They have pledged $1 million dollars to two research labs that will be investigating 1) if the use of cannabinoids will help post-concussion treatment and prevention of concussions and 2) what is the optimal form and dosage of CBD and THC to reduce pain and treatment injuries. Overall, more research is needed to determine the therapeutic and adverse effects of cannabis use on pain management and traumatic brain injuries.