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Parkinson’s disease, also known as PD, is the second most common neurodegenerative disorder. The disease is characterized by a loss of dopamine-producing neurons in the substantia nigra, which is an area of the brain responsible for movement. Cannabis, specifically CBD, has shown promise in treating some of the symptoms of PD. In this video we will define Parkinson’s disease and cannabis, explain how cannabis can help with PD, and physician perspectives on prescribing cannabis. This video was created by Demystifying Medicine students Simran Matharu, Mahek Minhas and Micaela McNulty in collaboration with the McMaster Demystifying Medicine Program Copyright McMaster University 2021 For more information visit: https://www150.statcan.gc.ca/n1/pub/82-003-x/2014011/article/14112-eng.htm Time Stamps: Introduction/What is Parkinson’s Disease? → 00:00 - 01:23 What is Cannabis? → 01:24 - 02:34 How Can Cannabis Help With Parkinson’s? → 02:35 - 05:09 Physician Perspectives → 05:10 - 07:19 Conclusion → 07:20 - 07:52 References: Bega, D., Simuni, T., Okun, M. S., Chen, X., & Schmidt, P. (2016). Medicinal cannabis for Parkinson's disease: Practices, beliefs, and attitudes among providers at national Parkinson Foundation centers of excellence. Movement Disorders Clinical Practice, 4(1), 90-95. Benner, E. J., Banerjee, R., Reynolds, A. D., Sherman, S., Pisarev, V. M., Tsiperson, V., Nemachek, C., Ciborowski, P., Przedborski, S., Mosley, R. L., & Gendelman, H. E. (2008). Nitrated alpha-synuclein immunity accelerates degeneration of nigral dopaminergic neurons. PloS one, 3(1), e1376. Clapper, J. R., Mangieri, R. A., & Piomelli, D. (2009). The endocannabinoid system as a target for the treatment of cannabis dependence. Neuropharmacology, 56, 235–243. de Lau, L. M., & Breteler, M. M. (2006). Epidemiology of Parkinson’s disease. The Lancet Neurology, 5(6), 525–535. Edelstein, O. E., Wacht, O., Isralowitz, R., Reznik, A., & Bachner, Y. G. (2020). Beliefs and attitudes of graduate gerontology students about medical marijuana use for Alzheimer’s and Parkinson’s disease. Complementary Therapies in Medicine, 52, 102418. Gardiner, K. M., Singleton, J. A., Sheridan, J., Kyle, G. J., & Nissen, L. M. (2019). Health professional beliefs, knowledge, and concerns surrounding medicinal cannabis – A systematic review. PLOS ONE, 14(5), e0216556. Hauser, R. A., Rascol, O., Korczyn, A. D., Jon Stoessl, A., Watts, R. L., Poewe, W., De Deyn, P. P., & Lang, A. E. (2007). Ten-year follow-up of Parkinson's disease patients randomized to initial therapy with ropinirole or levodopa. Movement disorders: official journal of the Movement Disorder Society, 22(16), 2409–2417. Jankovic, J. (2008). Parkinson’s disease: Clinical features and diagnosis. Journal of Neurology, Neurosurgery & Psychiatry, 79(4), 368–376. Klein, C., Karanges, E., Spiro, A., Wong, A., Spencer, J., Huynh, T., Gunasekaran, N., Karl, T., Long, L. E., Huang, X.-F., Liu, K., Arnold, J. C., & McGregor, I. S. (2011). Cannabidiol potentiates Δ9-tetrahydrocannabinol (THC) behavioural effects and alters THC pharmacokinetics during acute and chronic treatment in adolescent rats. Psychopharmacology, 218(2), 443–457. Lang, A. E., & Lozano, A. M. (1998). Parkinson’s Disease. New England Journal of Medicine, 339(16), 1130–1143. Laun, A. S., & Song, Z. H. (2017). GPR3 and GPR6, novel molecular targets for cannabidiol. Biochemical and biophysical research communications, 490(1), 17–21. Marras, C., Beck, J. C., Bower, J. H., Roberts, E., Ritz, B., Ross, G. W., Abbott, R. D., Savica, R., Van Den Eeden, S. K., Willis, A. W., & Tanner, C. (2018). Prevalence of Parkinson’s disease across North America. Npj Parkinson’s Disease, 4(1), 21. Nutt J. G. (2000). Response to L-dopa in PD: the long and the short of it. Neurology, 54(10), 1884–1885. https://doi.org/10.1212/wnl.54.10.1884 Oeckl, P., Hengerer, B., & Ferger, B. (2014). G-protein coupled receptor 6 deficiency alters striatal dopamine and cAMP concentrations and reduces dyskinesia in a mouse model of Parkinson's disease. Experimental neurology, 257, 1–9. https://doi.org/10.1016/j.expneurol.2014.04.010 Severe Spasticity. (2020). https://lioresal.com/severe-spasticity/. Venderová, K., Růzicka, E., Vorísek, V., & Visnovský, P. (2004). Survey on cannabis use in Parkinson's disease: subjective improvement of motor symptoms. Movement disorders: official journal of the Movement Disorder Society, 19(9), 1102–1106. https://doi.org/10.1002/mds.20111 Wang, M., Wang, Y.-H., Avula, B., Radwan, M. M., Wanas, A. S., Mehmedic, Z., van Antwerp, J., ElSohly, M. A., & Khan, I. A. (2017). Quantitative Determination of Cannabinoids in Cannabis and Cannabis Products Using Ultra-High-Performance Supercritical Fluid Chromatography and Diode Array/Mass Spectrometric Detection. Journal of Forensic Sciences, 62(3), 602–611. https://doi.org/10.1111/1556-4029.13341

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Inflammation and full spectrum hemp oil Having a high inflammation in our bodies is also sometimes called lifestyle disease, due to our unhealthy habits. Inflammation is often linked to a cause to autoimmune diseases such as neuropathic pain, hypertension, Alzheimer’s disease, and depression CBD may play a therapeutic role in both cases of inflammation. The cannabinoid has shown potential in helping to mediate the immune response associated with autoimmune diseases such as those mentioned above, along with neuropathic pain, hypertension, Alzheimer’s disease, and depression. A scientific paper regarding this mechanism states that CBD offers promise in the field of anti-inflammatory drug development. The molecule may act to combat inflammation and its associated oxidative stress in numerous ways, including exerting an immunosuppressive effect on macrophages and microglial cells, cells that play a role in inflammation and immunity. CBD has also been shown to significantly reduce chronic inflammatory pain by possibly activating glycine receptors. Further research published within the journal PLoS One investigated the effects of CBD on intestinal inflammation. Application of the cannabinoid led to decreased levels of macrophages within the intestines of mice after CBD treatment, suggesting future therapeutic strategies involving CBD in the treatment of inflammatory bowel diseases. https://kanep.co/

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