Cannabinoids and the expanded endocannabinoid system in neurological disorders
Abstract
Anecdotal evidence that cannabis preparations have medical benefits together with the discovery of the psychotropic plant cannabinoid Δ 9-tetrahydrocannabinol (THC) initiated efforts to develop cannabinoid-based therapeutics. These efforts have been marked by disappointment, especially in relation to the unwanted central effects that result from activation of cannabinoid receptor 1 (CB1), which have limited the therapeutic use of drugs that activate or inactivate this receptor. The discovery of CB2 and of endogenous cannabinoid receptor ligands (endocannabinoids) raised new possibilities for safe targeting of this endocannabinoid system. However, clinical success has been limited, complicated by the discovery of an expanded endocannabinoid system - known as the endocannabinoidome - that includes several mediators that are biochemically related to the endocannabinoids, and their receptors and metabolic enzymes. The approvals of nabiximols, a mixture of THC and the non-psychotropic cannabinoid cannabidiol, for the treatment of spasticity and neuropathic pain in multiple sclerosis, and of purified botanical cannabidiol for the treatment of otherwise untreatable forms of paediatric epilepsy, have brought the therapeutic use of cannabinoids and endocannabinoids in neurological diseases into the limelight. In this Review, we provide an overview of the endocannabinoid system and the endocannabinoidome before discussing their involvement in and clinical relevance to a variety of neurological disorders, including Parkinson disease, Alzheimer disease, Huntington disease, multiple sclerosis, amyotrophic lateral sclerosis, traumatic brain injury, stroke, epilepsy and glioblastoma.
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The endocannabinoid system is widespread throughout the central nervous system and plays important roles in many cognitive and behavioral processes.
“The ECS is widespread throughout the central nervous system and is known to play important roles in many cognitive and behavioral processes [84, 85].”
From Consequences of adolescent drug use (2023) · cites this paper as [85]
The ECS modulates the HPA axis, cognition, learning and memory, intestinal-barrier function, inflammation, and energy metabolism.
“The ECS modulates a multitude of physiological processes, including the HPA axis (241), cognition, learning and memory (242), intestinal-barrier function (243), inflammation (244), energy metabolism (245), among others (reviewed recently (239)).”
From Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis (2023) · cites this paper as [239]
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- Authors
- Cristino, L., Bisogno, T., & Di Marzo, V.
- Affiliations
- Istituto di Chimica Biomolecolare (IT)
- Istituto di Farmacologia Traslazionale (IT)
- Venue
- Nature Reviews Neurology
- Published
- 2019-12-12
- Volume
- 16
- Issue
- 1
- Pages
- 9-29
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W2996080671
- Cited by
- 970
- References
- 351
- Citations by year
- 2026: 79 · 2025: 126 · 2024: 173 · 2023: 185 · 2022: 183 · 2021: 142 · 2020: 82
- FWCI
- 13.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- cannabinoids, endocannabinoid system, endocannabinoidome, neurological disorders, CB1 receptor, CB2 receptor, nabiximols, cannabidiol, THC, multiple sclerosis, spasticity, neuropathic pain, pediatric epilepsy, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis, traumatic brain injury, stroke, glioblastoma
- MeSH terms
- Analgesics, Animals, Cannabidiol, Cannabinoids, Drug Combinations, Humans, Nervous System Diseases, Dronabinol, Receptor, Cannabinoid, CB1, Receptor, Cannabinoid, CB2, Endocannabinoids
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