We recently posted an overview of what is known on the effect of cannabidiol (CBD) on the brain. We made the point that CBD, while non-intoxicating, has been shown to have clear activity in neural networks, notably in fronto-striatal connectivity, and that it functions as an antipsychotic and an anxiolytic. This much is safe to say from the growing abundance of clinical trials, even if the underlying neurobiological substrates still need elucidation.But there is much left to do.
As a whole, and this is normal in the research trajectory, the studies to date employ varying methodologies. There is heterogeneity in what was examined and how, ranging through dosing strategies, routes of administration, sampling and controlling methods, and imaging modalities. It was common for CBD and THC to be given as individual compounds in separate sessions, for example, but not always. Chosen cognitive paradigms varied as well. Effects on brain activity could turn out to depend on the nature of the task used or the stimulus, each of which could elicit other, distinct, forms of brain activity. Memory paradigms necessarily involve temporal and prefrontal areas, while emotional and salience processing is governed by limbic activation, at least at the basic level. Testing in one of these domains might well provoke activity in the other, however, which could complicate interpretation of results. The studies examined brain effects in healthy subjects and patients afflicted with one or another form of illness, too. These are problematic comparison arms. In the latter category of subjects itself, progression of illness is difficult to measure or control for. The same is true of medical age, and also the effects of concomitant use of other drugs. Finally, of course, the studies tended to recruit young, healthy, male subjects, leaving the ecological validity of the body of research still unestablished. The picture of CBD as a reliable modulator of neural networks, with relevance for treatment of psychosis, anxiety and addiction, is established, in other words, in a replicable way – but with limitations. Future research will need to address issues like these. In order to understand the neural substrates better, studies should also focus on extended CBD treatment of patients with psychiatric disorders in combination with neuroimaging assessments. Correlation with more and better imaging will not only fill this gap, but will also help remedy the critically confounding effect of individual patient variability.
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The foregoing is a report on trends and developments in the cannabinoid industry. No product described herein is intended to diagnose, treat, cure or prevent any disease or syndrome.
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