Kev Tshawb Fawb Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Cannabinoids hauv Kev Tswj Kev Coj Tus Cwj Pwm, Psychological, Thiab Lub Cev Cov tsos mob ntawm Neurocognitive Disorders

Abstract

1. Lub hom phiaj

Peb tau lees paub qhov kev tshuaj xyuas no los txiav txim siab txog kev ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj cannabis raws li kev kho mob rau tus cwj pwm, kev puas siab puas ntsws, thiab lub cev muaj zog cov tsos mob cuam tshuam nrog cov kab mob neurocognitive.

2. Cov txheej txheem

Peb tau ua PRISMA-kev taw qhia kev tshuaj xyuas los txheeb xyuas cov kev tshawb fawb siv cov tshuaj cannabis los kho tus cwj pwm, kev puas siab puas ntsws, thiab cov tsos mob ntawm cov neeg muaj Alzheimer's disease (AD) dementia, Parkinson's disease (PD), thiab Huntington's disease (HD). Peb suav tias yog cov lus Askiv uas muab cov ntaub ntawv qub rau peb lossis ntau tus neeg koom, tsis hais txog kev tsim qauv.

3. Kev tshawb nrhiav

Peb tau txheeb xyuas 25 qhov kev tshawb fawb hla xyoo 1991 txog 2021 suav nrog 14 qhov kev sim tswj, 5 kev tshawb fawb tsav, 5 kev soj ntsuam kev tshawb fawb, thiab 1 rooj plaub. Feem ntau, cov kev sim cannabinoids yog dronabinol, tag nrho cov cannabis, thiab cannabidiol, thiab cov kev kuaj mob suav nrog AD (n=11), PD (n=11), thiab HD (n=3) . Thawj qhov tshwm sim yog cov tsos mob ntawm lub cev muaj zog (piv txwv li, dyskinesia), pw tsaug zog cuam tshuam, kev paub, kev sib npaug, lub cev hnyav, thiab qhov tshwm sim ntawm kev kho mob-tshuaj tsis zoo tshwm sim.

4. Cov lus xaus

Cov ntsiab lus piav qhia ntawm qhov kev tshawb pom los ntawm cov kev tshawb fawb tsawg tsawg hauv cheeb tsam qhia txog kev sib koom ua ke ntawm cov khoom siv cannabidiol thiab nyem los ntawm cov tsos mob ntawm lub cev muaj zog hauv HD thiab PD thiab kev sib koom ua ke ntawm cov hluavtaws cannabinoids thiab kev pab cuam los ntawm kev coj cwj pwm thiab kev puas siab puas ntsws cov tsos mob ntawm dementia thoob plaws. AD, PD, thiab HD. Cov lus xaus ua ntej no tuaj yeem qhia siv cov nroj tsuag raws li cov khoom siv hluavtaws cannabinoids kom muaj kev nyab xeeb, lwm txoj kev kho mob rau kev tswj cov tsos mob neuropsychiatric hauv cov neeg mob tsis muaj zog neurocognitive.

Nyem qhov no kom tau txais Cistanche cov txiaj ntsig

Taw qhia

Hauv cov pej xeem, qhov kev pheej hmoo ntawm Alzheimer's disease (AD) yog 1 feem pua ​​​​ntawm hnub nyoog 60 xyoo thiab ob zaug txhua 5 xyoos tom qab ntawd (Alzheimer Society of Canada 2010). National Population Health Study of Neurological Conditions kwv yees tias AD suav rau cov kev kho mob txhua xyoo thiab cov neeg saib xyuas cov nqi tag nrho yog $ 10.4 billion, nrog rau kev cia siab yuav nce 60 feem pua ​​​​los ntawm 2031 (Public Health Agency of Canada 2014). Feem ntau, kev saib xyuas hauv tsev thiab kev saib xyuas mus sij hawm ntev yog qhov loj tshaj plaws rau cov nqi ncaj qha; Tsis tas li ntawd, cov neeg saib xyuas tsev neeg pab txhawb cov nuj nqis tseem ceeb (19.2 lab teev tsis them nyiaj hauv 2011, ib tus lej tau kwv yees ua ob npaug los ntawm 2031).

Cov tsos mob ntawm tus cwj pwm thiab kev puas siab puas ntsws ntawm dementia (BPSD) yog suav tias yog cov teeb meem feem ntau ntawm txhua hom dementia, piv txwv li, siab li 90 feem pua ​​​​ntawm ntau hom dementia thiab ntau dua 95 feem pua ​​​​hauv AD (Ikeda et al. 2004; Cerejeira li al. . 2012). BPSD tuaj yeem ua rau muaj kev xav tsis zoo thiab lub cev tsis ua haujlwm hauv pawg neeg mob no (Mintzer li al. 1998), thiab ib qho ntawm cov tsos mob neuropsychiatric feem ntau (NPS) cuam tshuam nrog BPSD hauv AD yog kev ntxhov siab (Benoit li al. 1999). Lwm cov tsos mob muaj xws li agitation, aggression, kev nyuaj siab, apathy, delusions, thiab hallucinations, nrog rau kev hloov nyob rau hauv pw tsaug zog thiab qab los noj mov (Cerejeira li al. 2012).

Txawm hais tias qhov zaus thiab qhov hnyav ntawm BPSD, tsis muaj cov kev xaiv tshuaj kho mob meej meej. Ob peb cov tshuaj uas siv los ntawm daim ntawv lo muaj qhov ua tau zoo me me thiab muaj feem cuam tshuam tseem ceeb, hais txog qhov xav tau kev kho mob tsis zoo rau BPSD (Ballard and Waite 2006). Qee tus kws sau ntawv qhia tias BPSD ntau tshaj plaws hauv AD yog kev ntxhov siab, muaj ntau dua 65 feem pua ​​​​ntawm BPSD cov teeb meem (Benoit li al. 1999), uas tau ua rau muaj kev tawm tswv yim tias kev ntxhov siab (tsis yog kev nyuaj siab, lwm qhov kev pheej hmoo rau AD) yuav ua tus kwv yees zoo dua ntawm kev paub txog kev poob qis (Bierman li al. 2009). Kev kho tshuaj kho mob ntawm BPSD, suav nrog kev ntxhov siab, feem ntau suav hais tias yog los ntawm cov kev tshawb fawb hauv cov tub ntxhais hluas ntawm cov neeg muaj kev ntxhov siab tab sis tsis muaj kev kuaj mob dementia (Baldwin li al. 2005). Cov kev kho mob rau kev xav thiab kev ntxhov siab hauv cov neeg laus feem ntau suav nrog cov tshuaj tiv thaiv kev ntxhov siab (xws li xaiv cov tshuaj serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors), thiab benzodiazepines (Linden li al. 2004). Cov kev kho mob tam sim no rau BPSD suav nrog SSRIs, atypical antipsychotics, thib ob tiam antipsychotics, non-tricyclic antidepressants, thiab luv-acting benzodiazepines (Tampi li al. 2016), tab sis kev kho cov lus teb rau cov tshuaj no muaj ntau yam, thiab kev xaiv tshuaj nyob ntawm ntau yam ntxiv. qhov muaj thiab qhov hnyav ntawm cov xwm txheej tsis zoo (AEs) ntau dua li ntawm kev ua tau zoo ntawm cov tshuaj xaiv. AEs tuaj yeem suav nrog kev pheej hmoo siab ntawm pob txha pob txha / ntog, nce kev paub txog kev poob qis, thiab kev tuag los ntawm cov xwm txheej cerebrovascular (Reus li al. 2016; Vigen et al. 2011; Tampi li al. 2016). Lub Tsev Haujlwm Saib Xyuas Kev Nyab Xeeb Kev Noj Qab Haus Huv (ISMP) tuav ib Daim Ntawv Teev Npe Beers piav qhia txog cov tshuaj no kom tsis txhob muaj cov neeg laus vim muaj kev pheej hmoo ntau ntxiv (American Geriatrics Society 2015). Cov npe muaj xws li benzodiazepines, tricyclic antidepressants, thiab antipsychotics. Tsis tas li ntawd, haloperidol thiab risperidone - ob qho ntawm cov tshuaj tiv thaiv kab mob dav dav tshaj plaws rau BPSD (De Deyn li al. 1999; Suh li al. 2006) - tau pom tias ua kom muaj cov xwm txheej apoptotic hauv cov kab lis kev cai mammalian thiab exacerbate cell tuag vim yog AD- hais txog -amyloid peptide (Wei et al. 2006).

Dementia yog qhov nyuaj rau kev kho mob vim qhov dav ntawm cov tsos mob cuam tshuam thiab feem ntau xav tau cov tshuaj polypharmacy nyuaj nrog cov nyom AE profiles. Kev tshawb nrhiav lwm txoj hauv kev los tswj BPSD hauv cov neeg mob AD tsis ntev los no tau hloov mus rau kev cais tawm ntawm Cannabis sativa cog, piv txwv li, cannabinoids (Liu li al. 2015), qee qhov qhia tau cog lus tias yog anxiolytics (Fusar-Poli li al. 2009) thiab hauv kev tswj kev nyuaj siab thiab kev puas siab puas ntsws bipolar (Ashton li al. 2005). Cov ntaub ntawv muaj feem cuam tshuam tsis meej, tab sis kuj tseem muaj cov lus qhia tias cannabinoids tuaj yeem daws kev nyuaj siab thib ob rau cov kab mob hauv lub neej, xws li HIV, mob qog noj ntshav, ntau yam sclerosis, lossis kab mob siab C (Brunt li al. 2014). Txawm li cas los xij, tsis muaj cov ntaub ntawv pov thawj-raws li kev nyab xeeb, kev zam, thiab kev ua tau zoo ntawm cannabinoids tau txhawb nqa kev tsis txaus siab ntawm cov kws kho mob kom tso cai rau cannabis lossis lwm yam kev rho tawm los tswj BPSD.

Qhuav CistanchethiabCistanche ntsiav tshuaj

Cannabinoids siv lawv cov teebmeem los ntawm kev cuam tshuam nrog endocannabinoid system (ECS), tshwj xeeb yog cannabinoid 1 (CB1R) thiab cannabinoid 2 (CB2R) receptors. CB1Rs muaj ntau nyob thoob plaws hauv lub cev nrog cov lus qhia tseem ceeb hauv lub hauv nruab nrab lub paj hlwb, thaum CB2Rs nyob rau ntau qhov chaw hauv lub cev tiv thaiv kab mob thiab cov ntaub so ntswg (Lu thiab Mackie 2020). ECS yog ib qho tseem ceeb ntawm cov kab mob neuromodulatory cuam tshuam nrog ntau yam kev puas siab puas ntsws, neurodegenerative, thiab lub cev muaj zog xws li schizophrenia, anorexia, AD, Parkinson's disease (PD), thiab Huntington's disease (HD) (Fernandez-Ruiz li al. 2015; Basavarajappa et al. 2017).

Cov txiaj ntsig tau los ntawm kev tshawb fawb txog kev kho mob thiab kev kho mob tau qhia tias kev tswj hwm ntawm cannabis cuam tshuam nrog kev txhim kho hauv BPSD (nrog rau kev ntxhov siab thiab kev pw tsaug zog) thiab tswj qhov hnyav thiab mob hauv cov neeg mob AD (Sherman li al. 2018). Txawm hais tias cannabis cuam tshuam nrog kev pheej hmoo ntawm euphoria, tsaug zog, thiab puas siab puas ntsws, kev sim yav dhau los nrog cov neeg mob AD tau pom tias AEs feem ntau tau txais txiaj ntsig zoo ntawm cov koob tshuaj (Sherman li al. 2018). Yog li ntawd, kev saib xyuas yog hloov mus rau cannabinoids xws li cannabidiol (CBD), uas ua rau muaj txiaj ntsig zoo rau lub hlwb yam tsis muaj kev cuam tshuam 'siab' cuam tshuam nrog nws cov paub zoo dua thiab tau kawm ntau dua cov sib koom ua ke Δ9 -tetrahydrocannabinol (THC). Raws li cov pej xeem muaj hnub nyoog, kev txhim kho lub neej zoo thiab kev ywj pheej yog qhov tseem ceeb zuj zus. Yog li, kev nkag siab zoo dua ntawm cannabinoids yuav ua li cas thiaj li muaj txiaj ntsig zoo rau tus neeg mob dementia yog qhov tseem ceeb, tsis yog rau cov neeg koom nrog ncaj qha nkaus xwb tab sis thaum kawg rau peb lub nra hnyav ntxiv. Txog qhov kawg no, peb tau xaiv los ua pov thawj raws li kev tshuaj xyuas los tshuaj xyuas qhov ua tau zoo thiab kev nyab xeeb ntawm CBM raws li qhov kev xaiv kho mob rau BPSD. Cov chaw saib xyuas ntawm AD thiab suav nrog PD thiab HD vim tias ob qho kev mob hlwb no tseem muaj BPSD tseem ceeb rau lawv qhov kev nthuav qhia kho mob (Cloak thiab Al Khalili 2021; Gelderblom li al. 2017).

Cov txiaj ntsig

1. Kawm xaiv

Ntawm thawj 1950 kab lus tau txheeb xyuas, 222 tseem muaj peev xwm tsim nyog tom qab tshem tawm cov duplicates thiab tshuaj xyuas cov lus piav qhia ntxiv. Thaum kawg, 25 kev tshawb fawb (Ahmed et al. 2015; Balash et al. 2017; Bruce et al. 2018; Carroll et al. 2004; Chagas et al. 2014a; Chagas et al. 2011bet 9; Cons. 2009; Herrmann et al. 2019; Lopez-Sendon Moreno et al. 2016; Lotan et al. 2014; Mahlberg thiab Walther 2007; Mesnage et al. 2004; Shelef et al. 2016; 2016; 2001; van den Elsen et al. 2015a; van den Elsen et al. 2015b; van den Elsen et al. 2017; Venderova et al. 2004; Volicer et al. 1997; Walther et al. 2006; Walther et al. 2006; ; Woodward et al. 2014; Zuardi et al. 2009) tau ntsib cov txheej txheem suav nrog rau kev tshuaj xyuas (Daim duab 1).

2. Kawm yam ntxwv

Qhov kev tshuaj xyuas zaum kawg suav nrog cov ntawv luam tawm los ntawm 1991 txog 2021. Feem ntau (n=15) tau randomized, tswj kev sim, thiab muaj ib qho kev tshawb fawb rov qab. Qhov seem cuaj txoj kev tshawb fawb suav nrog cov kev tshawb fawb qhib-label (n=5), kev tshawb fawb (n=3), thiab ib rooj plaub (n=1). Peb suav nrog cuaj txoj kev tshawb fawb tom kawg hauv peb cov lus piav qhia, txawm hais tias cov kev tshawb fawb no feem ntau tsis qhia txog kev kho mob zoo lossis cov lus nug txog kev ua tau zoo. Cov tshuaj ntsuam xyuas cannabinoids feem ntau yog dronabinol (n=10), tag nrho cov cannabis (n=5), cannabidiol (n=4), nabilone (n=3), Nabiximols (n=2), thiab cannabinoid receptor antagonists (SR 141716, SR 48692, SR 142801) (n=1). Cov kev tshawb fawb suav nrog cov neeg mob AD/dementia (n=11), PD (n=11), thiab HD (n=3).

3. Kev pheej hmoo ntawm kev tsis ncaj ncees hauv kev tshawb fawb

Raws li kev hloov kho Downs thiab Black kev ntsuam xyuas cov cuab yeej (MacLehose li al. 2000), daim ntawv teev cov qhab nia siab tshaj plaws yog 28, nrog 20–28 yog 'zoo', 15–19 yog ' ncaj ncees', thiab 14 thiab qis dua raug saib tias ' pluag '. Cov qhab nia zoo qhia cov khoom yog 'zoo' zoo (n=12), 'fair' zoo (n=6), thiab 'tsis zoo' zoo (n =7). Nyob rau hauv 'zoo' rau 'fair' pawg zoo, feem ntau yog crossover RCTs (Ahmed li al. 2015; Carroll li al. 2004; Consroe li al. 1991; Curtis et al. 2009; Herrmann et al. 2019; Sendon Moreno et al. 2016; Sieradzan et al. 2001; van den Elsen et al. 2015b; Volicer et al. 1997; Walther et al. 2011; van der Hiel et al. 2017), one parallel Lee (RCT) al. 2015), ib qho kev tshawb fawb rov qab los (Woodward et al. 2014). Txawm hais tias cov kev tshawb fawb no feem ntau tsis qhia txog kev kho mob zoo lossis cov lus nug txog kev ua tau zoo, peb tau txheeb xyuas ntau qhov 'zoo' rau 'faj' zoo qhib-label pilot kev tshawb fawb (Lotan li al. 2014; Shelef li al. 2016) thiab 'zoo' cov ntaub ntawv zoo. (Chagas et al. 2014b). Nyob rau hauv qeb 'tsis zoo' zoo, ob qho tib si RCTs (Chagas li al. 2014a; Mahlberg thiab Walther 2007), ib qho yog crossover RCT (Mesnage et al. 2004), thiab lwm plaub suav nrog kev tshawb fawb (Balash et al. 2017 ; Bruce et al. 2018; Venderova et al. 2004) thiab qhib-label pilot kawm (Shohet li al. 2017). Cov kab lus tsis tas yuav txheeb xyuas qhov tshwm sim thawj zaug hauv kev taw qhia lossis cov txheej txheem, feem ntau tsis muaj zog, thiab muaj cov txheej txheem txheej txheem ntau dua li ib nrab ntawm cov kev tshawb fawb, suav nrog ntau yam uas qhia txog qhov muaj txiaj ntsig zoo, tsis muaj cov qauv sawv cev ntawm tag nrho cov pejxeem, thiab tsis muaj kev cuam tshuam txog kev ua raws cai, lossis kev ntsuas kev tsis ncaj ncees (yog tias cov kev tshawb fawb tsis pom qhov muag, qhov no tuaj yeem yog qhov tseem ceeb hauv kev txhais lus).

Cistanche ntxiv

4. Cannabinoids rau Parkinson's disease thiab Huntington's disease

Rau cov neeg uas muaj PD lossis HD, kev tsom mus rau cov kev tshawb fawb feem ntau yog ntawm dyskinesia lossis kev txhim kho chorea. Ntawm cov no, tsis muaj leej twg qhia txog kev nyab xeeb raws li qhov tshwm sim thawj zaug, thiab tsuas yog ib qho ntawm cov kev tshawb fawb PD tau tshaj tawm cov tsos mob ntawm kev puas siab puas ntsws, ntsuas siv Brief Psychiatric Rating Scale (BPRS), uas tau pib tsim los ntsuas cov tsos mob ntawm tus mob schizophrenia, tab sis tau siv hauv AD. /dementia kev sim tshuaj (xws li, (Sultzer li al. 2008)). Peb paub ntau yam ntawm BPRS ntsuas cov khoom ntsuas tib yam tab sis tuaj yeem suav nrog ntau yam khoom dua li lwm tus. Cov qauv no feem ntau tsis tau teev tseg hauv peb qhov kev tshuaj xyuas, tab sis tag nrho cov kev tshawb fawb raws li kev ntsuam xyuas siv BPRS yog cov kev tshawb fawb hauv tib neeg, peb xav tias qhov no yuav tsis cuam tshuam rau peb cov kev txhais lus. Lwm qhov kev tshaj tawm thawj zaug suav nrog PD cov tsos mob (n=2), dyskinesia (n=2), cov tsos mob ntawm REM pw tsaug zog cwj pwm tsis zoo (RBD) (n=1), ncua ua ntej tig "rau" (n=1), thiab Unified PD Rating Scale (UPDRS) dyskinesia (n=1), lub cev muaj zog (n=2), lossis tag nrho (n=1) ​​qhab nia. CBM txhim kho cov tsos mob uas tsis yog lub cev muaj zog (xws li txo qis kev poob, kev nyuaj siab, thiab mob, thaum txhawb kev pw tsaug zog) hauv PD cov ntsiab lus (Balash li al. 2017), thaum CBM ua rau UPDRS cov qhab nia tsis zoo, txawm hais tias cov no tsis muaj qhov tseem ceeb (Carroll li al. 2004) . Lwm txoj kev tshawb nrhiav pom tsis muaj qhov sib txawv ntawm cov qhab nia UPDRS ntawm pab pawg kho mob (Chagas li al. 2014a). Txawm li cas los xij, ob txoj kev tshawb fawb qhia txog kev txhim kho (qis) hauv UPDRS cov qhab nia, suav nrog lub cev muaj zog (rigidity, tremor) thiab cov tsos mob tsis yog lub cev muaj zog (pw tsaug zog, mob), nrog haus luam yeeb (tag nrho) cannabis siv (Lotan li al. 2014; Shohet li al. 2017). Muaj qhov txo qis ntawm qhov zaus ntawm RBD cov xwm txheej ntsig txog (Chagas li al. 2014a) thiab qis nruab nrab M thiab Q chorea qhab nia nrog CBD siv (Consroe li al. 1991). Hauv qhov sib piv, tsis muaj qhov sib txawv ntawm UHDRS tag nrho cov qhab nia ntawm lub cev muaj zog nrog nabilone, uas txo tag nrho cov qhab nia dyskinesia hauv cov kev kawm (Curtis et al. 2009). Thaum kawg, qhov 'kev ncaj ncees' zoo, qhib-daim ntawv tshawb fawb qhia plaub lub lis piam ntawm CBD txhim kho cov qhab nia BPRS (cov tsos mob puas siab puas ntsws, tsis muaj kev cuam tshuam rau lub cev muaj zog) hauv rau PD cov neeg mob (Zuardi li al. 2009).

5. Cannabinoids rau dementia

Feem ntau, cov kev tshawb fawb ntawm cov neeg uas muaj dementia tau tshaj tawm BPSD, xws li kev ntxhov siab, pw tsaug zog, tsis kam noj zaub mov, thiab kev ua haujlwm ntawm lub cev tsis muaj zog. Tag nrho cov kev tshawb fawb dementia tsom rau cov tib neeg nrog AD, tab sis feem ntau suav nrog cov tib neeg uas muaj kev sib xyaw dementia (xws li, vascular lossis frontotemporal nta). Ob ntawm cov kev tshawb fawb no tau tshaj tawm AEs, thiab ob qho kev tshaj tawm ntawm Neuropsychiatric Inventory (NPI) yog thawj qhov tshwm sim. Lwm cov txiaj ntsig tau tshaj tawm tseem ceeb suav nrog kev ua haujlwm thaum nruab hnub (n=1), kev paub (raws li Mini-Mental State Examination; MMSE) (n=1), static balance (n=1), thiab lub cev hnyav (n=1). Ob peb (13 feem pua) cov kev tshawb fawb suav nrog cov neeg mob HD (n=3), tsuas yog ib qho qhia txog qhov tshwm sim thawj zaug ntawm qhov tsis muaj qhov tshwm sim tsis zoo (SAEs; n=1) thiab lwm qhov ob qho kev tshaj tawm thawj qhov tshwm sim ntawm M thiab Q chorea qhov hnyav (n=1) ​​thiab tag nrho cov qhab nia lub cev muaj zog siv Unified Huntington's Disease Rating Scale (UHDRS), ib qho cuab yeej los ntsuas cov yam ntxwv kho mob thiab chav kawm HD (n=1) . Ob qhov kev tshawb fawb ntxiv suav nrog cov neeg mob dementia thiab cov neeg mob uas muaj kab mob ntev uas siv cov cannabis kho mob. Plaub lub lis piam ntawm THC txo qis NPI cov qhab nia hauv cov neeg mob AD (xws li kev xav, kev ua phem, kev tsis txaus siab, thiab pw tsaug zog) (Shelef et al. 2016), thaum lwm txoj kev tshawb nrhiav pom tias THC txo NPI / NPS cov qhab nia tom qab 14 thiab 21 hnub, tab sis cov qhab nia. tsis txawv ntawm cov placebo tom qab 21- hnub cim (van den Elsen li al. 2015a). Lwm txoj kev tshawb nrhiav pom tsis muaj qhov sib txawv ntawm pawg dronabinol thiab cov placebo ntawm NPI / NPS qhab nia (van den Elsen li al. 2015b). Dronabinol nce lub cev hnyav (kev txhim kho hauv anorexia thiab kev coj tus cwj pwm tsis zoo) (Volicer et al. 1997) thiab txo cov kev ua haujlwm nocturnal ntawm lub hauv paus mus rau 14 hnub (Walther et al. 2006).

6. Kev nyab xeeb

Tsib txoj kev tshawb fawb tau siv CBD cov khoom, tsis muaj AEs pom nyob rau hauv ob (Chagas li al. 2014b; Zuardi li al. 2009), me me AEs nyob rau hauv ib tug (Carroll li al. 2004), thiab AEs tsis qhia nyob rau hauv ib tug (Chagas et al. 2014a). Qhov thib tsib txoj kev tshawb nrhiav pom qhov txawv txav ntawm qhov kuaj pom hauv ntau dua 50 feem pua ​​​​ntawm cov neeg mob (Consroe li al. 1991). Txawm li cas los xij, cov txiaj ntsig no tau txwv rau 12 ntawm 70 qhov kev sim tau khiav, thiab qhov txawv txav tsis zoo tshaj plaws sab nraum qhov ib txwm muaj. Tsis tas li ntawd, cov kev txawv txav no tsis sib xws nrog cov ntaub ntawv qhia txog kev mob tshwm sim ntawm cannabis, vim tias tsis muaj qhov sib txawv ntawm cov khoom muag thaum muab piv rau CBD thiab cov placebo (Consroe li al. 1991). Raws li cov txiaj ntsig no, peb tsis tuaj yeem txheeb xyuas qhov kev txhawj xeeb meej txog kev nyab xeeb ntawm CBD-raws li cov khoom siv rau kev siv dementia. Thaum muaj coob tus me me AEs tau tshaj tawm (98 tag nrho), tsuas yog rau qhov muaj feem cuam tshuam rau dronabinol; ob (kev qaug zog, kiv taub hau) ntawm qhov koob tshuaj qis dua ntawm 1.5 mg thiab plaub (kev qaug zog, ntxhov siab) ntawm koob ntau dua ntawm 3.0 mg. Tsis tas li ntawd, tsis muaj qhov sib txawv tseem ceeb hauv AEs tau tshaj tawm nrog dronabinol dua li cov placebo hauv ob lub sijhawm ntawm kev kawm crossover (Ahmed et al. 2015). Cov neeg koom nrog tau txais dronabinol tau tshaj tawm AEs zoo ib yam li cov neeg tau txais cov placebo, thiab cov qhab nia ntawm lub cim xeeb tau txo qis zoo ib yam ntawm cov pab pawg (van den Elsen li al. 2015a; van den Elsen et al. 2015b). Txawm hais tias qee qhov kev rho tawm los ntawm AEs tau tshaj tawm, ib tus ntawm ob tus neeg mob uas tau rho tawm hauv ib qho ntawm qhov kev sim tau ua vim yog kev siv tshuaj tiv thaiv kev puas siab puas ntsws ntau (van den Elsen li al. 2015b).

Cistanche tubulosa

7. Cov ntsiab lus ntawm kev tshawb pom

Qhov kev tshuaj xyuas no tau sau tseg nees nkaum-tsib kab lus tshawb nrhiav CBM rau kev kho mob neurocognitive. Peb pom tias CBM cov qauv uas muaj CBD ntau dua tau cuam tshuam nrog kev txhim kho lub cev muaj zog, xws li dyskinesia thiab chorea, cuam tshuam nrog HD thiab PD. CBM nrog ntau dua THC concentration kuj tau tshwm sim los qhia txog kev koom tes nrog kev txo qis ntawm BPSD, xws li pw tsaug zog thiab ntxhov siab. Zuag qhia tag nrho, CBM tau tshwm sim tau txais txiaj ntsig zoo, vim tias qhov tshwm sim ntawm kev kho mob-emergent AEs tsawg; Txawm li cas los xij, CBM nrog cov ntsiab lus THC siab dua tuaj yeem ua rau lub hauv paus kev paub. Cov lus xaus ua ntej no tuaj yeem qhia siv cov nroj tsuag raws li cov khoom siv hluavtaws cannabinoids kom muaj kev nyab xeeb, lwm txoj kev kho mob rau kev tswj cov tsos mob neuropsychiatric hauv cov neeg mob tsis muaj zog neurocognitive.

Xaus

Peb qhov kev tshuaj xyuas zoo tau qhia txog qhov tsis txaus ntawm cov kev tshawb fawb hauv cheeb tsam no. Cov ntawv ceeb toom tau txheeb xyuas ntawm no tau qhia txog kev sib koom ua ke ntawm CBD-raws li cov khoom lag luam thiab nyem los ntawm cov tsos mob ntawm lub cev muaj zog hauv HD thiab PD, thiab kev sib koom ua ke ntawm cov khoom siv cannabinoids thiab nyem rau BPSD (tag nrho peb qhov kev kuaj mob). Muab cov teeb meem kev nyab xeeb paub nrog ntau cov kev tswj hwm tshuaj kho mob ib txwm muaj, cov ntsiab lus ntawm cov ntaub ntawv pov thawj no tuaj yeem siv los qhia tus kws kho mob txog cov txiaj ntsig sib txawv ntawm cov nroj tsuag raws li cov khoom siv cannabinoids los kho cov teeb meem uas cov tsos mob neuropsychiatric tsim rau cov neeg mob neurocognitive vulnerability. . Ua ntej txhua qhov kev pom zoo kho mob tuaj yeem ua tau, nws yuav yog qhov tseem ceeb rau kev rov ua dua qee qhov kev sim tshuaj ntsuam xyuas.