Dopaminerge Störungen mit Endocannabinoid-Beteiligung
Endocannabinoide sind in eine Vielzahl von Störungsbildern involviert, darunter etliche, die typischerweise mit einem erhöhten (fett) oder verringerten (kursiv) oder verringerten oder erhöhten (kursiv und fett) Dopaminspiegel korrelieren:123
- 1. Endocannabinoide bei verschiedenen Störungsbildern
- 2. Cannabinoide bei Parkinson
- 3. Psychose-Risikofaktoren bei Cannabiskonsum
1. Endocannabinoide bei verschiedenen Störungsbildern
| Störung | Dopamin | AEA | 2-AG | CB1R | CB2R |
|---|---|---|---|---|---|
| ADHS | DA verringert | AEA erhöht4 | CB1R-Agonist verbesserte Hyperaktivität/Impulsivität5 | ||
| Cardiovaskuläre Störungen6 | |||||
| ASS789101112131415 | AEA verringert16, Endocannabinoide verringert17 | ||||
| Parkinson1819 | verringert | AEA erhöht20 | 2-AG erhöht21 | CB1R-Expression in Basalganglien erhöht222324 | CB2R erhöht2526 |
| Alzheimer2728 | AEA-Erhöhung hilfreich2930 | CB1R verringert31 | CB2R erhöht32 | ||
| Huntington28 | verringerte bis völlig verlorene CB1R und D1R33 | ||||
| Multiple Sklerose34 | AEA erhöht in Liquor und peripheren Lymphozyten erhöht35 | 2-AG unverändert in Liquor und peripheren Lymphozyten35 | |||
| Fragiles-X-Syndrom34 | 2-AG-Erhöhung in Tiermodell hilfreich36 | CB1R aufgrund Überstimulation verringert. CBD könnte hilfreich sein.37 | |||
| amyotrophe Lateralsklerose | |||||
| traumatische Hirnverletzungen | |||||
| Schlaganfall | |||||
| Epilepsie | verringert | AEA erhöht nach Krampfanfällen | 2-AG erhöht nach Krampfanfällen | ||
| Glioblastom | verringert | ||||
| Angststörungen | AEA verringert3839 AEA-Erhöhung hilfreich40 | 2-AG-Erhöhung hilfreich40 | CB2R-Antagonisten hilfreich41 | ||
| PTSD und fehlerhafte Löschung aversiver Erinnerungen42 | verringert | AEA verringert4344 AEA unverändert45 AEA-Stressantwort unverändert4647 | 2-AG verringert45 2-AG-Stressantwort verringert4647 | CB1R erhöht4344 | |
| Depression4849 | verringert | AEA bei leichter Depression erhöht, bei schwerer eher unverändert39 AEA-Erhöhung hilfreich50 Fluoxetin verringerte AEA in limbischen Regionen50 Tianeptin erhöhte AEA im Hippocampus und dorsalen Striatum50 Imipramin erhöht Endocannabinoide im dorsalen Striatum50 Escitalopram erhöhte Endocannabinoide im Hippocampus und dorsalen Striatum ODER verringerte sie im Cortex und Cerebellum50 | 2-AG verringert50 bei Frauen mit schwerer Depression3938 2-AG tendenziell erhöht bei leichter Depression39 Fluoxetin erhöhte 2-AG im PFC50 Tianeptin erhöhte 2-AG im dorsalen Striatum und PFC50 Imipramin erhöht Endocannabinoide im dorsalen Striatum50 Escitalopram erhöhte Endocannabinoide im Hippocampus und dorsalen Striatum{ ODER verringerte sie im Cortex und Cerebellum50 | ||
| Bipolare Störung51 | |||||
| Essstörungen525354 | |||||
| Psychose5556 | erhöht | ||||
| Schizophrenie | Negativsymptome: verringertes Dopamin im PFC / Positivsymptome: erhöhtes Dopamin im dorsomedialen Striatum57585960616263 | AEA im Gehirn 8-fach erhöht64 | CB1R erhöht64 |
2. Cannabinoide bei Parkinson
Cannabinoide bei Parkinson
Parkinson entsteht durch eine schrittweise Degeneration dopaminerger Neuronen der Substantia nigra, was die dopaminerge Neurotransmission im Striatum immer weiter einschränkt.65
Möglicherweise ist eine gestörte Endocannabinoid-Signalübertragung in den Basalganglien Ursache für Parkinson. Cannabinoide werden zur Behandlung von Parkinson-Symptomen und zur Verzögerung der Parkinson-Entstehung diskutiert und getestet.66676869
- CB1R-Agonisten
- Antioxidative Phytocannabinoide scheinen in Parkinson-Tiermodellen die Degeneration dopaminerger Neuronen von Parkinson zu hemmen77
- andere Studien faden keine starke antioxidative Wirkung von Cannabinoiden78
- CB2Rs sind an der Kontrolle motorischer Effekte beteiligt7980
- Cannabinoide wirken neuroprotektiv818283 und hemmen die Parkinson-Entwicklung bei Parkinson-Tiermodellen84
Cannabiskonsum zeigte bei Parkinson in Studien
- bei 45,9 %85 bis 78 %86 Verbesserungen durch Cannabis-Konsum
- Motorik
- weniger Schmerzen87
- verbesserten Schlaf87 durch Nabilon91
- verringerte Angst durch Nabilon91
CBD bewirkte bei Parkinson
- eine Verringerung der Parkinson-Gesamtwerte92
- eine signifikante Verringerung psychotischer Symptome92
- keine Verbesserung motorischer oder allgemeiner Symptome in Doppelblindstudie9392
In einem Parkinson-Tiermodell fanden sich deutlich erhöhte Mengen an TRPV1, was die erhöhte Schmerzempfindlichkeit bei Parkinson erklären könnte.94
3. Psychose-Risikofaktoren bei Cannabiskonsum
Besondere Psychose-Risikofaktoren bei Cannabis-Konsum:95
- häufiger Konsum
- Konsum von Cannabis mit hohem Δ9-THC-Gehalt
- früher Konsum (Adoleszenz)
- familiäre Vorgeschichte von Psychosen
- Psychose-Prodromalsymptome
- Nervosität
- Ängstlichkeit
- Unruhe
- Ängste oder Depressionen
- Rückzug aus sozialen Bindungen
- verringerte Lebensfreude und Leistungsfähigkeit
- Bewältigung von Ausbildung oder Beruf eingeschränkt gegenüber früher
- Träger des Val-Allels von COMT
- Halluzinationen als Drogenwirkung
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