And The Underlying Connection between Pediatric Epilepsy and Autism
Loren DeVito, PhD, Staff Writer for Terpenes and Testing Magazine
Over the past few years, the conversation around autism has reached quite a fever pitch. Although the link between autism spectrum disorder (ASD) and vaccines was completely debunked many years ago, the anxiety and misinformation surrounding this condition has caused long-lasting damage to both the medical community and parents alike.1 Part of this misinformation stems from a perception of its inflated prevalence, likely due to increased awareness of ASD and improved diagnostic criteria.2
But the mystery of autism persists because there are no treatments that address its core symptoms, and children with severe forms of the condition often face a very difficult life ahead. But, there is hope.
As we learn more about ASD and its connection to another related condition – epilepsy – researchers are getting closer to developing effective treatments using cannabinoids.
What is ASD?
Autism Spectrum Disorder, or ASD, includes a wide range of neurodevelopmental conditions that affect social behaviors. Children begin showing signs of ASD within the first few years of life.3 While the severity of ASD differs, most children have trouble with nonverbal communication, such as eye contact and facial expressions, and exhibit delays in cognitive development or hyperactivity and aggression.4 Some children with ASD may develop into adults with mild social impairments, while others may have significant impairments requiring intensive interventions.
How is ASD Related to Epilepsy?
People with ASD are at an increased risk of developing epilepsy, or seizure disorders, and those with certain types of epilepsy are more likely to develop ASD.5,6 While this association is not fully understood, it may be related to disruptions that occur early in life that cause later problems in development. However, insights into epilepsy may help researchers figure out how to treat ASD.
Cannabinoids for ASD?
Just a few months ago, the US FDA approved a cannabis-based medicine, Epidiolex, to treat severe forms of pediatric epilepsy. This cannabidiol (CBD) treatment effectively and safely reduces seizures in children with Lennox-Gastaut syndrome and Dravet syndrome.7,8 And now, researchers are looking into how it might help people with ASD.
Clinical trials studying the effects of cannabinoids on autism are currently underway in NYC, Jerusalem, and London. Two of these studies are exploring the effect of different cannabinoids (CBD and cannabidivarin, CBDV) on different symptoms of ASD in children, while one is focused on understanding how CBD and CBDV affect the brain functions in adults with ASD.9-11 Initial results of the Israeli trial indicate beneficial effects of CBD on behavioral problems, as well as anxiety and communication problems, in children with ASD.12
While these results are very promising, is there any other evidence to support CBD for ASD?
Stephen T. Schultz first proposed that ASD may be linked to the endocannabinoid system (the body’s internal cannabis system) in 2010.13 This theory was preceded by several pre-clinical studies indicating a role for cannabinoids in alleviating ASD-like behaviors in animal models.14 In fact, this evidence taken together, as well as advocacy from parents and support groups, has prompted policy makers in several states to include autism as a qualifying condition for medical cannabis.
Where Do We Go From Here?
While parents in certain states can use CBD to help their children, without data from clinical trials, they lack the guidance needed to understand the right dose and precise effects different cannabinoids have on their child’s specific condition. As these trials are just beginning, it may take a few years until a more complete picture of the effects of cannabis on ASD is revealed.
Until then, those affected by ASD can learn more about advocacy groups like Mothers Advocating Medical Marijuana for Autism (MAMMA) who are working with legislators so that more families have access to the medical cannabis their children need.
- Rao, T.S.S., Andrade, C., “The MMR Vaccine and Autism: Sensation, Refutation, Retraction, and Fraud”, Indian J Psychiatry, 2011, Volume 53.
- Xu, G., Strathearn, L., Liu, B., Bao, B., “Prevalence of Autism Spectrum Disorder Among US Children and Adolescents, 2014-2016”, JAMA, 2018, Volume 319.
- Park, H.R., et al., “A Short Review on the Current Understanding of Autism Spectrum Disorders”, Exp Neurobiol, 2016, Volume 25.
- Fakhoury, M., “Autistic Spectrum Disorders: A Review of Clinical Features, Theories and Diagnosis”, Int J Dev Neurosci, 2015, Volume 43.
- Sundelin, H.E.K., et al., “Autism and Epilepsy: A Population-based Nationwide Cohort Study”, Neurology, 2016, Volume 87.
- Spence, S.J., Schneider, M.T., “The Role of Epilepsy and Epileptiform EEGs in Autism Spectrum Disorders”, Pediatr Res, 2009, Volume 65.
- Thiele, E.A,. et al., “Cannabidiol In Patients with Seizures Associated with Lennox-Gastaut Syndrome (GWPCARE4): A Randomised, Double-blind, Placebo-controlled Phase 3 Trial”, Lancet, 2018, Volume 6736.
- Devinsky, O., et al., “Trial of Cannabidiol for Drug-resistant Seizures in the Dravet Syndrome”, NEJM, 2017, Volume 376.
- US National Library of Medicine, “Cannabidivarin (CBDV) vs. Placebo in Children With Autism Spectrum Disorder (ASD)”, Available at: https://clinicaltrials.gov/ct2/show/NCT03202303, Accessed: October 1, 2018.
- US National Library of Medicine, “Cannabinoids for Behavioral Problems in Children With ASD (CBA)”, Available at: https://clinicaltrials.gov/ct2/show/NCT02956226, Accessed: October 1, 2018.
- US National Library of Medicine, “Shifting Brain Excitation-Inhibition Balance in Autism Spectrum Disorder”, Available at: https://clinicaltrials.gov/ct2/show/NCT03537950, Accessed: October 1, 2018.
- Aran, A., Cassuto, H., Lubotzky, L., “Cannabidiol Based Medical Cannabis in Children with Autism- a Retrospective Feasibility Study”, Neurology, 2018, Volume 90.
- Schultz, S.T., “Can Autism Be Triggered By Acetaminophen Activation of the Endocannabinoid System?”, Acta Neurobiol Exp, 2010, Volume 70.
- Zamberletti, E., Gabaglio, M., Parolaro, D., “The Endocannabinoid System and Autism Spectrum Disorders: Insights from Animal Models”, Int J Mol Sci, 2017, Volume 18.
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