Muscular Dystrophy Overview

Muscular Dystrophy (MD) is a group of disorders that cause progressive weakness and degeneration of the skeletal muscles that control movement. MD is believed to be caused by over thirty different genetic disorders that are classified into nine different types. The categories vary in the severity and extent of muscle weakness and degeneration, age of onset, rate of progression, and pattern of inheritance.

Duchenne MD

The most common form of MD is Duchenne MD, which primarily affects boys with an average onset between 3 and 5 years. The disease is characterized by rapid progression, with most boys unable to walk by age 12, and later requiring a respirator to breathe. Without proper care, individuals with Duchenne MD are expected to die in their late teens or early twenties, but with aggressive multidisciplinary care many affected individuals survive into their 30s and even some into their 40s.

Becker MD

Becker MD is related to Duchenne MD, but it is less severe. Muscle weakness usually begins between ages 11 and 25, and is first noticed in the upper arms and shoulders, upper legs, and pelvis areas. The severity of muscle atrophy and weakness varies greatly among individuals with Becker MD.

Facioscapulohumeral MD

This form of MD initially affects the muscles of the face, shoulders, and upper arms. It is the third most common type of MD and usually onsets during the teenage years, but may occur as early as childhood or as late as age 40. Muscle weakness progresses slowly, and most individuals with Facioscapulohumeral MD live a normal lifespan.

Myotonic MD

Also known as Steinert’s disease and dystrophia myotonica, Myotonic MD is another common form of MD that has a typical onset between age 20 and 30. It is characterized by sudden muscle contractions with the inability to relax. Individuals with Myotonic MD usually live a long life, with variable and slowly progressive disability.

Congenital MD

A type of MD that occurs at birth or becomes evident before age 2 is known as Congenital MD. This form of MD affects both girls and boys. Like Becker MD, the severity and extent of this disease varies from person to person. Most children with Congenital MD cannot sit or stand without support, and some may never learn to walk. Some children with Congenital MD die in infancy, while others live to adulthood with minimal disability.

Other Types of Muscular Dystrophy

There are four other less common classifications of MD with various patterns of disability: Distal MD, Emery-Dreifuss MD, Limb-girdle MD, and Oculopharyngeal MD.

Symptoms of Muscular Dystrophy

The symptoms of MD vary case by case because it is a group of several conditions. The most common symptoms across all individuals with MD affect the following functions:

• Walking
• Insomnia
• Balance
• Muscle stiffness
• Expressing emotions
• Daytime drowsiness
• Thinking
• Muscle weakness
• Difficulty breathing and swallowing
• Developmental delays
• Cardiovascular function
• Muscle pains and cramps
• Motor control
• Childhood learning disabilities
• Loss of muscle mass
• Drooping eyelids

A common experience for people with MD is chronic pain and inflammation due to muscle spasms, stiff joints, and pressure sores.

Conventional Treatment of Muscular Dystrophy

There is no cure for MD. Instead, various therapies and medications are used to treat the symptoms of MD with the goal of improving the quality of life for patients. These include physical therapy, occupational therapy, and corrective surgery. Medication can be used to slow or control the symptoms of MD. These drugs are:

• Glucocorticoids, such as prednisone to increase muscle strength, ability, and respiratory function and slow the progression of weakness. Side effects may include weight gain. Long-term use may result in brittle bones, cataracts, and high blood pressure.
• Anticonvulsants to help control seizures and muscle spasms.
• Immunosuppressants to delay damage to dying muscle cells.
• Antibiotics to treat respiratory infections.

Research is currently being done to use gene replacement therapy, genetic modification therapy, and cell-based therapy to help find new treatments for MD.

The Endocannabinoid System and Muscular Dystrophy

All human bodies contain an endocannabinoid system (ECS) that is a complex network of cell-signaling receptors responsible for regulating many biological systems that are affected by MD. The ECS creates and uses cannabinoids to govern these functions. Cannabinoids are present in the cannabis plant, and are also generated naturally by the body.

The CB1 and CB2 receptors in the ECS interact with cannabinoids from plants (phytocannabinoids) and from the body (endocannabinoids) to regulate an array of bodily functions. The ECS regulates the body’s pain response from muscle spasms, manages inflammation, interacts with the nervous system, and plays a part in the immune system.

Using CBD to Treat Muscular Dystrophy

The endocannabinoid system releases an endocannabinoid called anandamide when a person is in pain. The anandamide manages the body’s pain and inflammation response to reduce the sensation of pain. CBD helps the body retain more anandamide by blocking the fatty acid that breaks down anandamide as part of the normal ECS function. Higher levels of anandamide in the body contribute to the following:

• Reduces pain associated with MD complications such as muscular spasticity, spasms, and injury.
• Regulates inflammation, which is an immune response within the body.
• Improves mood, sleep, and reduces anxiety.

CBD has been shown in mice studies to significantly improve the complications in mice with mild forms of muscular dystrophy. One study from 2019 demonstrated that CBD reduces inflammation, reduces the loss of mobility, and reduced cell degradation in subject mice. The study also found that mice given CBD treatment showed stimulated muscle fiber formation.

CBD as a Substitute for Painkillers and Corticosteroids

Patients with MD often use opioids and corticosteroids to manage the pain and inflammation associated with MD. These drugs often have side effects like digestive issues, drowsiness, weight gain, and bone weakness. Opioids use also puts the patient at risk of developing an addiction or substance abuse problem.

CBD has been shown to be effective at reducing pain and inflammation. Before using CBD, speak with your medical practitioner. CBD has some known drug interactions which are important to discuss with your doctor before incorporating it into your treatment plan.

Conclusion

CBD interacts with the body’s endocannabinoid system to provide relief for some of the complications associated with muscular dystrophy. CBD has been shown to be effective in regulating MD symptoms including pain, inflammation, insomnia, and anxiety. Although more knowledge is needed, the latest research shows CBD to have promise as part of a future MD treatment plan.

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