Target for Epilepsy Treatment

Out of all the neurological medical conditions, epilepsy is the most common, effecting around if not over 50 million people worldwide (4). There are numerous forms of treatments used for epilepsy. The effectiveness of epilepsy treatments is good for many individuals which use anti epileptic drugs available, but for many individuals, the current drugs that are used are not effective, leaving one with un-controlled seizures. Current research shows there being numerous factors concerning the firing of neuron’s which are being looked at for the treatment of epilepsy. These include things such as: Signaling pathways, enzymes, proteins, channels, and receptors. (7). Here we will look at a channel that is thought to be a possible  target for epilepsy treatment. (4)

 

What Channel is important ?

A Channel that has been shown to have numerous effects on neurons is called TRPV1 and is expressed on sensory neuron’s. It is responsive to things such as heat, endocannabinoids which concern CBD, and protons. It also concerns things such as chronic pain, epilepsy, bladder disorders, diabetes, and obesity. (3). Calcium ions are a main contributor to the treatment of epilepsy. These occur in a specific part of the brain, and since this is a calcium permeable channel, it is seen as a mediator of epilepsy in this brain region (6). It has been shown to be a factor in conditions which is neurological  such as cerebral palsy, epilepsy, and cognitive disabilities in newly born babies. It is thought that this could be a target in the treatment of newly born infants which may have a condition which may lead to the previous conditions mentioned. (2)

 

What part of the brain is effected ?

There are numerous lobes and parts to the brain, and depending on the type of epilepsy that an individual has, either certain parts, or the entire brain can be effected. Some seizures are considered partial, effecting only specific parts of the brain, while others effect the entire brain. One of the main forms is temporal lobe epilepsy or TLE for short. This is probably the most common form of epilepsy that is seen, and many of the studies concerning treatments have been performed on these types of seizures. Although this is the case, it doesn’t mean that other possible treatments wouldn’t work with other types of seizures, but the results from the studies done concerned this type of seizure more than the others.

 

Effects of the Channel

The effects of different treatment for this are similar concerning the results that were seen from studies. It is thought that the channel may be an underlying mechanism as an epilepsy target since it has been shown for subjects which it was reduced as having a prolonged onset, shorter duration, and decrease in seizure frequency. (1).  Treatments have to do with the control of the channel concerning the amount used, and the size of the channel. The channel size is higher in patients with TLE, which effects the capacity and firing frequency of the neuron. Over expression and distribution patterns of the channel may be involved in the formation of this form of epilepsy. (8). It has been shown for both this channel, and serotonin receptors to be two main targets, with other protein receptors being targets for CBD as well. (5)  It has also been thought that blockage of the channel (TRPV1) along with a type of serotonin may help inhibit seizures, with serotonin delaying the onset and decreased the duration of seizures seen. The administration of an antagonist of the channel  may also have similar but not identical effects on the frequency and duration of seizures seen. (9).   The balance of both excitation and inhibition of the factors previously mentioned are important concerning epilepsy. This is where agonists or antagonists come into play. Using an antagonist of this as a form of treatment for epilepsy concerning alterations in the brain region may be effective (10). The alteration of the channel has been shown to have a positive effect on reducing the intensity and duration of seizures that occur, but more research should be done in order to better understand how it works.

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Other factors

Since the channel mentioned is the only one that concerns the use of CBD, this may be at least some general explanation on how CBD may work in controlling seizures. As previously mentioned, there are other numerous factors that could be looked at concerning controlling the firing of neuron’s (7). This in turn could assist in the development of other treatments to be used for epilepsy. Since channels are only one factor concerning the firing of neuron’s, the effects of marijuana and CBD on the other factors should be looked at as well. When it is better understood exactly how the CBD may assist in decreasing the frequency, duration, and intensity of seizures, it will be easier to assess the best form of treatment for the individual. This may be using the CBD only as an add on to current medications being taken, or changing treatments all together, but will depend on the individual.

 

Conclusion

From the numerous neurological conditions that exist, epilepsy is the most common, effecting more individuals than all the other conditions. Although there are numerous forms of treatments that are used, many are non-effective on individuals which have no response to the drugs that are taken. This is where research in to new forms of drugs comes into play, with one being that of CBD which is in the marijuana plant. There are numerous factors concerning the frequency of firing of neuron’s which is what must be controlled in order to control seizures (7), but current treatment uses only one or two of these. One of these which concerns channels and is associated with CBD is thought to play a role in decreasing the frequency and duration of seizures. This is probably due to one or more of a few factors involved in it’s activity (11), The fact that this is associated with CBD may also be an indicator of the possible effectiveness of using marijuana to control seizures, but to better understand this and create a better form of treatment, the research being done should be continued.

 

References 

1. https://pubmed.ncbi.nlm.nih.gov/31722723/

2. https://pubmed.ncbi.nlm.nih.gov/31142341/

3. https://pubmed.ncbi.nlm.nih.gov/27976413/

4. https://pubmed.ncbi.nlm.nih.gov/25029033/

5. https://pubmed.ncbi.nlm.nih.gov/33169541/

6. https://pubmed.ncbi.nlm.nih.gov/26411767/

7. https://pubmed.ncbi.nlm.nih.gov/33202963/

8. https://pubmed.ncbi.nlm.nih.gov/22936245/

9. https://pubmed.ncbi.nlm.nih.gov/24674273/

10. https://pubmed.ncbi.nlm.nih.gov/25713512/

11. https://pubmed.ncbi.nlm.nih.gov/32656346/