Acute CBD administration at a dose of 300 mg decreased anxiety in patients with PD, and there was also decreased tremor amplitude in an anxiogenic situation.

There were statistically significant differences in the VAMS anxiety factor for the drug; CBD attenuated the anxiety experimentally induced by the SPST. Repeated-measures ANOVA showed significant differences in the drug for the variable related to tremor amplitude as recorded by the accelerometer.

A randomised, double-blinded, placebo-controlled, crossover clinical trial was conducted. A total of 24 individuals with PD were included and underwent two experimental sessions within a 15-day interval. After taking CBD or a placebo, participants underwent the SPST. During the test, the following data were collected: heart rate, systemic blood pressure and tremor frequency and amplitude. In addition, the Visual Analog Mood Scales (VAMS) and Self-Statements during Public Speaking Scale were applied. Statistical analysis was performed by repeated-measures analysis of variance (ANOVA) while considering the drug, SPST phase and interactions between these variables.

Cannabidiol (CBD) is one of the main components of Cannabis sativa and has anxiolytic properties, but no study has been conducted to evaluate the effects of CBD on anxiety signs and symptoms in patients with Parkinson’s disease (PD). This study aimed to evaluate the impacts of acute CBD administration at a dose of 300 mg on anxiety measures and tremors induced by a Simulated Public Speaking Test (SPST) in individuals with PD.

References

American Psychiatric Association ( 2013 ) Diagnostic and Statistical Manual of Mental Disorders ( 5th ed. ). Washington, DC : American Psychiatric Press .

Google Scholar Crossref

Arjmand, S, Vaziri, Z, Behzadi, M, et al . ( 2015 ) Cannabinoids and tremor induced by motor-related disorders: friend or foe? Neurotherapeutics 12: 778 – 787 .

Google Scholar Crossref | Medline

Barbosa, MT, Caramelli, P, Maia, DP, et al . ( 2006 ) Parkinsonism and Parkinson’s disease in the elderly: a community-based survey in Brazil (the Bambui study) . Mov Disord 21: 800 – 808 .

Google Scholar Crossref | Medline

Bergamaschi, MM, Queiroz, RHC, Chagas, MHN, et al . ( 2011 a) Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients . Neuropsychopharmacology 36: 1219 .

Google Scholar Crossref | Medline | ISI

Bergamaschi, MM, Queiroz, RH, Zuardi, AW, et al . ( 2011 b) Safety and side effects of cannabidiol, a Cannabis sativa constituent . Curr Drug Saf 6: 237 – 249 .

Google Scholar Crossref | Medline

Blessing, EM, Steenkamp, MM, Manzanares, J, et al . ( 2015 ) Cannabidiol as a potential treatment for anxiety disorders . Neurotherapeutics 12: 825 – 836 .

Google Scholar Crossref | Medline | ISI

Braak, H, Del Tredici, K ( 2008 ) Nervous system pathology in sporadic Parkinson disease . Neurology 70: 1916 – 1925 .

Google Scholar Crossref | Medline | ISI

Broen, MPG, Narayen, NE, Kuijf, ML, et al . ( 2016 ) Prevalence of anxiety in Parkinson’s disease: a systematic review and meta-analysis . Mov Disord 31: 1125 – 1133 .

Google Scholar Crossref | Medline

Brown, JD, Winterstein, AG ( 2019 ) Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use . J. Clin. Med 8(7): 989 .

Google Scholar Crossref

Campos, AC, Guimarães, FS ( 2008 ) Involvement of 5HT1A receptors in the anxiolytic-like effects of cannabidiol injected into the dorsolateral periaqueductal gray of rats . Psychopharmacology 199: 223 – 230 .

Google Scholar Crossref | Medline | ISI

Campos, AC, Fogaça, MV, Sonego, AB, et al . ( 2016 ) Cannabidiol, neuroprotection and neuropsychiatric disorders . Pharmacol Res 112: 119 – 127 .

Google Scholar Crossref | Medline

Campos, AC, Moreira, FA, Gomes, FV, et al . ( 2012 ) Multiple mechanisms involved in the large spectrum therapeutic potential of cannabidiol in psychiatric disorders . Philos Trans R Soc Lond B Biol Sci 367: 3364 – 3378 .

Google Scholar Crossref | Medline | ISI

Chagas, MHN, Oliveira, THGF, Linares, IMP, et al . ( 2017 ) Can anxiety increase tremors in patients with Parkinson’s disease? An experimental model . Eur Arch Psychiatry Clin Neurosci 44: 85 – 88 .

Google Scholar

Chagas, MHN, Tumas, V, Loureiro, S, et al . ( 2009 ) Does the association between anxiety and Parkinson’s disease really exist? A literature review . Curr Psychiatry Rev 5: 29 – 36 .

Google Scholar Crossref

Chagas, MHN, Zuardi, AW, Tumas, V, et al . ( 2014 ) Effects of cannabidiol in the treatment of patients with Parkinson’s disease: an exploratory double-blind trial . J Psychopharmacol 28: 1088 – 1098 .

Google Scholar SAGE Journals | ISI

Dai, H, Zhang, P, Lueth, T ( 2015 ) Quantitative assessment of parkinsonian tremor based on an inertial measurement unit . Sensors 15: 25055 – 25071 .

Google Scholar Crossref

Dissanayaka, NN, O’Sullivan, JD, Pachana, NA, et al . ( 2016 ) Disease-specific anxiety symptomatology in Parkinson’s disease . Int Psychogeriatr 1 – 11 .

Google Scholar

Dissanayaka, NN, White, E, O’Sullivan, JD, et al . ( 2014 ) The clinical spectrum of anxiety in Parkinson’s disease . Mov Disord 29: 967 – 975 .

Google Scholar Crossref | Medline

Doder, M, Rabiner, EA, Turjanski, N, et al . ( 2003 ) Tremor in Parkinson’s disease and serotonergic dysfunction: an 11C-WAY 100635 PET study . Neurology 60(4) 601 – 605 .

Google Scholar Crossref | Medline

Duvarci, S, Pare, D ( 2014 ) Amygdala microcircuits controlling learned fear . Neuron 82: 966 – 980 .

Google Scholar Crossref | Medline | ISI

Fahn, S, Elton, RL and members of the UPDRS development committee ( 1987 ) Unified Parkinson’s disease rating scale (UPDRS) . In: Fahn, S, Marsden, CD, Calne, DB, et al . (eds) Recent Developments in Parkinson’s Disease. Florham Park, NJ : Macmillan Health Care .

Google Scholar

Fusar-Poli, P, Allen, P, Bhattacharyya, S, et al . ( 2010 ) Modulation of effective connectivity during emotional processing by Delta 9-tetrahydrocannabinol and cannabidiol . Int J Neuropsychopharmacol 13: 421 – 432 .

Google Scholar Crossref | Medline | ISI

García-Arencibia, M, García, C, Kurz, A, et al . ( 2009 ) Cannabinoid CB1 receptors are early downregulated followed by a further upregulation in the basal ganglia of mice with deletion of specific park genes . J Neural Transm Suppl 73: 269 – 275 .

Google Scholar

Gibson, JD. What is the interpretation of spectral entropy? ( 1994 ) In: Proceedings of 1994 IEEE International Symposium on Information Theory , Trondheim, Norway , , p. 440 . Piscataway, NJ : IEEE .

Google Scholar Crossref

Gomes, FV, Resstel, LBM, Guimarães, FS ( 2011 ) The anxiolytic-like effects of cannabidiol injected into the bed nucleus of the stria terminalis are mediated by 5-HT1A receptors . Psychopharmacology 213: 465 – 473 .

Google Scholar Crossref | Medline

Gordon, PH, Pullman, SL, Louis, ED, et al . ( 2002 ) Mirtazapine in Parkinsonian tremor . Parkinsonism Relat Disord 9: 125 – 126 .

Google Scholar Crossref | Medline

Hoehn, MM, Yahr, MD ( 1967 ) Parkinsonism: onset, progression and mortality . Neurology 17: 427 – 442 .

Google Scholar Crossref | Medline | ISI

Hofmann, SG, Dibartolo, PM ( 2000 ) An instrument to assess self-statements during public speaking: scale development and preliminary psychometric properties . Behav Ther 31: 499 – 515 .

Google Scholar Crossref | Medline | ISI

Hui, YP, Wang, T, Han, LN, et al . ( 2015 ) Anxiolytic effects of prelimbic 5-HT(1A) receptor activation in the hemiparkinsonian rat . Behav Brain Res 277: 211 – 220 .

Google Scholar Crossref | Medline

Huot, P, Fox, SH ( 2013 ) The serotonergic system in motor and non-motor manifestations of Parkinson’s disease . Exp Brain Res 230: 463 – 476 .

Google Scholar Crossref | Medline

Jang, W, Han, J, Park, J, et al . ( 2013 ). Wave form analysis of tremor may help to differentiate Parkinson’s disease from drug-induced parkinsonism . Physiol Meas 34: N15 – N24 .

Google Scholar Crossref | Medline

Iffland, K, Grotenhermen, F ( 2017 ) An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies . Cannabis Cannabinoid Res 2: 139 – 154 .

Google Scholar Crossref | Medline

Linares, IM, Zuardi, AW, Pereira, LC, et al . ( 2019 ) Cannabidiol presents an inverted U-shaped dose–response curve in a simulated public speaking test . Braz J Psychiatry 41: 9 – 14 .

Google Scholar Crossref | Medline

McNair, DM, Frankenthaler, LM, Czerlinsky, T, et al . ( 1982 ) Simulated public speaking as a model of clinical anxiety . Psychopharmacol 77: 7 – 10 .

Google Scholar Crossref | Medline | ISI

Marinus, J, Zhu, K, Marras, C, et al . ( 2018 ) Risk factors for non-motor symptoms in Parkinson’s disease . Lancet Neurol 17: 559 – 568 .

Google Scholar Crossref | Medline

Millar, SA, Stone, NL, Yates, AS, et al . ( 2018 ) A systematic review on the pharmacokinetics of cannabidiol in humans . Front Pharmacol 9: 1365 .

Google Scholar Crossref | Medline

Moriyama, TS, Chagas, MHN, Silveira-Moriyama, L, et al . ( 2016 ) Diagnosing social anxiety in Parkinson’s disease: characteristics and frequencies according to two diagnostic criteria . Rev Psiquiatr Clín 43: 139 – 142 .

Google Scholar Crossref

Norris, H ( 1971 ) The action of sedatives on brain stem oculomotor systems in man . Neuropharmacol 10: 181 – 191 .

Google Scholar Crossref | Medline | ISI

Osório, FL, Crippa, JAS, Loureiro, SR ( 2008 ) Self statements during public speaking scale (SSPS): cross-cultural adaptation for Brazilian Portuguese and internal consistency . Rev Psiquiatr Clín 35: 207 – 211 .

Google Scholar

Peres, FF, Lima, AC, Hallak, JEC, et al . ( 2018 ) Cannabidiol as a promising strategy to treat and prevent movement disorders? Front Pharmacol 9: 1 – 12 .

Google Scholar Crossref | Medline

Pisanti, S, Malfitano, AM, Ciaglia, E, et al . ( 2017 ) Cannabidiol: state of the art and new challenges for therapeutic applications . Pharmacol Ther 175: 133 – 150 .

Google Scholar Crossref | Medline

Ponti, M, Bet, P, Oliveira, CL, et al . ( 2017 ) Better than counting seconds: Identifying fallers among healthy elderly using fusion of accelerometer features and dual-task Timed Up and Go . PLoS one 12: e0175559 .

Google Scholar Crossref | Medline

Pontone, GM, Williams, JR, Anderson, KE, et al . ( 2013 ) Pharmacologic treatment of anxiety disorders in Parkinson’s disease . Am J Geriatr Psychiatry 21: 520 – 528 .

Google Scholar Crossref | Medline | ISI

Ruehle, S, Rey, AA, Remmers, F, et al . ( 2012 ) The endocannabinoid system in anxiety, fear memory and habituation . J Psychopharmacol 26: 23 – 39 .

Google Scholar SAGE Journals | ISI

Ruiz, PJG, Bernardos, VS, Bartolomé, M, et al . ( 2007 ) Capit timed tests quantify age-related motor decline in normal subjects . J Neurol Sci 260: 283 – 285 .

Google Scholar Crossref | Medline

Sagna, A, Gallo, JJ, Pontone, GM ( 2014 ) Systematic review of factors associated with depression and anxiety disorders among older adults with Parkinson’s disease . Parkinsonism Relat Disord 20: 708 – 715 .

Google Scholar Crossref | Medline

Schwab, RS, England, AC ( 1969 ) Projection technique for evaluating surgery in Parkinson’s disease . In: Gillingham, FJ, Donaldson, MC (eds) Third Symposium on Parkinson’s Disease . Edinburgh, UK : Livingston , pp. 152 – 157 .

Google Scholar

Sun, YN, Wang, T, Wang, Y, et al . ( 2015 ) Activation of 5-HT1A receptors in the medial subdivision of the central nucleus of the amygdala produces anxiolytic effects in a rat model of Parkinson’s disease . Neuropharmacol 95: 181 – 191 .

Google Scholar Crossref | Medline

Svíženská, I, Dubový, P, Šulcová, A ( 2008 ) Cannabinoid receptors 1 and 2 (CB1 and CB2), their distribution, ligands and functional involvement in nervous system structures – a short review . Pharmacol Biochem Behav 90: 501 – 511 .

Google Scholar Crossref | Medline | ISI

Vriend, C, Boedhoe, PSW, Rutten, S, et al . ( 2016 ) A smaller amygdala is associated with anxiety in Parkinson’s disease: a combined FreeSurfer-VBM study . J Neurol Neurosurg Psychiatry 87: 493 – 500 .

Google Scholar Crossref | Medline

Wile, DJ, Ranawaya, R, Kiss, ZH ( 2014 ) Smart watch accelerometry for analysis and diagnosis of tremor . J Neurosci Methods 230: 1 – 4 .

Google Scholar Crossref | Medline

Zuardi, AW, Karniol, I ( 1981 ) Estudo Transcultural de uma Escala de Auto-avaliação para estados subjetivos . J Bras Psiquiatr 31: 403 – 496 .

Google Scholar

Zuardi, AW, Cosme, RA, Graeff, FG, et al . ( 1993 ) Effects of ipsapirone and cannabidiol on human experimental anxiety . J Psychopharmacol 7: 82 – 88 .

Google Scholar SAGE Journals | ISI