Amyotrophic Lateral Sclerosis (ALS)

What is ALS?

Amyotrophic lateral sclerosis, aka Lou Gehrig’s Disease, is a rare neurological disorder that attacks nerve cells that control voluntary muscle movement. Voluntary muscles are the ones we choose to move and control things like walking, writing, chewing, and talking.  Unfortunately, there is no cure for ALS, and symptoms typically progress and worsen over time. 

ALS is a motor neuron disease caused by the gradual deterioration and death of motor neurons. Motor neurons are nerve cells that connect the brain to the spinal cord and muscles throughout the body. As motor neurons degenerate, they stop sending messages to the muscles, and the muscles gradually weaken, twitch, and waste away. Eventually, the brain loses its ability to initiate and control voluntary movements.

Early symptoms of ALS usually include muscle weakness or stiffness. Gradually all voluntary muscles are affected, and patients eventually lose their strength and the ability to speak, eat, move, and breathe. Most people with ALS die from respiratory failure within three to five years of the symptoms’ first appearance. Approximately ten percent of people with ALS survive for ten or more years.

Who is Lou Gehrig? 

amyotrophic lateral sclerosis was identified as a disease in 1869 by French neurologist Jean-Martin Charcot. The disease became widely known in June 1941, when it ended the career of one of American baseball’s best and most beloved players, Lou Gehrig. Even now, ALS is commonly referred to as Lou Gehrig’s disease.

What are the symptoms?

The onset of amyotrophic lateral sclerosis (ALS) can be subtle, but these symptoms gradually develop into more obvious symptoms, including:

• Muscle cramps in the arm, leg, shoulder, or tongue
• Tight and stiff muscles 
• Muscle weakness affecting arms, legs, neck, or diaphragm
• Slurred speech
• Difficulty chewing or swallowing

What causes ALS?

The cause of amyotrophic lateral sclerosis is unknown, and scientists do not yet know why the disease affects some people and not others. However, evidence suggests that genetic and environmental factors play a role in motor neuron degeneration and ALS development.

Risk factors for ALS include:

• Age. Although ALS can strike at any age, symptoms commonly develop between 55 and 75.
• Gender. Men are more likely than women to develop ALS. However, as people age, the difference between men and women disappears.
• Race and ethnicity. Caucasians and non-Hispanics are most likely to develop the disease.

How is ALS diagnosed?

There isn’t an official test that provides a diagnosis of amyotrophic lateral sclerosis. It is usually diagnosed based on a detailed history of the symptoms observed by a physician, a review of the individual’s complete medical record, and a series of tests to rule out other diseases and track for signs of worsening symptoms. 

Medical Cannabis as ALS Treatment

Therapeutic options for amyotrophic lateral sclerosis, the most common adult-onset motor neuron disorder, remain limited. Emerging evidence from clinical studies and transgenic mice models of ALS suggests that cannabinoids, the bioactive ingredients of Cannabis sativa, might have some therapeutic benefit for this condition. However, Delta 9-THC, the predominant cannabinoid in marijuana, induces mind-altering effects and is partially addictive, compromising its clinical effectiveness.

Scientists tested whether CBN, a non-psychotropic cannabinoid, influences disease progression and survival in the SOD1 rat model of ALS. CBN was delivered via subcutaneously implanted osmotic mini-pumps over 12 weeks. Researchers found that this treatment significantly delayed disease onset by more than two weeks while not affecting survival rates. This study is still in its early stages. Further research and human studies are necessary to determine whether non-psychotropic cannabinoids might help alleviate amyotrophic lateral sclerosis symptoms compared to other drugs.