Cannabis Extract Shows Promise for Childhood Neuropsychiatric Syndrome Through Epigenetic Mechanisms
A full-spectrum low-THC cannabis extract (NTI164) significantly improved OCD, tics, ADHD, and emotional regulation in 14 children with PANS, with multi-omics revealing that it modifies the epigenetic and immune dysregulation underlying the condition.
Quick Facts
What This Study Found
12 weeks of NTI164 (20 mg/kg/day) decreased CGI-Severity from 4.8 to 3.3 (p=0.002) with significant improvements in OCD (p=0.0001), tics (p<0.0001), ADHD (p=0.028), emotional regulation (p<0.0001), and quality of life (p=0.011). Multi-omics revealed NTI164 modified dysregulated epigenetic, ribosomal, and immune pathways in patient leukocytes.
Key Numbers
N=14; mean age 12.1; 20 mg/kg/day NTI164; CGI-S: 4.8→3.3 (p=0.002); CYBOCS-II OCD p=0.0001; YGTSS tics p<0.0001; Conner's ADHD p=0.028; RCADS-P emotional p<0.0001; EQ-5D-Y QoL p=0.011; well-tolerated
How They Did This
Open-label trial of 14 children with chronic-relapsing PANS (mean age 12.1, 71% male) receiving NTI164 for 12 weeks, with clinical assessments using gold-standard tools and pre/post blood samples analyzed by bulk and single-cell transcriptomics, proteomics, phosphoproteomics, and DNA methylation.
Why This Research Matters
PANS is a devastating condition with limited treatment options, and this study provides both clinical evidence of benefit and mechanistic evidence that a cannabis extract can modify the underlying epigenetic and immune dysfunction.
The Bigger Picture
This is among the first studies to combine clinical outcomes with deep multi-omics profiling to show how a cannabis extract works at the molecular level, presenting epigenetic machinery as a new therapeutic target.
What This Study Doesn't Tell Us
Open-label without placebo control; very small sample (n=14); PANS diagnosis can be heterogeneous; cannot separate placebo effects; NTI164 is a complex mixture making mechanism attribution difficult; 12-week duration only.
Questions This Raises
- ?Would a placebo-controlled trial confirm these results?
- ?Which components of NTI164 drive the epigenetic effects?
- ?Could this approach work for other autoimmune neuropsychiatric conditions?
- ?What are the long-term effects?
Trust & Context
- Key Stat:
- Evidence Grade:
- Open-label pilot with multi-omics validation provides compelling preliminary evidence, but lack of placebo control and small sample demand cautious interpretation.
- Study Age:
- Published 2026; represents cutting-edge integration of cannabinoid therapeutics and multi-omics.
- Original Title:
- Medicinal cannabis plant extract (NTI164) modifies epigenetic, ribosomal, and immune pathways in paediatric acute-onset neuropsychiatric syndrome.
- Published In:
- Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, e00828 (2026)
- Authors:
- Keating, Brooke A, Han, Velda X, Nishida, Hiroya, Aryamanesh, Nader, Marshall, Lee L, Gloss, Brian S, Lau, Xianzhong, Dissanayake, Ruwani, Dervish, Suat, Graham, Mark E, Mohammad, Shekeeb S, Kanhangad, Manoj, Fahey, Michael C, Patel, Shrujna, Dale, Russell C
- Database ID:
- RTHC-08379
Evidence Hierarchy
Frequently Asked Questions
Can cannabis help children with PANS?
This small trial of a low-THC cannabis extract showed significant improvements in OCD, tics, ADHD, and emotional regulation in 14 children with PANS — but without a placebo group, these promising results need confirmation in larger controlled studies.
How does cannabis affect PANS at the molecular level?
Multi-omics analysis revealed that PANS patients have dysregulated epigenetic and immune pathways, and the cannabis extract (NTI164) significantly modified these pathways — suggesting it works as a disease modifier rather than just treating symptoms.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08379APA
Keating, Brooke A; Han, Velda X; Nishida, Hiroya; Aryamanesh, Nader; Marshall, Lee L; Gloss, Brian S; Lau, Xianzhong; Dissanayake, Ruwani; Dervish, Suat; Graham, Mark E; Mohammad, Shekeeb S; Kanhangad, Manoj; Fahey, Michael C; Patel, Shrujna; Dale, Russell C. (2026). Medicinal cannabis plant extract (NTI164) modifies epigenetic, ribosomal, and immune pathways in paediatric acute-onset neuropsychiatric syndrome.. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, e00828. https://doi.org/10.1016/j.neurot.2025.e00828
MLA
Keating, Brooke A, et al. "Medicinal cannabis plant extract (NTI164) modifies epigenetic, ribosomal, and immune pathways in paediatric acute-onset neuropsychiatric syndrome.." Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 2026. https://doi.org/10.1016/j.neurot.2025.e00828
RethinkTHC
RethinkTHC Research Database. "Medicinal cannabis plant extract (NTI164) modifies epigeneti..." RTHC-08379. Retrieved from https://rethinkthc.com/research/keating-2026-medicinal-cannabis-plant-extract
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.