First study finds elevated endocannabinoid levels in the spinal fluid of Tourette syndrome patients

Cerebrospinal fluid levels of key endocannabinoids were significantly elevated in Tourette syndrome patients compared to controls, with 2-AG levels correlating with ADHD severity.

Müller-Vahl, Kirsten R et al.·Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology·2020·Moderate EvidenceCase-Control
RTHC-02735Case ControlModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case-Control
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

In the first study measuring CSF endocannabinoids in Tourette syndrome, both AEA (anandamide, p=0.0018) and 2-AG (p=0.0003) were significantly elevated in 20 TS patients compared to 19 controls. PEA and arachidonic acid were also elevated. 2-AG levels correlated with ADHD symptom severity (p<0.01).

Key Numbers

20 TS patients vs 19 controls; AEA elevated (p=0.0018); 2-AG elevated (p=0.0003); PEA elevated (p=0.02); AA elevated (p<0.0001); 2-AG correlated with ADHD severity (p<0.01).

How They Did This

Case-control study comparing CSF levels of endocannabinoids (AEA, 2-AG), PEA, and arachidonic acid in 20 adult Tourette syndrome patients vs. 19 controls using LC/MRM quantification.

Why This Research Matters

Cannabis-based medicines have been reported to improve tics in Tourette syndrome, but the biological basis was unknown. This first-ever CSF study confirms endocannabinoid system involvement in TS pathophysiology.

The Bigger Picture

The elevated endocannabinoid levels could represent either a compensatory response to tic-related neural dysfunction or a primary pathological mechanism. Either way, it validates the endocannabinoid system as a therapeutic target for Tourette syndrome.

What This Study Doesn't Tell Us

Small sample; cross-sectional design; cannot determine if elevated levels are cause or consequence; CSF may not perfectly reflect brain-regional endocannabinoid activity; adult patients only.

Questions This Raises

  • ?Are endocannabinoid levels in CSF responsive to treatment with cannabinoid medications?
  • ?Would measuring CSF endocannabinoids help predict who responds to cannabis-based therapy?

Trust & Context

Key Stat:
First CSF study: both AEA and 2-AG significantly elevated in Tourette syndrome
Evidence Grade:
Moderate: first-of-its-kind study with significant findings, but small sample and cross-sectional.
Study Age:
Published 2020.
Original Title:
Cerebrospinal fluid endocannabinoid levels in Gilles de la Tourette syndrome.
Published In:
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 45(8), 1323-1329 (2020)
Database ID:
RTHC-02735

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Compares people with a condition to similar people without it.

What do these levels mean? →

Frequently Asked Questions

Are endocannabinoid levels abnormal in Tourette syndrome?

Yes. This first-ever CSF study found both major endocannabinoids (anandamide and 2-AG) were significantly elevated in TS patients compared to controls.

Does this explain why cannabis helps Tourette syndrome?

It provides biological support. The elevated endocannabinoid levels confirm the system is involved in TS, though whether the elevation is compensatory or pathological remains to be determined.

Read More on RethinkTHC

Cite This Study

RTHC-02735·https://rethinkthc.com/research/RTHC-02735

APA

Müller-Vahl, Kirsten R; Bindila, Laura; Lutz, Beat; Musshoff, Frank; Skripuletz, Thomas; Baumgaertel, Charlotte; Sühs, Kurt-Wolfram. (2020). Cerebrospinal fluid endocannabinoid levels in Gilles de la Tourette syndrome.. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 45(8), 1323-1329. https://doi.org/10.1038/s41386-020-0671-6

MLA

Müller-Vahl, Kirsten R, et al. "Cerebrospinal fluid endocannabinoid levels in Gilles de la Tourette syndrome.." Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2020. https://doi.org/10.1038/s41386-020-0671-6

RethinkTHC

RethinkTHC Research Database. "Cerebrospinal fluid endocannabinoid levels in Gilles de la T..." RTHC-02735. Retrieved from https://rethinkthc.com/research/muller-vahl-2020-cerebrospinal-fluid-endocannabinoid-levels

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.