Mild traumatic brain injury (MTBI) in the Canadian Veteran population: transforming recovery with medical cannabis

Abstract: Mild Traumatic Brain Injury (mTBI) is a growing public health concern. Between 2001 to 2010, rates of mTBI related Emergency Department visits increased by 70% in Canada. Approximately, 22–25% of soldiers returning from war zones are also affected by mTBI (eg. blast injuries and direct impact to the head with or without loss of consciousness) and this percentage is likely underestimated, as mTBI is generally under reported and veterans are not adequately accessed for this operational stress injury. These mild to severe brain traumas have short-term and long-term effects on a veteran’s physical health, cognitive functioning, emotional regulation, and psychosocial adaptation. The presence of mTBI also complicates and exacerbates the clinical symptoms of chronic pain, depression, anxiety, and PTSD. Post traumatic brain injury inflammation continues to progress long after the initial insult, resulting in secondary neuronal network damage. Due to the complex nature of this type of injury, a multi-modal approach is necessary for treatment of mTBI. Clinically, the current standard pharmacological treatments available fall short and often cause adverse side effects. Medical Cannabis (MC) is an innovative treatment that is showing promising clinical results. MC has neuroprotective effects, specifically anti-inflammatory and antioxidant properties. It has roles in pain modification and in neuroregenerative cellular cascades. Many sufferers of mTBI also experience severe insomnia and chronic post-traumatic headaches, conditions for which MC has beneficial clinical effects. This presentation will focus on the relationship between the dysregulation of the autonomic nervous system (ANS), inflammation, and clinical symptoms associated with mTBI. The clinical applications of innovative neuromodulatory strategies for regulating the ANS dysregulation, reducing inflammation, and decreasing mTBI symptoms with standardized MC regimens and other neuroscience-based modalities will be discussed in the Canadian Veteran population.