Cannabinoids as Modulatory Agents in the Treatment of Autism Spectrum Disorder
Autism spectrum disorder, ASD, is a complex multi-system condition involving neurological, gastrointestinal, immune, and other biological functions. ASD is incompletely understood and also remains inadequately treated. Many of the current pharmaceutical treatments have associated side effects which further complicate the clinical picture: benzodiazepines, neuroleptics, CNS stimulants, and antidepressants.
What is obvious in ASD is that there is imbalance and dysfunction within the neurochemical and electrical systems of the brain. The human endocannabinoid system, ECS, acts to modulate many aspects of human function; these include neurotransmission, inflammatory response, immune function, cellular homeostasis, among others. Modulation is defined as "changing or adjusting things within a system so they exist or function in balanced or proper fashion, or amount…” Cannabinoids are uniquely different from other neuro-active compounds in that they act to modulate biological processes. In contrast, pharmaceutical compounds commonly used to treat symptoms of ASD either block or stimulate specfic physiological processes.
A significant proportion of patients with ASD experience seizures, estimated at over 30%; and are on anticonvulsants. Many also suffer from episodic neuropsychiatric symptoms; such as impulsive behavior, agitation and anger outbursts, transient inattention and focusing problems, episodes of detachment, and focal motor symptoms such as tics, twitches, and jerks. As the brain works through electro-chemical mechanisms, seizures as well these episodic phenomena may be reflected on EEG. CBD, or cannabidiol, the non-hallucinogenic component of cannabis/marijuana has properties of treating seizures and stabilizing abnormal brain electrical activity through “neuro-modulation.”
This presentation will discuss the mechanisms by which cannabinoids exert therapeutic benefits; in particular, treating seizures and other episodic symptoms seen with ASD. Case studies with before and after treatment EEG tracings will be presented. The revolutionary nature of non-systemic Direct Effects™ cannabinoid therapy and its particular pertinence to pediatric age patients will also be discussed.
Ronald Aung-Din, MD
Dr. Ronald Aung-Din practices General Neurology & Neuro-Psychiatry in Sarasota, FL. He is board-certified by American Board of Psychiatry & Neurology; and member, American Academy of Neurology.
After studies in Mechanical and Environmental Engineering at Bucknell (Lewisburg, PA) and Cornell (Ithaca, NY) Universities, he worked for a period as an engineer. He then attended Columbia University in New York City for Premedical studies, followed by Medical School at University of Texas Southwestern Medical School, Dallas, TX. Residencies in Neurology and Neurosurgery were at University of Florida, Gainesville, FL. Additional studies included a Medical Student Fellowship in Cardiology at Radcliffe Infirmary, Oxford and Clinical Neurology Postgraduate Fellowship at National Hospital for Nervous Disease, Queen Square, London, UK.
Through affiliation with Lovelace Scientific Resources, Inc., Albuquerque, NM and his own clinical practice, he has participated in over 60 pharmaceutical industry-sponsored clinical trials. He currently functions as Principal Investigator in a number of ongoing drug research studies in MS, epilepsy, pain, Parkinson’s disease; and other neurological and psychiatric disorders. Dr. Aung-Din is also active in treating varied conditions using delivery of neuro-active drugs with Direct Effects Therapy, a technology developed by him for which 8 patents have to date been granted in the United States, Europe, and Australia; with others pending.
Publications using this novel therapy in migraine, Parkinson’s disease, and diabetic neuropathy appeared in Drug Delivery Technology, Vol.10. No 8, p. 48, October 2010 and Drug Delivery Technology, Vol. 9. No 9, p. 44, October 2009, www.drugdeliverytech.com; and in June 2015 www.drug-dev.com: “THERAPEUTIC FOCUS - Direct Effects(TM) Diabetic Neuropathy Therapy: Treating Symptoms & Modifying Disease.” Publications on the use of cannabinoids also appeared in June 2016 and May 2017 issues of DDT.
Direct Effects Therapy is unique in that therapeutic effect occurs through cutaneous free-nerve endings with direct afferent connections to CNS. As such, general circulation and blood-brain-barrier are bypassed, with avoidance of systemic side effects and drug interactions. Therapeutic benefits are also frequently realized within a short period, less than 15 minutes. AfGin Pharma, LLC was founded by Dr. Aung-Din in 2009 to advance this unique technology and its goal of “Enhanced Neuro-Therapeutics through Direct Effects Topical Technology;” website: afginpharma.com.
