Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago Medical School, and the Brain Health Research Centre, Dunedin.
Brain Research New Zealand.
Curr Opin Neurol. 2019 Feb;32(1):131-136. doi: 10.1097/WCO.0000000000000631.
Recent enthusiasm for cannabinoid drugs for the treatment of chronic pain and some forms of epilepsy, raises the question of whether they could be useful for other disorders associated with abnormal neuronal activity in the brain, such as subjective tinnitus. Indeed, there is evidence to indicate that some tinnitus sufferers self-medicate using Cannabis. The aim of this review is to critically evaluate the available evidence relating to the effects of cannabinoids on tinnitus.
Despite the fact that cannabinoids have been shown to decrease neuronal hyperactivity in many parts of the brain, the current evidence suggests that in auditory brain regions such as the dorsal cochlear nucleus, they have the potential to facilitate neuronal hyperactivity and exacerbate tinnitus. All of the available experimental evidence from animal studies suggests that cannabinoid CB1 receptor agonists will either have no effect on tinnitus or will worsen it.
In our opinion, the use of the available cannabinoid drugs to alleviate tinnitus, based on their alleged efficacy for neuropathic pain conditions and some forms of epilepsy, is premature and not supported by the available evidence.
目的综述：近期，人们对大麻素类药物治疗慢性疼痛和某些类型癫痫的热情高涨，这引发了一个疑问，即它们是否可能对其他与大脑神经元异常活动相关的疾病（如主观性耳鸣）有效。事实上，有证据表明，一些耳鸣患者使用大麻自我治疗。本综述旨在批判性地评估现有关于大麻素类药物对耳鸣影响的证据。
最新发现：尽管大麻素类药物已被证明可降低大脑许多区域的神经元过度兴奋，但目前的证据表明，在听觉脑区（如背侧耳蜗核），它们有可能促进神经元过度兴奋并加重耳鸣。所有来自动物研究的现有实验证据表明，大麻素 CB1 受体激动剂对耳鸣要么没有影响，要么会使其恶化。
总结：我们认为，基于大麻素类药物对神经病理性疼痛和某些类型癫痫的所谓疗效，将其用于缓解耳鸣尚不成熟，并且没有现有证据支持。
