Considering the Effects of Cannabinoids and Exercise on the Brain: A Narrative Review

Recently, there has been rising interest in the use of cannabis and its derivatives as therapeutic tools to support brain health, particularly in athletes. Cannabis-based substances interact with the endogenous cannabinoid (i.e., endocannabinoid) system, which is involved in widespread physiological processes that contribute to brain function. In other work, the benefits of exercise for brain health have been prominently noted. Despite large bodies of work on both cannabinoid and exercise influences on brain function, there is an understudied overlap in their physiological effects that may be especially important in athletic populations regularly engaged in high volumes of exercise. This narrative review describes mechanistic overlaps between cannabinoid and exercise effects on brain function. The literature search was broad, emphasizing research published since 2010 and including randomized clinical trials, observational studies, case studies, preclinical work, both human and animal studies, and information presented in related review articles. The focal point of the current review is the potentially overlapping effects of cannabinoids and exercise on brain function via physiological processes underpinning inflammation, vascular function, and neuroplasticity. Mechanisms are described in detail with consideration of common and contrasting influences of cannabinoids and exercise on the brain. Altogether, the compiled information suggests that indirect and direct interactions between these two therapeutic avenues have potential to introduce additive, synergistic, or opposing effects. Considering such interactions will be critical in optimizing therapeutic strategies involving cannabinoids as they are increasingly applied in the sport sciences and beyond.