The association of circulating endocannabinoids with neuroimaging and blood biomarkers of neuro-injury

Shiraz Vered, Alexa S. Beiser, Liron Sulimani, Sharon Sznitman, Mitzi M. Gonzales, Hugo J. Aparicio, Charles DeCarli, Matthew R. Scott, Saptaparni Ghosh, Gil M. Lewitus, David Meiri, Sudha Seshadri, Galit Weinstein

Research output: Contribution to journalArticlepeer-review


Background: Preclinical studies highlight the importance of endogenous cannabinoids (endocannabinoids; eCBs) in neurodegeneration. Yet, prior observational studies focused on limited outcome measures and assessed only few eCB compounds while largely ignoring the complexity of the eCB system. We examined the associations of multiple circulating eCBs and eCB-like molecules with early markers of neurodegeneration and neuro-injury and tested for effect modification by sex. Methods: This exploratory cross-sectional study included a random sample of 237 dementia-free older participants from the Framingham Heart Study Offspring cohort who attended examination cycle 9 (2011–2014), were 65 years or older, and cognitively healthy. Forty-four eCB compounds were quantified in serum, via liquid chromatography high-resolution mass spectrometry. Linear regression models were used to examine the associations of eCB levels with brain MRI measures (i.e., total cerebral brain volume, gray matter volume, hippocampal volume, and white matter hyperintensities volume) and blood biomarkers of Alzheimer’s disease and neuro-injury (i.e., total tau, neurofilament light, glial fibrillary acidic protein and Ubiquitin C-terminal hydrolase L1). All models were adjusted for potential confounders and effect modification by sex was examined. Results: Participants mean age was 73.3 ± 6.2 years, and 40% were men. After adjustment for potential confounders and correction for multiple comparisons, no statistically significant associations were observed between eCB levels and the study outcomes. However, we identified multiple sex-specific associations between eCB levels and the various study outcomes. For example, high linoleoyl ethanolamide (LEA) levels were related to decreased hippocampal volume among men and to increased hippocampal volume among women (β ± SE = − 0.12 ± 0.06, p = 0.034 and β ± SE = 0.08 ± 0.04, p = 0.026, respectively). Conclusions: Circulating eCBs may play a role in neuro-injury and may explain sex differences in susceptibility to accelerated brain aging. Particularly, our results highlight the possible involvement of eCBs from the N-acyl amino acids and fatty acid ethanolamide classes and suggest specific novel fatty acid compounds that may be implicated in brain aging. Furthermore, investigation of the eCBs contribution to neurodegenerative disease such as Alzheimer’s disease in humans is warranted, especially with prospective study designs and among diverse populations, including premenopausal women.

Original languageEnglish
Article number154
JournalAlzheimer's Research and Therapy
Issue number1
StatePublished - 12 Sep 2023

Bibliographical note

Funding Information:
This study was supported by grants from the National Institute on Aging (R01 AG054076, R01 AG049607, R01 AG033040, R01 AG063507, U01 AG052409, RF1 AG061872, U01 AG049505, U01 AG058589 and P30 AG066546), the National Institute of Neurological Disorders and Stroke (R01 NS017950 and UH2 NS100605), and the NHLBI contract for the Framingham Heart Study (contract no. N01-HC-25195, HHSN268201500001I, and 75N92019D00031).

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.


  • Blood biomarkers
  • Brain aging
  • Brain MRI
  • Endocannabinoids
  • Neuro-injury
  • Neurodegeneration
  • Sex

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience


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