101
|
Renard J, Krebs MO, Le Pen G, Jay TM. Long-term consequences of adolescent cannabinoid exposure in adult psychopathology. Front Neurosci 2014; 8:361. [PMID: 25426017 PMCID: PMC4226229 DOI: 10.3389/fnins.2014.00361] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/21/2014] [Indexed: 01/10/2023] Open
Abstract
Marijuana is the most widely used illicit drug among adolescents and young adults. Unique cognitive, emotional, and social changes occur during this critical period of development from childhood into adulthood. The adolescent brain is in a state of transition and differs from the adult brain with respect to both anatomy (e.g., neuronal connections and morphology) and neurochemistry (e.g., dopamine, GABA, and glutamate). These changes are thought to support the emergence of adult cerebral processes and behaviors. The endocannabinoid system plays an important role in development by acting on synaptic plasticity, neuronal cell proliferation, migration, and differentiation. Delta-9-tetrahydrocanabinol (THC), the principal psychoactive component in marijuana, acts as a partial agonist of the cannabinoid type 1 receptor (CB1R). Thus, over-activation of the endocannabinoid system by chronic exposure to CB1R agonists (e.g., THC, CP-55,940, and WIN55,212-2) during adolescence can dramatically alter brain maturation and cause long-lasting neurobiological changes that ultimately affect the function and behavior of the adult brain. Indeed, emerging evidence from both human and animal studies demonstrates that early-onset marijuana use has long-lasting consequences on cognition; moreover, in humans, this use is associated with a two-fold increase in the risk of developing a psychotic disorder. Here, we review the relationship between cannabinoid exposure during adolescence and the increased risk of neuropsychiatric disorders, focusing on both clinical and animal studies.
Collapse
Affiliation(s)
- Justine Renard
- Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S894 Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et Neurosciences Paris, France ; Centre Hospitalier Sainte-Anne, Service Hospitalo Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes Paris, France
| | - Marie-Odile Krebs
- Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S894 Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et Neurosciences Paris, France ; Centre Hospitalier Sainte-Anne, Service Hospitalo Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes Paris, France
| | - Gwenaëlle Le Pen
- Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S894 Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et Neurosciences Paris, France ; Centre Hospitalier Sainte-Anne, Service Hospitalo Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes Paris, France
| | - Thérèse M Jay
- Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S894 Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et Neurosciences Paris, France ; Centre Hospitalier Sainte-Anne, Service Hospitalo Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes Paris, France
| |
Collapse
|
102
|
Suárez-Pinilla P, López-Gil J, Crespo-Facorro B. Immune system: a possible nexus between cannabinoids and psychosis. Brain Behav Immun 2014; 40:269-82. [PMID: 24509089 DOI: 10.1016/j.bbi.2014.01.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/29/2014] [Accepted: 01/29/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Endocannabinoid system is involved in the regulation of the brain-immune axis. Cannabis consumption is related with the development, course, and severity of psychosis. The epidemiological evidence for increased occurrence of immunological alterations in patients with psychosis has not been sufficiently addressed. The aim of this review is to establish whether there is any scientific evidence of the influence of cannabinoids on aspects of immunity that affect susceptibility to psychotic disorder induction. METHODS A comprehensive search of PubMed/MEDLINE, EMBASE and ISI Web of Knowledge was performed using combinations of key terms distributed into three blocks: "immune", "cannabinoid", and "endocannabinoid receptor". Studies were considered to be eligible for the review if they were original articles, they reported a quantitative or qualitative relation between cannabinoid ligands, their receptors, and immune system, and they were carried out in vitro or in mammals, included humans. All the information was systematically extracted and evaluated. RESULTS We identified 122 articles from 446 references. Overall, endocannabinoids enhanced immune response, whereas exogenous cannabinoids had immunosuppressant effects. A general change in the immune response from Th1 to Th2 was also demonstrated for cannabinoid action. Endogenous and synthetic cannabinoids also modulated microglia function and neurotransmitter secretion. CONCLUSION The actions of cannabinoids through the immune system are quite regular and predictable in the peripheral but remain fuzzy in the central nervous system. Despite this uncertainty, it may be hypothesized that exposure to exocannabinoids, in particular during adolescence might prompt immunological dysfunctions that potentially cause a latent vulnerability to psychosis. Further investigations are warranted to clarify the relationship between the immunological effects of cannabis and psychosis.
Collapse
Affiliation(s)
- Paula Suárez-Pinilla
- University Hospital Marqués de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - José López-Gil
- University Hospital Marqués de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- University Hospital Marqués de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| |
Collapse
|
103
|
Bossong MG, Jansma JM, Bhattacharyya S, Ramsey NF. Role of the endocannabinoid system in brain functions relevant for schizophrenia: an overview of human challenge studies with cannabis or ∆9-tetrahydrocannabinol (THC). Prog Neuropsychopharmacol Biol Psychiatry 2014; 52:53-69. [PMID: 24380726 DOI: 10.1016/j.pnpbp.2013.11.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 10/16/2013] [Accepted: 11/25/2013] [Indexed: 12/30/2022]
Abstract
Accumulating evidence suggests involvement of the endocannabinoid system in the pathophysiology of schizophrenia, which signifies a potential application for this system in the treatment of this disorder. However, before new research can focus on potential treatments that work by manipulating the endocannabinoid system, it needs to be elucidated how this system is involved in symptoms of schizophrenia. Here we review human studies that investigated acute effects of cannabis or ∆9-tetrahydrocannabinol (THC) on brain functions that are implicated in schizophrenia. Results suggest that the impact of THC administration depends on the difficulty of the task performed. Impaired performance of cognitive paradigms is reported on more challenging tasks, which is associated with both activity deficits in temporal and prefrontal areas and a failure to deactivate regions of the default mode network. Comparable reductions in prefrontal activity and impairments in deactivation of the default mode network are seen in patients during performance of cognitive paradigms. Normal performance levels after THC administration demonstrated for less demanding tasks are shown to be related to either increased neural effort in task-specific regions ('neurophysiological inefficiency'), or recruitment of alternative brain areas, which suggests a change in strategy to meet cognitive demands. Particularly a pattern of performance and brain activity corresponding with an inefficient working memory system is consistently demonstrated in patients. These similarities in brain function between intoxicated healthy volunteers and schizophrenia patients provide an argument for a role of the endocannabinoid system in symptoms of schizophrenia, and further emphasize this system as a potential novel target for treatment of these symptoms.
Collapse
Affiliation(s)
- Matthijs G Bossong
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom.
| | - J Martijn Jansma
- Rudolf Magnus Institute of Neuroscience, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Sagnik Bhattacharyya
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | - Nick F Ramsey
- Rudolf Magnus Institute of Neuroscience, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| |
Collapse
|
104
|
Muhl D, Kathmann M, Hoyer C, Kranaster L, Hellmich M, Gerth CW, Faulhaber J, Schlicker E, Leweke FM. Increased CB2 mRNA and anandamide in human blood after cessation of cannabis abuse. Naunyn Schmiedebergs Arch Pharmacol 2014; 387:691-5. [PMID: 24788457 DOI: 10.1007/s00210-014-0984-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
In previous studies, long-term cannabis use led to alterations of the endocannabinoid system including an increase in CB1 and/or CB2 receptor messenger RNA (mRNA) in blood cells and an increase in the serum level of the endocannabinoid 2-arachidonoyl glycerol. However, in those studies, cannabis use was stopped only few days before testing or not interrupted at all. Therefore, one cannot decide whether the alterations are due to long-term cannabis abuse or are confounded by acute effects of cannabis. Blood was sampled from donors that had smoked marijuana ≥20 times in their lives but had abstained from cannabis for ≥6 months (high-frequency users, HFU) and from controls (cannabis use ≤5 times lifetime). CB1 and CB2 mRNA was determined in peripheral mononuclear blood cells using the reverse transcriptase polymerase chain reaction. Serum anandamide level was assayed using electrospray tandem mass spectrometry. CB2 mRNA was increased by 45 % in HFU when compared to controls, whereas CB1 mRNA did not differ. The anandamide level in HFU exceeded that in controls by 90 %. Tobacco smoking could be excluded as a confounding factor. In conclusion, marijuana users that had smoked marijuana ≥20 times in their lives and stopped cannabis use at least 6 months before the study show an increase in CB2 receptor mRNA in the blood and in serum anandamide level. These alterations resemble those obtained for marijuana smokers that had stopped cannabis use only few days before testing and may be implicated in the pathogenesis of disorders associated with long-term cannabis use.
Collapse
Affiliation(s)
- Daniela Muhl
- Department of Psychiatry and Psychotherapy, University of Cologne, 50924, Cologne, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
105
|
Addington J, Case N, Saleem MM, Auther AM, Cornblatt BA, Cadenhead KS. Substance use in clinical high risk for psychosis: a review of the literature. Early Interv Psychiatry 2014; 8:104-12. [PMID: 24224849 PMCID: PMC4356483 DOI: 10.1111/eip.12100] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 09/22/2013] [Indexed: 11/29/2022]
Abstract
AIM In the literature, there is evidence suggesting an association between substance use and psychosis. However, little is known about substance use in those who may be in the pre-psychotic phase, that is, those who are putatively prodromal are considered to be at clinical high risk (CHR) of developing psychosis. METHODS We conducted a review of publications measuring patterns and rates of substance use in CHR for psychosis individuals and the effects on the transition to psychosis. RESULTS Of 5527 potentially relevant research papers, 10 met inclusion criteria of CHR subjects and specifically mentioned substance use in the sample. The results of these studies varied. Cannabis, alcohol and tobacco/nicotine were reported as the most commonly used substances. There was limited information on the changes in patterns of use over time. Two out of the ten studies found a significant association between the use of substances and subsequent transition to psychosis. In one of these studies, substance abuse was a predictor of psychosis when included as a variable in a prediction algorithm. In the other study, the abuse of cannabis and nicotine was associated with transition to psychosis. CONCLUSIONS We found limited evidence to suggest that increased rates of substance use may be associated with transition to psychosis. However, further prospective research examining the association between substance use and transition to psychosis is required before any firm conclusions can be made.
Collapse
Affiliation(s)
- Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Nevicia Case
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Majid M. Saleem
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Andrea M. Auther
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks
| | - Barbara A. Cornblatt
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks
- The Feinstein Institute for Medical Research, Manhasset, New York
| | | |
Collapse
|
106
|
Bumb JM, Schwarz E, Enning F, Rohleder C, Findeisen P, Leweke FM, Noelte I. Sleep deprivation in humans: Effects on melatonin in cerebrospinal fluid and serum. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jan Malte Bumb
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health; Heidelberg University; Mannheim Germany
| | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health; Heidelberg University; Mannheim Germany
| | - Frank Enning
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health; Heidelberg University; Mannheim Germany
| | - Cathrin Rohleder
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health; Heidelberg University; Mannheim Germany
| | - Peter Findeisen
- Institute for Clinical Chemistry; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - F Markus Leweke
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health; Heidelberg University; Mannheim Germany
| | - Ingo Noelte
- Department of Neuroradiology; University Hospital Mannheim; Mannheim Germany
| |
Collapse
|
107
|
Tan H, Ahmad T, Loureiro M, Zunder J, Laviolette SR. The role of cannabinoid transmission in emotional memory formation: implications for addiction and schizophrenia. Front Psychiatry 2014; 5:73. [PMID: 25071606 PMCID: PMC4074769 DOI: 10.3389/fpsyt.2014.00073] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/13/2014] [Indexed: 11/26/2022] Open
Abstract
Emerging evidence from both basic and clinical research demonstrates an important role for endocannabinoid (ECB) signaling in the processing of emotionally salient information, learning, and memory. Cannabinoid transmission within neural circuits involved in emotional processing has been shown to modulate the acquisition, recall, and extinction of emotionally salient memories and importantly, can strongly modulate the emotional salience of incoming sensory information. Two neural regions in particular, the medial prefrontal cortex (PFC) and the basolateral nucleus of the amygdala (BLA), play important roles in emotional regulation and contain high levels of cannabinoid receptors. Furthermore, both regions show profound abnormalities in neuropsychiatric disorders such as addiction and schizophrenia. Considerable evidence has demonstrated that cannabinoid transmission functionally interacts with dopamine (DA), a neurotransmitter system that is of exceptional importance for both addictive behaviors and the neuropsychopathology of disorders like schizophrenia. Research in our laboratory has focused on how cannabinoid transmission both within and extrinsic to the mesolimbic DA system, including the BLA → mPFC circuitry, can modulate both rewarding and aversive emotional information. In this review, we will summarize clinical and basic neuroscience research demonstrating the importance of cannabinoid signaling within this neural circuitry. In particular, evidence will be reviewed emphasizing the importance of cannabinoid signaling within the BLA → mPFC circuitry in the context of emotional salience processing, memory formation and memory-related plasticity. We propose that aberrant states of hyper or hypoactive ECB signaling within the amygdala-prefrontal cortical circuit may lead to dysregulation of mesocorticolimbic DA transmission controlling the processing of emotionally salient information. These disturbances may in turn lead to emotional processing, learning, and memory abnormalities related to various neuropsychiatric disorders, including addiction and schizophrenia-related psychoses.
Collapse
Affiliation(s)
- Huibing Tan
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada
| | - Tasha Ahmad
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada
| | - Michael Loureiro
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada
| | - Jordan Zunder
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada
| | - Steven R Laviolette
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada ; Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada ; Department of Psychology, Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada
| |
Collapse
|
108
|
Schubart CD, Sommer IEC, Fusar-Poli P, de Witte L, Kahn RS, Boks MPM. Cannabidiol as a potential treatment for psychosis. Eur Neuropsychopharmacol 2014; 24:51-64. [PMID: 24309088 DOI: 10.1016/j.euroneuro.2013.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/18/2022]
Abstract
Although cannabis use is associated with an increased risk of developing psychosis, the cannabis constituent cannabidiol (CBD) may have antipsychotic properties. This review concisely describes the role of the endocannabinoid system in the development of psychosis and provides an overview of currently available animal, human experimental, imaging, epidemiological and clinical studies that investigated the antipsychotic properties of CBD. In this targeted literature review we performed a search for English articles using Medline and EMBASE. Studies were selected if they described experiments with psychosis models, psychotic symptoms or psychotic disorders as outcome measure and involved the use of CBD as intervention. Evidence from several research domains suggests that CBD shows potential for antipsychotic treatment.
Collapse
Affiliation(s)
- C D Schubart
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - I E C Sommer
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - P Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - L de Witte
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - R S Kahn
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - M P M Boks
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands.
| |
Collapse
|
109
|
Have the genetics of cannabis involvement gone to pot? NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 2014; 61:71-108. [PMID: 25306780 DOI: 10.1007/978-1-4939-0653-6_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
110
|
Bioque M, García-Bueno B, MacDowell KS, Meseguer A, Saiz PA, Parellada M, Gonzalez-Pinto A, Rodriguez-Jimenez R, Lobo A, Leza JC, Bernardo M. Peripheral endocannabinoid system dysregulation in first-episode psychosis. Neuropsychopharmacology 2013; 38:2568-77. [PMID: 23822951 PMCID: PMC3828529 DOI: 10.1038/npp.2013.165] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/27/2013] [Accepted: 06/25/2013] [Indexed: 01/13/2023]
Abstract
Several hypotheses involving alterations of the immune system have been proposed among etiological explanations for psychotic disorders. The endocannabinoid system (ECS) has a homeostatic role as an endogenous neuroprotective and anti-inflammatory system. Alterations of this system have been associated with psychosis. Cannabis use is a robust risk factor for these disorders that could alter the ECS signalling. In this study, 95 patients with a first episode of psychosis (FEP) and 90 healthy controls were recruited. Protein expression of cannabinoid receptor 2 (CB2), the protein levels of the main endocannabinoid synthesizing enzymes N-acyl phosphatidylethanolamine phospholipase (NAPE) and diacylglycerol lipase (DAGL), and of degradation enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL) were determined by western blot analysis in peripheral blood mononuclear cells (PBMCs). Patients with a FEP showed a decreased expression of CB2 and of both endocannabinoids synthesizing enzymes (NAPE and DAGL) in comparison to healthy controls. After controlling for age, gender, body mass index, and cannabis use, NAPE and DAGL expression remained significantly decreased, whereas FAAH and MAGL expression were increased. On the other hand, FEP subjects with history of severe cannabis use showed a larger ECS dysregulation compared with healthy controls. These results indicate an ECS dysregulation in PBMC of FEP patients. The alteration of the ECS presented at the initial phases of psychosis could be contributing to the pathophysiology of the disease and constitutes a possible biomarker of psychotic disorders and an interesting pharmacological target to take into account for therapeutic purposes.
Collapse
Affiliation(s)
- Miquel Bioque
- Schizophrenia Clinic Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Borja García-Bueno
- Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Karina S MacDowell
- Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Ana Meseguer
- Schizophrenia Clinic Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pilar A Saiz
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, IIS Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Gonzalez-Pinto
- Hospital Universitario de Álava (sede Santiago), Universidad Nacional de Educación a Distancia, Vitoria, Spain
| | | | - Antonio Lobo
- Department of Psychiatry. Hospital Clínico Universitario and University of Zaragoza, Zaragoza, Spain
| | - Juan C Leza
- Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Miguel Bernardo
- Schizophrenia Clinic Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psycobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - From the FLAMM-PEPs study—Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
- Schizophrenia Clinic Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital 12 de Octubre (i+12), Madrid, Spain
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Child and Adolescent Psychiatry Department, IIS Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Hospital Universitario de Álava (sede Santiago), Universidad Nacional de Educación a Distancia, Vitoria, Spain
- Department of Psychiatry. Hospital Clínico Universitario and University of Zaragoza, Zaragoza, Spain
- Department of Psychiatry and Clinical Psycobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| |
Collapse
|
111
|
Ceccarini J, De Hert M, Van Winkel R, Peuskens J, Bormans G, Kranaster L, Enning F, Koethe D, Leweke FM, Van Laere K. Increased ventral striatal CB1 receptor binding is related to negative symptoms in drug-free patients with schizophrenia. Neuroimage 2013; 79:304-12. [DOI: 10.1016/j.neuroimage.2013.04.052] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 03/26/2013] [Accepted: 04/15/2013] [Indexed: 11/16/2022] Open
|
112
|
Costa M, Squassina A, Congiu D, Chillotti C, Niola P, Galderisi S, Pistis M, Del Zompo M. Investigation of endocannabinoid system genes suggests association between peroxisome proliferator activator receptor-α gene (PPARA) and schizophrenia. Eur Neuropsychopharmacol 2013; 23:749-59. [PMID: 22920733 DOI: 10.1016/j.euroneuro.2012.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 06/18/2012] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
Abstract
Schizophrenia (SZ) is a complex psychiatric disorder with a large genetic burden and an estimated hereditability of 80%. A large number of neuroanatomical and psychopharmacological studies suggest a central role of the endocannabinoid (eCB) system in the susceptibility of the disease. To further investigate this hypothesis, we performed an association study with genes codifying for key elements of the eCB system in a sample of 170 schizophrenic patients and 350 healthy controls of Italian ancestry. A total of 57 Tag SNPs (tSNPs) were selected using HapMap CEU population SNP database spanning the following genes: cannabinoid receptor 1 (CNR1), peroxisome proliferator activator receptor-α (PPARA), fatty acid amide hydrolase (FAAH) and N-acyl phosphatidylethanolamine phospholipase D (NAPE-PLD). Seven out of the 32 tSNPs within PPARA (rs4253765, rs4263776, rs6007662, rs1800206, rs4253763, rs6008197 and rs4253655) and 3 out of 12 tSNPs within CNR1 (rs1049353, rs7766029 and rs806366) were nominally associated with SZ (uncorrected p<0.05). The same pattern of association was observed in the genotype analysis, with rs4253765 showing the highest level of significance (uncorrected p=2×10(-3)). None of these associations survived after permutation test. Our findings suggest a potential role for PPARA in the susceptibility to SZ, but further studies on larger independent samples are warranted in order to clarify the involvement of this gene in the pathophysiology of SZ.
Collapse
Affiliation(s)
- Marta Costa
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | |
Collapse
|
113
|
Morgan CJA, Page E, Schaefer C, Chatten K, Manocha A, Gulati S, Curran HV, Brandner B, Leweke FM. Cerebrospinal fluid anandamide levels, cannabis use and psychotic-like symptoms. Br J Psychiatry 2013; 202:381-2. [PMID: 23580381 DOI: 10.1192/bjp.bp.112.121178] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Anandamide is a ligand of the endocannabinoid system. Animals show a depletion following repeated Δ(9)-tetrahydrocannabinol (THC) administration but the effect of cannabis use on central nervous system levels of endocannabinoids has not been previously examined in humans. Cerebrospinal fluid (CSF) levels of the endocannabinoids anandamide, 2-arachidonoylglycerol (2-AG) and related lipids were tested in 33 volunteers (20 cannabis users). Lower levels of CSF anandamide and higher levels of 2-AG in serum were observed in frequent compared with infrequent cannabis users. Levels of CSF anandamide were negatively correlated with persisting psychotic symptoms when drug-free. Higher levels of anandamide are associated with a lower risk of psychotic symptoms following cannabis use.
Collapse
|
114
|
Cachope R. Functional diversity on synaptic plasticity mediated by endocannabinoids. Philos Trans R Soc Lond B Biol Sci 2013; 367:3242-53. [PMID: 23108543 DOI: 10.1098/rstb.2011.0386] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Endocannabinoids (eCBs) act as modulators of synaptic transmission through activation of a number of receptors, including, but not limited to, cannabinoid receptor 1 (CB1). eCBs share CB1 receptors as a common target with Δ(9)-tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana. Although THC has been used for recreational and medicinal purposes for thousands of years, little was known about its effects at the cellular level or on neuronal circuits. Identification of CB1 receptors and the subsequent development of its specific ligands has therefore enhanced our ability to study and bring together a substantial amount of knowledge regarding how marijuana and eCBs modify interneuronal communication. To date, the eCB system, composed of cannabinoid receptors, ligands and the relevant enzymes, is recognized as the best-described retrograde signalling system in the brain. Its impact on synaptic transmission is widespread and more diverse than initially thought. The aim of this review is to succinctly present the most common forms of eCB-mediated modulation of synaptic transmission, while also illustrating the multiplicity of effects resulting from specializations of this signalling system at the circuital level.
Collapse
Affiliation(s)
- Roger Cachope
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| |
Collapse
|
115
|
Saito A, Ballinger MDL, Pletnikov MV, Wong DF, Kamiya A. Endocannabinoid system: potential novel targets for treatment of schizophrenia. Neurobiol Dis 2012; 53:10-7. [PMID: 23220619 DOI: 10.1016/j.nbd.2012.11.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 11/23/2012] [Accepted: 11/28/2012] [Indexed: 10/27/2022] Open
Abstract
Accumulating epidemiological evidences suggest that cannabis use during adolescence is a potential environmental risk for the development of psychosis, including schizophrenia. Consistently, clinical and preclinical studies, using pharmacological approaches and genetically engineered animals to target endocannabinoid signaling, reveal the multiple varieties of endocannabinoid system-mediated human and animal behaviors, including cognition and emotion. Recently, there has been substantial progress in understanding the molecular mechanisms of the endocannabinoid system for synaptic communications in the central nervous system. Furthermore, the impact of endocannabinoid signaling on diverse cellular processes during brain development has emerged. Thus, although schizophrenia has etiological complexities, including genetic heterogeneities and multiple environmental factors, it now becomes crucial to explore molecular pathways of convergence of genetic risk factors and endocannabinoid signaling, which may provide us with clues to find novel targets for therapeutic intervention. In this review, epidemiological, clinical, and pathological evidences on the role of the endocannabinoid system in the pathophysiologies of schizophrenia will be presented. We will also make a brief overview of the recent progress in understanding molecular mechanisms of the endocannabinoid system for brain development and function, with particular focus on cannabinoid receptor type 1 (CB1R)-mediated cascade, the most well-characterized cannabinoid receptor. Lastly, we will discuss the potential of the endocannabinoid system in finding novel therapeutic targets for prevention and treatment of schizophrenia.
Collapse
Affiliation(s)
- Atsushi Saito
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD21287, USA
| | | | | | | | | |
Collapse
|
116
|
Deiana S. Medical use of cannabis. Cannabidiol: a new light for schizophrenia? Drug Test Anal 2012; 5:46-51. [PMID: 23109356 DOI: 10.1002/dta.1425] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 09/04/2012] [Accepted: 09/05/2012] [Indexed: 11/12/2022]
Abstract
The medical properties of cannabis have been known for many centuries; its first documented use dates back to 2800 BC when it was described for its hallucinogenic and pain-relieving properties. In the first half of the twentieth century, a number of pharmaceutical companies marked cannabis for indications such as asthma and pain, but since then its use has sharply declined, mainly due to its unpredictable effects, but also for socio-political issues. Recently, great attention has been directed to the medical properties of phytocannabinoids present in the cannabis plant alongside the main constituent Δ⁹-Tetrahydrocannabinol (THC); these include cannabinoids such as cannabidiol (CBD), cannabigerol (CBG), and tetrahydrocannabivarin (THCV). Evidence suggests an association between cannabis and schizophrenia: schizophrenics show a higher use of marijuana as compared to the healthy population. Additionally, the use of marijuana can trigger psychotic episodes in schizophrenic patients, and this has been ascribed to THC. Given the need to reduce the side effects of marketed antipsychotics, and their weak efficacy on some schizophrenic symptoms, cannabinoids have been suggested as a possible alternative treatment for schizophrenia. CBD, a non-psychoactive constituent of the Cannabis sativa plant, has been receiving growing attention for its anti-psychotic-like properties. Evidence suggests that CBD can ameliorate positive and negative symptoms of schizophrenia. Behavioural and neurochemical models suggest that CBD has a pharmacological profile similar to that of atypical anti-psychotic drugs and a clinical trial reported that this cannabinoid is a well-tolerated alternative treatment for schizophrenia.
Collapse
Affiliation(s)
- Serena Deiana
- Department CNS Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. K., Biberach an der Riss, Germany.
| |
Collapse
|
117
|
The Endocannabinoid System and its Role in Schizophrenia: A Systematic Review of the Literature. BRAZILIAN JOURNAL OF PSYCHIATRY 2012; 34 Suppl 2:S163-77. [DOI: 10.1016/j.rbp.2012.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
118
|
Confounders of excessive brain volume loss in schizophrenia. Neurosci Biobehav Rev 2012; 37:2418-23. [PMID: 23000300 DOI: 10.1016/j.neubiorev.2012.09.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/15/2012] [Accepted: 09/11/2012] [Indexed: 11/23/2022]
Abstract
There is convincing evidence that schizophrenia is characterised by progressive brain volume changes during the course of the illness. In a large longitudinal study it was shown that different age-related trajectories of brain tissue loss are present in patients compared to healthy subjects, suggesting that brain maturation that occurs in the third and fourth decade of life is abnormal in schizophrenia. However, studies show that medication intake and cannabis use are important confounding factors when interpreting brain volume (change) abnormalities. Indeed, continues use of cannabis, but not cigarette smoking, is associated to a more pronounced loss of grey matter in the anterior cingulated and the prefrontal cortex. Atypical antipsychotics have been found to be related to smaller decreases in tissue loss. Moreover, independent of antipsychotic medication intake, the brain volume abnormalities appear associated to the outcome of the illness.
Collapse
|
119
|
Delayed preattentional functioning in early psychosis patients with cannabis use. Psychopharmacology (Berl) 2012; 222:507-18. [PMID: 22402706 DOI: 10.1007/s00213-012-2676-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 02/20/2012] [Indexed: 12/17/2022]
Abstract
RATIONALE Cannabis use is prevalent among the early psychosis (EP) population. The event-related potentials, mismatch negativity (MMN) and P3a are reduced in EP. Cannabinoids have been shown to modulate N-methyl-D-aspartate receptors which are involved in MMN generation. OBJECTIVES This study is the first to investigate the effects of cannabis use on MMN/P3a in EP. METHODS EP was defined as a history of psychosis or psychotic symptoms with no progression to date to chronic schizophrenia. Twenty-two EP patients with cannabis use (EP + CANN), 22 non-cannabis-using EP patients (EP-CANN) and 21 healthy controls participated in this study. MMN/P3a was elicited using a two-tone, auditory paradigm with 8% duration deviants. RESULTS As expected, EP-CANN showed marked reductions in MMN/P3a amplitudes compared to controls. However, EP + CANN showed evidence of a different pattern of neurophysiological expression of MMN/P3a compared to non-using patients, most notably in terms of delayed frontal MMN/P3a latencies. CONCLUSIONS This study provides further evidence that MMN/P3a deficits are present during early psychosis and suggests that this biomarker may have utility in differentiating substance- from non-substance-related psychoses.
Collapse
|
120
|
Vasic N, Connemann BJ, Wolf RC, Tumani H, Brettschneider J. Cerebrospinal fluid biomarker candidates of schizophrenia: where do we stand? Eur Arch Psychiatry Clin Neurosci 2012; 262:375-91. [PMID: 22173848 DOI: 10.1007/s00406-011-0280-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 12/03/2011] [Indexed: 02/07/2023]
Abstract
Here, we review the cerebrospinal fluid (CSF) candidate markers with regard to their clinical relevance as potential surrogates for disease activity, prognosis assessment, and predictors of treatment response. We searched different online databases such as MEDLINE and EMBASE for studies on schizophrenia and CSF. Initial studies on cerebrospinal fluid in patients with schizophrenia revealed increased brain-blood barrier permeability with elevated total protein content, increased CSF-to-serum ratio for albumin, and intrathecal production of immunoglobulins in subgroups of patients. Analyses of metabolites in CSF suggest alterations within glutamatergic neurotransmission as well as monoamine and cannabinoid metabolism. Decreased levels of brain-derived neurotrophic factor and nerve growth factor in CSF of first-episode patients with schizophrenia reported in recent studies point to a dysregulation of neuroprotective and neurodevelopmental processes. Still, these findings must be considered as non-specific. A more profound characterization of the particular psychopathological profiles, the investigation of patients in the prodromal phase or within the first episode of schizophrenia promoting longitudinal investigations, implementation of different approaches of proteomics, and rigorous adherence to standard procedures based on international CSF guidelines are necessary to improve the quality of CSF studies in schizophrenia, paving the way for identification of syndrome-specific biomarker candidates.
Collapse
Affiliation(s)
- Nenad Vasic
- Department of Psychiatry and Psychotherapy III, University of Ulm, Germany.
| | | | | | | | | |
Collapse
|
121
|
Alterations of theory of mind network activation in chronic cannabis users. Schizophr Res 2012; 139:19-26. [PMID: 22695256 DOI: 10.1016/j.schres.2012.05.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 04/30/2012] [Accepted: 05/24/2012] [Indexed: 11/22/2022]
Abstract
Chronic cannabis use is associated with cognitive impairment and has been identified as a risk factor for schizophrenia. Patients with schizophrenia show profound deficits in social cognition such as the ability to attribute mental states to others, referred to as "theory of mind" (ToM). Aberrant activation of the ToM network has been demonstrated across different phases of schizophrenia, including at-risk stages. Accordingly, we aimed to investigate the ToM network in chronic cannabis users. Fifteen cannabis users received functional brain imaging during performance of a ToM cartoon story task. Findings were compared with 14 control subjects. Cannabis users showed less activation in the left parahippocampal gyrus, the right precuneus and cuneus, but greater activation in the left cuneus and the right anterior cingulate gyrus compared to healthy controls. These activation patterns resemble those found in at-risk populations, suggesting that cannabis use can affect the processing of social information similar to other risk factor constellations for psychosis.
Collapse
|
122
|
New insights on endocannabinoid transmission in psychomotor disorders. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:51-8. [PMID: 22521335 PMCID: PMC3389227 DOI: 10.1016/j.pnpbp.2012.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/26/2012] [Accepted: 04/01/2012] [Indexed: 11/21/2022]
Abstract
The endocannabinoids are lipid signaling molecules that bind to cannabinoid CB(1) and CB(2) receptors and other metabotropic and ionotropic receptors. Anandamide and 2-arachidonoyl glycerol, the two best-characterized examples, are released on demand in a stimulus-dependent manner by cleavage of membrane phospholipid precursors. Together with their receptors and metabolic enzymes, the endocannabinoids play a key role in modulating neurotransmission and synaptic plasticity in the basal ganglia and other brain areas involved in the control of motor functions and motivational aspects of behavior. This mini-review provides an update on the contribution of the endocannabinoid system to the regulation of psychomotor behaviors and its possible involvement in the pathophysiology of Parkinson's disease and schizophrenia.
Collapse
|
123
|
Fišar Z. Cannabinoids and monoamine neurotransmission with focus on monoamine oxidase. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:68-77. [PMID: 22234284 DOI: 10.1016/j.pnpbp.2011.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/11/2011] [Accepted: 12/21/2011] [Indexed: 12/19/2022]
Abstract
Progress in understanding the mechanisms of action of cannabinoids was made after discovery of cannabinoid receptors and finding their endogenous ligands. New findings are obtained using both endogenous cannabinoids and plant or synthetic cannabinoids. Activation of cannabinoid receptors on synaptic terminals results in regulation of ion channels, neurotransmitter release and synaptic plasticity. Neuromodulation of synapses by cannabinoids is proving to have a wide range of functional effects, making them potential targets as medical preparations in a variety of illnesses, including some neurodegenerative and mental disorders. Brain monoamines are involved in many of the same processes affected by neuropsychiatric disorders and by different psychotropic drugs, including cannabinoids. Basic information is summarized in the paper about mechanisms of action of cannabinoids on monoaminergic systems, with a view to inhibition of monoamine oxidase.
Collapse
Affiliation(s)
- Zdeněk Fišar
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Ke Karlovu 11, 120 00 Prague 2, Czech Republic.
| |
Collapse
|
124
|
Cannabinoid receptors mediate methamphetamine induction of high frequency gamma oscillations in the nucleus accumbens. Neuropharmacology 2012; 63:565-74. [PMID: 22609048 DOI: 10.1016/j.neuropharm.2012.04.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 04/25/2012] [Accepted: 04/27/2012] [Indexed: 11/20/2022]
Abstract
Patients suffering from amphetamine-induced psychosis display repetitive behaviors, partially alleviated by antipsychotics, which are reminiscent of rodent stereotypies. Due to recent evidence implicating endocannabinoid involvement in brain disorders, including psychosis, we studied the effects of endocannabinoid signaling on neuronal oscillations of rats exhibiting methamphetamine stereotypy. Neuronal network oscillations were recorded with multiple single electrode arrays aimed at the nucleus accumbens of freely-moving rats. During the experiments, animals were dosed intravenously with the CB1 receptor antagonist rimonabant (0.3 mg/kg) or vehicle followed by an ascending dose regimen of methamphetamine (0.01, 0.1, 1, and 3 mg/kg; cumulative dosing). The effects of drug administration on stereotypy and local gamma oscillations were evaluated. Methamphetamine treatment significantly increased high frequency gamma oscillations (∼80 Hz). Entrainment of a subpopulation of nucleus accumbens neurons to high frequency gamma was associated with stereotypy encoding in putative fast-spiking interneurons, but not in putative medium spiny neurons. The observed ability of methamphetamine to induce both stereotypy and high frequency gamma power was potently disrupted following CB1 receptor blockade. The present data suggest that CB1 receptor-dependent mechanisms are recruited by methamphetamine to modify striatal interneuron oscillations that accompany changes in psychomotor state, further supporting the link between endocannabinoids and schizophrenia spectrum disorders.
Collapse
|
125
|
Morgan CJA, Gardener C, Schafer G, Swan S, Demarchi C, Freeman TP, Warrington P, Rupasinghe I, Ramoutar A, Tan N, Wingham G, Lewis S, Curran HV. Sub-chronic impact of cannabinoids in street cannabis on cognition, psychotic-like symptoms and psychological well-being. Psychol Med 2012; 42:391-400. [PMID: 21798112 DOI: 10.1017/s0033291711001322] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cannabis varies considerably in levels of its two major constituent cannabinoids - (delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Recently, we found evidence that those who smoked cannabis containing detectable levels of CBD had fewer psychotic-like symptoms than those whose cannabis had no CBD. The present study aimed, first, to replicate those findings and, second, to determine whether protective effects of CBD may extend to other harms of cannabis, such as memory impairment and reduced psychological well-being. METHOD A total of 120 current cannabis smokers, 66 daily users and 54 recreational users were classified into groups according to whether analysis of their hair revealed the presence or absence of CBD and high versus low levels of THC. All were assessed on measures of psychosis-like symptoms, memory (prose recall; source memory) and depression/anxiety. RESULTS Lower psychosis-like symptoms were found in those whose hair had CBD compared with those without. However, this was seen only in recreational users, who had higher levels of THC in their hair. Higher THC levels in hair were associated with increased depression and anxiety. Prose recall and source memory were poorer in daily users with high THC levels in hair while recognition memory was better in individuals with CBD present in hair. CONCLUSIONS CBD attenuates the psychotic-like effects of cannabis over time in recreational users. Higher THC negatively impacts on memory and psychological well-being. These findings raise concerns for the harms stemming from use of varieties such as 'skunk' (sensimillia), which lack any CBD but currently dominate the supply of cannabis in many countries.
Collapse
Affiliation(s)
- C J A Morgan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - C Gardener
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - G Schafer
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - S Swan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - C Demarchi
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - P Warrington
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - I Rupasinghe
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - A Ramoutar
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - N Tan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - G Wingham
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - S Lewis
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| |
Collapse
|
126
|
Viveros MP, Llorente R, Suarez J, Llorente-Berzal A, López-Gallardo M, de Fonseca FR. The endocannabinoid system in critical neurodevelopmental periods: sex differences and neuropsychiatric implications. J Psychopharmacol 2012; 26:164-76. [PMID: 21669929 DOI: 10.1177/0269881111408956] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This review focuses on the endocannabinoid system as a crucial player during critical periods of brain development, and how its disturbance either by early life stressful events or cannabis consumption may lead to important neuropsychiatric signs and symptoms. First we discuss the advantages and limitations of animal models within the framework of neuropsychiatric research and the crucial role of genetic and environmental factors for the establishment of vulnerable phenotypes. We are becoming aware of important sex differences that have emerged in relation to the psychobiology of cannabinoids. We will discuss sexual dimorphisms observed within the endogenous cannabinoid system, as well as those observed with exogenously administered cannabinoids. We start with how the expression of cannabinoid CB(1) receptors is regulated throughout development. Then, we discuss recent results showing how an experimental model of early maternal deprivation, which induces long-term neuropsychiatric symptoms, interacts in a sex-dependent manner with the brain endocannabinoid system during development. This is followed by a discussion of differential vulnerability to the pathological sequelae stemming from cannabinoid exposure during adolescence. Next we talk about sex differences in the interactions between cannabinoids and other drugs of abuse. Finally, we discuss the potential implications that organizational and activational actions of gonadal steroids may have in establishing and maintaining sex dependence in the neurobiological actions of cannabinoids and their interaction with stress.
Collapse
Affiliation(s)
- M P Viveros
- Departamento de Fisiología (Fisiología Animal II), Facultad de Biología, Universidad Complutense, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
127
|
Abstract
There are two well characterized cannabinoid receptors (CBRs), CB1-Rs and CB2-Rs, with other candidates, such as GPR55, PPARs and vanilloid TRPV1 (VR1) receptors, which are either activated by cannabinoids and/or endocannabinoids (eCBs). The neuronal and functional expression of CB2-Rs in the brain has been much less well characterized in comparison with the expression of the ubiquitous CB1-Rs. CB2-Rs were previously thought to be predominantly expressed in immune cells in the periphery and were traditionally referred to as peripheral CB2-Rs. We and others have now demonstrated the expression of CB2-Rs in neuronal, glial and endothelial cells in the brain, and this warrants a re-evaluation of the CNS effects of CB2-Rs. In the present review we summarize our current understanding of CNR2 genomic structure, its polymorphic nature, subtype specificity, from mice to human subjects, and its variants that confer vulnerabilities to neuropsychiatric disorders beyond neuro-immuno-cannabinoid activity.
Collapse
Affiliation(s)
- Emmanuel S Onaivi
- Department of Biology, William Paterson University, Wayne, NJ 07470, USA.
| | | | | | | |
Collapse
|
128
|
Rapp C, Bugra H, Riecher-Rössler A, Tamagni C, Borgwardt S. Effects of cannabis use on human brain structure in psychosis: a systematic review combining in vivo structural neuroimaging and post mortem studies. Curr Pharm Des 2012; 18:5070-80. [PMID: 22716152 PMCID: PMC3474956 DOI: 10.2174/138161212802884861] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/12/2012] [Indexed: 11/22/2022]
Abstract
It is unclear yet whether cannabis use is a moderating or causal factor contributing to grey matter alterations in schizophrenia and the development of psychotic symptoms. We therefore systematically reviewed structural brain imaging and post mortem studies addressing the effects of cannabis use on brain structure in psychosis. Studies with schizophrenia (SCZ) and first episode psychosis (FEP) patients as well as individuals at genetic (GHR) or clinical high risk for psychosis (ARMS) were included. We identified 15 structural magnetic resonance imaging (MRI) (12 cross sectional / 3 longitudinal) and 4 post mortem studies. The total number of subjects encompassed 601 schizophrenia or first episode psychosis patients, 255 individuals at clinical or genetic high risk for psychosis and 397 healthy controls. We found evidence for consistent brain structural abnormalities in cannabinoid 1 (CB1) receptor enhanced brain areas as the cingulate and prefrontal cortices and the cerebellum. As these effects have not consistently been reported in studies examining nonpsychotic and healthy samples, psychosis patients and subjects at risk for psychosis might be particularly vulnerable to brain volume loss due to cannabis exposure.
Collapse
Affiliation(s)
- Charlotte Rapp
- Department of Psychiatry, University of Basel, 4031 Basel, Switzerland
| | - Hilal Bugra
- Department of Psychiatry, University of Basel, 4031 Basel, Switzerland
| | | | - Corinne Tamagni
- Department of Psychiatry, University of Basel, 4031 Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, 4031 Basel, Switzerland
- Medical Image Analysis Centre, University of Basel, Switzerland
- King’s College London, Department of Psychosis Studies, De Crespigny Park, London SE5 8AF, United Kingdom
| |
Collapse
|
129
|
Discovery and development of integrative biological markers for schizophrenia. Prog Neurobiol 2011; 95:686-702. [DOI: 10.1016/j.pneurobio.2011.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 05/25/2011] [Accepted: 05/27/2011] [Indexed: 12/30/2022]
|
130
|
Hillard CJ, Weinlander KM, Stuhr KL. Contributions of endocannabinoid signaling to psychiatric disorders in humans: genetic and biochemical evidence. Neuroscience 2011; 204:207-29. [PMID: 22123166 DOI: 10.1016/j.neuroscience.2011.11.020] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/05/2011] [Accepted: 11/08/2011] [Indexed: 11/28/2022]
Abstract
The endocannabinoid signaling system is a widespread, neuromodulatory system in brain and is also widely utilized in the periphery to modulate metabolic functions and the immune system. Preclinical data demonstrate that endocannabinoid signaling is an important stress buffer and modulates emotional and cognitive functions. These data suggest the hypothesis that endocannabinoid signaling could be dysfunctional in a number of mental disorders. Genetic polymorphisms in the human genes for two important proteins of the endocannabinoid signaling system, the CB1 cannabinoid receptor (CB1R) and fatty acid amide hydrolase (FAAH), have been explored in the context of normal and pathological conditions. In the case of the gene for FAAH, the mechanistic relationships among the common genetic polymorphism, the expression of the FAAH protein, and its likely impact on endocannabinoid signaling are understood. However, multiple polymorphisms in the gene for the CB1R occur and are associated with human phenotypic differences without an understanding of the functional relationships among the gene, mRNA, protein, and protein function. The endocannabinoid ligands are found in the circulation, and several studies have identified changes in their concentrations under various conditions. These data are reviewed for the purpose of generating hypotheses and to encourage further studies in this very interesting and important area.
Collapse
Affiliation(s)
- C J Hillard
- Department of Pharmacology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | | | |
Collapse
|
131
|
Zoerner AA, Gutzki FM, Batkai S, May M, Rakers C, Engeli S, Jordan J, Tsikas D. Quantification of endocannabinoids in biological systems by chromatography and mass spectrometry: A comprehensive review from an analytical and biological perspective. Biochim Biophys Acta Mol Cell Biol Lipids 2011; 1811:706-23. [DOI: 10.1016/j.bbalip.2011.08.004] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 08/11/2011] [Accepted: 08/12/2011] [Indexed: 11/26/2022]
|
132
|
Cadenhead KS. Startle reactivity and prepulse inhibition in prodromal and early psychosis: effects of age, antipsychotics, tobacco and cannabis in a vulnerable population. Psychiatry Res 2011; 188:208-16. [PMID: 21555157 PMCID: PMC3114288 DOI: 10.1016/j.psychres.2011.04.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 03/22/2011] [Accepted: 04/12/2011] [Indexed: 10/18/2022]
Abstract
The use of biomarkers in the study of the prodrome and first episode of psychosis provides a means of not only identifying individuals at greatest risk for psychosis but also understanding neurodevelopmental abnormalities early in the course of illness. Prepulse inhibition (PPI), a marker that is deficient in schizophrenia and after developmental manipulations in animal models, was assessed in 75 early psychosis (EP), 89 at risk (AR) for psychosis and 85 comparison subjects (CS) at baseline and 6 months. Consistent with findings in chronic schizophrenia, PPI was stable with repeated assessment and EP subjects had reduced PPI but this was most evident in tobacco smokers. A significant positive PPI and age association in AR and EP samples, but not CS, demonstrated potential neurodevelopmental differences in early psychosis. Unexpected findings included the fact that medication naive EP subjects, as well as AR subjects who later developed psychosis, had greater PPI, introducing the possibility of early compensatory changes that diverge from findings in chronic patients. In addition, subjects with a history of cannabis use had greater startle reactivity while EP and AR subjects who used cannabis and were also taking an antipsychotic had greater PPI, again highlighting the potentially important cannabis/psychosis association.
Collapse
|
133
|
Serrano A, Parsons LH. Endocannabinoid influence in drug reinforcement, dependence and addiction-related behaviors. Pharmacol Ther 2011; 132:215-41. [PMID: 21798285 DOI: 10.1016/j.pharmthera.2011.06.005] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 06/17/2011] [Indexed: 12/12/2022]
Abstract
The endogenous cannabinoid system is an important regulatory system involved in physiological homeostasis. Endocannabinoid signaling is known to modulate neural development, immune function, metabolism, synaptic plasticity and emotional state. Accumulating evidence also implicates brain endocannabinoid signaling in the etiology of drug addiction which is characterized by compulsive drug seeking, loss of control in limiting drug intake, emergence of a negative emotional state in the absence of drug use and a persistent vulnerability toward relapse to drug use during protracted abstinence. In this review we discuss the effects of drug intake on brain endocannabinoid signaling, evidence implicating the endocannabinoid system in the motivation for drug consumption, and drug-induced alterations in endocannabinoid function that may contribute to various aspects of addiction including dysregulated synaptic plasticity, increased stress responsivity, negative affective states, drug craving and relapse to drug taking. Current knowledge of genetic variants in endocannabinoid signaling associated with addiction is also discussed.
Collapse
Affiliation(s)
- Antonia Serrano
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA 92037, USA
| | | |
Collapse
|
134
|
The schizophrenia susceptibility gene neuregulin 1 modulates tolerance to the effects of cannabinoids. Int J Neuropsychopharmacol 2011; 14:631-43. [PMID: 20701826 DOI: 10.1017/s146114571000091x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Cannabis increases the risk of schizophrenia in genetically vulnerable individuals. In this study we aim to show that the schizophrenia susceptibility gene neuregulin 1 (Nrg1) modulates the development of tolerance to cannabinoids in mice. Nrg1 heterozygous (HET) and wild-type (WT) mice were treated daily for 15 d with the synthetic analogue of Δ9-tetrahydrocannabinol, CP55,940 (0.4 mg/kg). We measured the impact of this exposure on locomotor activity, anxiety, prepulse inhibition (PPI), body temperature and FosB/ΔFosB immunohistochemistry. Tolerance to CP55,940-induced hypothermia and locomotor suppression developed more rapidly in Nrg1 HET mice than WT mice. Conversely in the light-dark test, while tolerance to the anxiogenic effect of CP55,940 developed in WT mice over days of testing, Nrg1 hypomorphs maintained marked anxiety even after 15 d of treatment. Repeated cannabinoid exposure selectively increased FosB/ΔFosB expression in the lateral septum, ventral part (LSV) of Nrg1 HET but not WT mice. On day 1 of exposure opposite effects of CP55,940 treatment were observed on PPI, i.e. it was facilitated in Nrg1 hypomorphs and impaired in WT mice, despite the drug significantly impairing the acoustic startle reflex equally in both genotypes. These effects of CP55,940 on PPI were not maintained as both genotypes became tolerant to cannabinoid action with repeated exposure. Our results highlight that Nrg1 modulates the development of cannabinoid tolerance dependent on the parameter being measured. Furthermore, these data reinforce the notion that the VLS is an important brain region involved in Nrg1-cannabinoid interactions.
Collapse
|
135
|
Cannabinoid CB1 receptor antagonism prevents neurochemical and behavioural deficits induced by chronic phencyclidine. Int J Neuropsychopharmacol 2011; 14:17-28. [PMID: 20196921 DOI: 10.1017/s1461145710000209] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Clinical and laboratory studies suggest that the endocannabinoid system is involved in schizophrenia disorders. Recent evidence indicates that cannabinoid receptor (CB1) antagonists have a pharmacological profile similar to antipsychotic drugs. We investigated the behavioural and biochemical effects of the CB1 antagonist AM251 in a phencyclidine (PCP) animal paradigm modelling the cognitive deficit and some negative symptoms of schizophrenia. Chronic AM251 (0.5 mg/kg for 3 wk) improved the PCP-altered recognition memory, as indicated by a significant amelioration of the discrimination index compared to chronic PCP alone (2.58 mg/kg for 1 month). AM251 also reversed the PCP-induced increase in immobility in the forced swim test resembling avolition, a negative sign of schizophrenia. In order to analyse the mechanisms underlying these behaviours, we studied the effects of AM251 on the endocannabinoid system (in terms of CB1 receptor density and functional activity and endocannabinoid levels) and c-Fos protein expression. The antagonist counteracted the alterations in CB1 receptor function induced by PCP in selected cerebral regions involved in schizophrenia. In addition, in the prefrontal cortex, the key region in the integration of cognitive and negative functions, AM251 markedly raised anandamide levels and reversed the PCP-induced increase of 2-arachidonoylglycerol concentrations. Finally, chronic AM251 fully reversed the PCP-elicited expression of c-Fos protein in the prefrontal cortical region. These findings suggest an antipsychotic-like profile of the CB1 cannabinoid receptor antagonist which, by restoring the function of the endocannabinoid system, might directly or indirectly normalize some of the neurochemical maladaptations present in this schizophrenia-like animal model.
Collapse
|
136
|
Martinotti G, Di lorio G, Tedeschi D, De Berardis D, Niolu C, Janiri L, Di Giannantonio M. Prevalence and intensity of basic symptoms among cannabis users: an observational study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 37:111-6. [PMID: 21219257 DOI: 10.3109/00952990.2010.541962] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND It is difficult to establish whether people who are prone to psychosis are drawn to cannabis use or whether cannabis use truly increases the incidence of psychotic experiences. OBJECTIVES The aim of our study was to evaluate, in a sample of healthy high school and university students, the presence and level of subjective experiences (SEs) and their relation to cannabis use. METHODS A total of 502 voluntary subjects were recruited; an anamnestic interview was administered to obtain socio-demographic information, cannabis use data, and psychiatric familial history. SEs were assessed using the Italian version of the Frankfurt Complaint Questionnaire (FCQ). RESULTS One hundred and fourteen subjects declared the use of cannabis: 20.5% smoked more than 1 joint per week, and 71.9% used cannabis for a period of more than 1 year. Cannabis users did not differ from the cannabis-free group in any of the 10 FCQ dimensions. Higher FCQ total scores were found in cannabis users with a familial history of psychiatric disorders respective to those without a psychiatric load (p<.05). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE In our study, SE intensity was not influenced by the use of cannabis. With regard to familial data, this is the first study to explore the relationship between SE and the presence of psychiatric problems in first-degree relatives. The association between FCQ intensity and psychiatric familial load may confirm the independence of these phenomena from the use of cannabis.
Collapse
|
137
|
Rais M, van Haren NEM, Cahn W, Schnack HG, Lepage C, Collins L, Evans AC, Hulshoff Pol HE, Kahn RS. Cannabis use and progressive cortical thickness loss in areas rich in CB1 receptors during the first five years of schizophrenia. Eur Neuropsychopharmacol 2010; 20:855-65. [PMID: 20863671 DOI: 10.1016/j.euroneuro.2010.08.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 07/08/2010] [Accepted: 08/18/2010] [Indexed: 02/02/2023]
Abstract
Cerebral grey matter volume reductions are progressive in schizophrenia, with larger grey matter volume decreases associated with cannabis use. It is unknown whether this grey matter loss is globally distributed over the entire brain or more pronounced in specific cortical brain regions. Fifty-one patients with recent-onset schizophrenia and 31 matched healthy subjects were included. For all subjects, magnetic resonance imaging scans were obtained at inclusion and at 5-year follow-up. Nineteen patients (ab-)used cannabis but no other illicit drugs; 32 patients and the healthy comparison subjects did not use any drugs during the 5-year follow-up. At follow-up, clinical outcome was measured. To evaluate the local differences in cortical thickness change over five years between the two groups regression analysis was carried out over the cortical surface. At inclusion cortical thickness did not differ between patients and controls and between cannabis-using and non-using patients. Over the follow-up period we found excessive thinning of the right supplementary motor cortex, inferior frontal cortex, superior temporal gyrus, angular gyrus, occipital and parietal lobe in patients relative to controls after controlling for cannabis use. Patients who used cannabis showed additional thinning in the left dorsolateral prefrontal cortex (DLPFC), left anterior cingulate cortex (ACC) and left occipital lobe as compared to those patients that did not use cannabis during the scan interval. First-episode schizophrenia patients who use cannabis show a more pronounced cortical thinning than non-using patients in areas known for their high density of CB1 receptors, such as the ACC and the DLPFC.
Collapse
Affiliation(s)
- Monica Rais
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
138
|
Malone DT, Hill MN, Rubino T. Adolescent cannabis use and psychosis: epidemiology and neurodevelopmental models. Br J Pharmacol 2010; 160:511-22. [PMID: 20590561 DOI: 10.1111/j.1476-5381.2010.00721.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cannabis is one of the most widely used illicit drugs among adolescents, and most users first experiment with it in adolescence. Adolescence is a critical phase for brain development, characterized by neuronal maturation and rearrangement processes, such as myelination, synaptic pruning and dendritic plasticity. The endocannabinoid system plays an important role in fundamental brain developmental processes such as neuronal cell proliferation, migration and differentiation. Therefore changes in endocannabinoid activity during this specific developmental phase, induced by the psychoactive component of marijuana, Delta(9)-tetrahydrocannabinol, might lead to subtle but lasting neurobiological changes that can affect brain functions and behaviour. In this review, we outline recent research into the endocannabinoid system focusing on the relationships between adolescent exposure to cannabinoids and increased risk for certain neuropsychiatric diseases such as schizophrenia, as highlighted by both human and animal studies. Particular emphasis will be given to the possible mechanisms by which adolescent cannabis consumption could render a person more susceptible to developing psychoses such as schizophrenia.
Collapse
Affiliation(s)
- Daniel T Malone
- Medicinal Chemistry and Drug Action, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Vic., Australia
| | | | | |
Collapse
|
139
|
Abstract
The endocannabinoids anandamide and 2-arachydonoylglycerol (2-AG) are lipids naturally derived from membrane precursors which bind cannabinoid receptors (CB1, CB2). This endocannabinoid system is disturbed in schizophrenia. Indeed, there seems to be an association between schizophrenia and polymorphisms of the CB1 receptor gene. Moreover, CB1 receptors are found in higher density in the prefrontal cortex, hippocampus and basal ganglia of patients with schizophrenia. Similarly, anandamide levels are increased in the cerebrospinal fluid (CSF) and in the serum of schizophrenia patients, including during the prodromal state, suggesting that they may play a protective role in psychosis homeostasis. Future studies are needed to further explore the role of the endocannabinoid system in the pathophysiology of schizophrenia.
Collapse
Affiliation(s)
| | | | | | - Stéphane Potvin
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-514-251-4015; Fax: +1-514-251-2617
| |
Collapse
|
140
|
Vulnerability Factors for the Psychiatric and Behavioral Effects of Cannabis. Pharmaceuticals (Basel) 2010; 3:2799-2820. [PMID: 27713377 PMCID: PMC4034098 DOI: 10.3390/ph3092799] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 08/23/2010] [Accepted: 08/25/2010] [Indexed: 11/18/2022] Open
Abstract
Cogent evidence shows that cannabis plays a variable role on behavioral regulation and the pathophysiology of most psychiatric conditions. Accordingly, cannabis has been alternatively shown to exacerbate or ameliorate mental symptoms, depending on its composition and route of consumption, as well as specific individual and contextual characteristics. The vulnerability to the psychological effects of cannabis is influenced by a complex constellation of genetic and environmental factors. In the present article, we will review the current evidence on the pharmacological, individual and situational factors that have been documented to affect the behavioral and psychiatric effects of cannabinoids.
Collapse
|
141
|
Early maternal deprivation induces changes on the expression of 2-AG biosynthesis and degradation enzymes in neonatal rat hippocampus. Brain Res 2010; 1349:162-73. [DOI: 10.1016/j.brainres.2010.06.042] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 06/15/2010] [Accepted: 06/17/2010] [Indexed: 11/18/2022]
|
142
|
Robinson SA, Loiacono RE, Christopoulos A, Sexton PM, Malone DT. The effect of social isolation on rat brain expression of genes associated with endocannabinoid signaling. Brain Res 2010; 1343:153-67. [DOI: 10.1016/j.brainres.2010.04.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 04/14/2010] [Accepted: 04/14/2010] [Indexed: 10/19/2022]
|
143
|
Inhibition of fatty-acid amide hydrolase and CB1 receptor antagonism differentially affect behavioural responses in normal and PCP-treated rats. Int J Neuropsychopharmacol 2010; 13:373-86. [PMID: 19607756 DOI: 10.1017/s146114570999023x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The 'cannabinoid hypothesis' of schizophrenia tulates that over-activity of the endocannabinoid system might contribute to the aetiology of schizophrenia. In keeping with this hypothesis, increased expression of CB1 receptors, elevation of the endocannabinoid anandamide (AEA) and cannabinoid-induced cognitive changes have been reported in animal models of schizophrenia and psychotic patients. In this study we measured brain endocannabinoid levels and [35S]GTPgammaS binding stimulated by the CB receptor agonist CP55,940 in rats undergoing withdrawal from subchronic administration of phencyclidine (PCP), a well-established pharmacological model of schizophrenia. We also investigated whether systemic application of the fatty-acid amide hydrolase (FAAH) inhibitor URB597 or CB1 receptor blockade by AM251 affected the following PCP-induced behavioural deficits reminiscent of schizophrenia-like symptoms: (1) working-memory impairment (cognitive deficit), (2) social withdrawal (negative symptom), and (3) hyperactivity in response to d-amphetamine challenge (positive symptoms). PCP-treated rats showed increased endocannabinoid levels in the nucleus accumbens and ventral tegmental area, whereas CB1 receptor expression and CP55,940-stimulated [35S]GTPgammaS binding were unaltered. URB597 reversed the PCP-induced social withdrawal but caused social withdrawal and working-memory deficits in saline-treated rats that were comparable to those observed after PCP treatment. Administration of AM251 ameliorated the working-memory deficit in PCP-treated rats, but impaired working memory in saline-injected controls. Taken together, these results suggest that FAAH inhibition may improve negative symptoms in PCP-treated rats but produce deleterious effects in untreated animals, possibly by disturbing endocannabinoid tone. A similar pattern (beneficial for schizophrenia-related cognitive deficits, but detrimental under normal conditions) accompanies CB1 receptor blockade.
Collapse
|
144
|
Abstract
The present review summarizes the latest information on the role and the pharmacological modulation of the endocannabinoid system in mood disorders and its potential implication in psychotic disorders such as schizophrenia. Reduced functionality might be considered a predisposing factor for major depression, so boosting endocannabinoid tone might be a useful alternative therapeutic approach for depressive disorders. The picture regarding endocannabinoids and anxiety is more complicated since either too much or too little anandamide can lead to anxiety states. However, a small rise in its level in specific brain areas might be beneficial for the response to a stressful situation and therefore to tone down anxiety. This effect might be achieved with low doses of cannabinoid indirect agonists, such as blockers of the degradative pathway (i.e. FAAH) or re-uptake inhibitors. Moreover several lines of experimental and clinical evidence point to a dysregulation of the endocannabinoid system in schizophrenia. The high anandamide levels found in schizophrenic patients, negatively correlated with psychotic symptoms, point to a protective role, whereas the role of 2-arachidonoyl glycerol is still unclear. There is a potential for pharmacological manipulation of the endocannabinoid system as a novel approach for treating schizophrenia, although experimental findings are still controversial, often with different effects depending on the drug, the dose, the species and the model used for simulating positive or negative symptoms. Besides all these limitations, SR141716A and cannabidiol show the most constant antipsychotic properties in dopamine- and glutamate-based models of schizophrenia, with profiles similar to an atypical antipsychotic drug.
Collapse
Affiliation(s)
- Daniela Parolaro
- DBSF and Neuroscience Center, University of Insubria, Via A. da Giussano 10, 21052 Busto Arsizio (Varese), Italy.
| | | | | | | | | |
Collapse
|
145
|
Taylor AH, Amoako AA, Bambang K, Karasu T, Gebeh A, Lam PMW, Marzcylo TH, Konje JC. Endocannabinoids and pregnancy. Clin Chim Acta 2010; 411:921-30. [PMID: 20302856 DOI: 10.1016/j.cca.2010.03.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 03/09/2010] [Accepted: 03/09/2010] [Indexed: 12/12/2022]
Abstract
Acylethanolamides such as anandamide (AEA), and monoacylglycerols like 2-arachidonoylglycerol are endocannabinoids that bind to cannabinoid, vanilloid and peroxisome proliferator-activated receptors. These compounds, their various receptors, the purported membrane transporter(s), and related enzymes that synthesize and degrade them are collectively referred to as the "endocannabinoid system (ECS)". Poorly defined cellular and molecular mechanisms control the biological actions of the ECS. Over the last decade evidence has been emerging to suggest that the ECS plays a significant role in various aspects of human reproduction. In this review, we summarize our current understanding of this role especially the involvement of AEA and related ECS elements in regulating oogenesis, embryo oviductal transport, blastocyst implantation, placental development and pregnancy outcomes, and sperm survival, motility, capacitation and acrosome reaction. Additionally, the possibility that plasma and tissue AEA and other cannabinoids may represent reliable diagnostic markers of natural and assisted reproduction and pregnancy outcomes in women will be discussed.
Collapse
Affiliation(s)
- Anthony H Taylor
- Reproductive Sciences Section, University of Leicester, Leicester, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
146
|
Adenosine-dopamine interactions in the pathophysiology and treatment of CNS disorders. CNS Neurosci Ther 2010; 16:e18-42. [PMID: 20345970 DOI: 10.1111/j.1755-5949.2009.00126.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Adenosine-dopamine interactions in the central nervous system (CNS) have been studied for many years in view of their relevance for disorders of the CNS and their treatments. The discovery of adenosine and dopamine receptor containing receptor mosaics (RM, higher-order receptor heteromers) in the striatum opened up a new understanding of these interactions. Initial findings indicated the existence of A(2A)R-D(2)R heterodimers and A(1)R-D(1)R heterodimers in the striatum that were followed by indications for the existence of striatal A(2A)R-D(3)R and A(2A)R-D(4)R heterodimers. Of particular interest was the demonstration that antagonistic allosteric A(2A)-D(2) and A(1)-D(1) receptor-receptor interactions take place in striatal A(2A)R-D(2)R and A(1)R-D(1)R heteromers. As a consequence, additional characterization of these heterodimers led to new aspects on the pathophysiology of Parkinson's disease (PD), schizophrenia, drug addiction, and l-DOPA-induced dyskinesias relevant for their treatments. In fact, A(2A)R antagonists were introduced in the symptomatic treatment of PD in view of the discovery of the antagonistic A(2A)R-D(2)R interaction in the dorsal striatum that leads to reduced D(2)R recognition and G(i/o) coupling in striato-pallidal GABAergic neurons. In recent years, indications have been obtained that A(2A)R-D(2)R and A(1)R-D(1)R heteromers do not exist as heterodimers, rather as RM. In fact, A(2A)-CB(1)-D(2) RM and A(2A)-D(2)-mGlu(5) RM have been discovered using a sequential BRET-FRET technique and by using the BRET technique in combination with bimolecular fluorescence complementation. Thus, other pathogenic mechanisms beside the well-known alterations in the release and/or decoding of dopamine in the basal ganglia and limbic system are involved in PD, schizophrenia and drug addiction. In fact, alterations in the stoichiometry and/or topology of A(2A)-CB(1)-D(2) and A(2A)-D(2)-mGlu5 RM may play a role. Thus, the integrative receptor-receptor interactions in these RM give novel aspects on the pathophysiology and treatment strategies, based on combined treatments, for PD, schizophrenia, and drug addiction.
Collapse
|
147
|
Wobrock T, Hasan A, Malchow B, Wolff-Menzler C, Guse B, Lang N, Schneider-Axmann T, Ecker UKH, Falkai P. Increased cortical inhibition deficits in first-episode schizophrenia with comorbid cannabis abuse. Psychopharmacology (Berl) 2010; 208:353-63. [PMID: 19997844 PMCID: PMC2806533 DOI: 10.1007/s00213-009-1736-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 11/16/2009] [Indexed: 12/25/2022]
Abstract
RATIONALE/OBJECTIVES There is a high prevalence of substance use disorder (SUD) in first-episode schizophrenia (SZ), but its contribution to the underlying SZ pathophysiology remains unclear. Several studies using transcranial magnetic stimulation (TMS) have observed abnormalities in human motor cortex (M1) excitability in SZ. Studies on cortical excitability comparing SZ patients with and without comorbid substance abuse are lacking. METHODS A total of 29 first-episode SZ patients participated in this study; 12 had a history of comorbid cannabis abuse (SZ-SUD) and 17 did not (SZ-NSUD). We applied TMS to right and left M1 areas to assess the resting motor threshold (RMT), short-interval cortical inhibition (SICI), intracortical facilitation (ICF), and the contralateral cortical silent period (CSP). RESULTS In SICI and ICF conditions, right M1 stimulation led to significantly higher motor evoked potential ratios in SZ-SUD compared to SZ-NSUD. This suggests lower cortical inhibition and increased ICF in first-episode SZ with previous cannabis abuse. There were no group differences in RMT and CSP duration. Neither were there any significant correlations between psychopathology (as indexed by Positive and Negative Syndrome Scale), disease characteristics, the extent of cannabis abuse, and TMS parameters (SICI, ICF, and CSP). CONCLUSIONS Comorbid cannabis abuse may potentiate the reduced intracortical inhibition and enhanced ICF observed in first-episode SZ patients in some previous studies. This finding suggests an increased alteration of GABA(A) and NMDA receptor activity in cannabis-abusing first-episode patients as compared to schizophrenia patients with no history of substance abuse. This may constitute a distinct vulnerability factor in this special population.
Collapse
Affiliation(s)
- Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Von-Siebold-Strasse 5, 37075 Göttingen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
148
|
Viveros MP, Llorente R, López-Gallardo M, Suarez J, Bermúdez-Silva F, De la Fuente M, Rodriguez de Fonseca F, Garcia-Segura LM. Sex-dependent alterations in response to maternal deprivation in rats. Psychoneuroendocrinology 2009; 34 Suppl 1:S217-26. [PMID: 19553026 DOI: 10.1016/j.psyneuen.2009.05.015] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Revised: 05/24/2009] [Accepted: 05/25/2009] [Indexed: 12/20/2022]
Abstract
We review here our latest results regarding short- and long-term effects of a neonatal maternal deprivation (MD) stress [24h at postnatal day (PND) 9] on diverse psychoneuroimmunoendocrine parameters, pointing out the existence of numerous sexual dimorphisms. Behavioral changes observed in MD animals might be at least in part attributable to neurodevelopmental effects of MD-induced elevated corticosterone levels. Our findings of short-term effects of MD on hippocampal and cerebellar neurons and glial cells appear to support this hypothesis. However, it is important to note that these cellular effects were more marked in males than in females. Moreover, in analyzing the effects of this neonatal stress on the endocannabinoid system (hippocampal endocannabinoid levels and CB1 receptors) we have also found that males were more affected by MD. Since all these sexual dimorphisms were found at an early neonatal age (PND 13), they are attributable to organizational effects of gonadal steroids. We discuss the potential implications of the elevated corticosterone and decreased leptin levels shown by MD animals in their diverse functional alterations, including the above mentioned neural effects as well as the intriguing persistent deficit in their immunological system. We also emphasize the necessity of analyzing the important influence of sex as regards the specific consequences of early life stress.
Collapse
Affiliation(s)
- M P Viveros
- Departamento de Fisiología (Fisiología Animal II), Facultad de Biología, Universidad Complutense, E-28040 Madrid, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
149
|
Koethe D, Hoyer C, Leweke FM. The endocannabinoid system as a target for modelling psychosis. Psychopharmacology (Berl) 2009; 206:551-61. [PMID: 19529920 DOI: 10.1007/s00213-009-1591-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Accepted: 06/05/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Model psychosis is characterised by experimentally induced symptoms of withdrawal from reality, frequently accompanied by perceptual disturbances, thought disorders, delusional ideas and sometimes by hallucinations. These "altered states of consciousness" provide a long-standing and valid approach to enhance our understanding of certain aspects of schizophrenia. DISCUSSION Targeting the endocannabinoid system to investigate its involvement in the pathophysiology of schizophrenia became increasingly relevant with the discovery of this system and amounting epidemiological evidence for a deleterious influence of cannabis use on both manifestation and course of the disease. The majority of studies in the field are targeted to investigate drug effect of cannabis and cannabinoids not immediately related to psychosis. CONCLUSION In this review, we summarise studies relevant for or designed as model psychosis experiments. Based on the data available, we examine the contribution of these studies to an improved neurobiological assessment of endocannabinoid functioning in psychosis and schizophrenia. An outline for future studies in the field and cross-links to other approaches to model psychosis is provided.
Collapse
Affiliation(s)
- Dagmar Koethe
- Central Institute of Mental Health, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | | | | |
Collapse
|
150
|
Fernandez-Espejo E, Viveros MP, Núñez L, Ellenbroek BA, Rodriguez de Fonseca F. Role of cannabis and endocannabinoids in the genesis of schizophrenia. Psychopharmacology (Berl) 2009; 206:531-49. [PMID: 19629449 DOI: 10.1007/s00213-009-1612-6] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 07/02/2009] [Indexed: 11/25/2022]
Abstract
RATIONALE Cannabis abuse and endocannabinoids are associated to schizophrenia. OBJECTIVES It is important to discern the association between schizophrenia and exogenous Cannabis sativa, on one hand, and the endogenous cannabinoid system, on the other hand. RESULTS On one hand, there is substantial evidence that cannabis abuse is a risk factor for psychosis in genetically predisposed people, may lead to a worse outcome of the disease, or it can affect normal brain development during adolescence, increasing the risk for schizophrenia in adulthood. Regarding genetic predisposition, alterations affecting the cannabinoid CNR1 gene could be related to schizophrenia. On the other hand, the endogenous cannabinoid system is altered in schizophrenia (i.e., increased density of cannabinoid CB1 receptor binding in corticolimbic regions, enhanced cerebrospinal fluid anandamide levels), and dysregulation of this system can interact with neurotransmitter systems in such a way that a "cannabinoid hypothesis" can be integrated in the neurobiological hypotheses of schizophrenia. Finally, there is also evidence that some genetic alterations of the CNR1 gene can act as a protectant factor against schizophrenia or can induce a better pharmacological response to atypical antipsychotics. CONCLUSIONS Cannabis abuse is a risk factor for psychosis in predisposed people, it can affect neurodevelopment during adolescence leading to schizophrenia, and a dysregulation of the endocannabinoid system can participate in schizophrenia. It is also worth noting that some specific cannabinoid alterations can act as neuroprotectant for schizophrenia or can be a psychopharmacogenetic rather than a vulnerability factor.
Collapse
Affiliation(s)
- Emilio Fernandez-Espejo
- Departamento de Fisiología Médica, Facultad de Medicina, Universidad de Sevilla, Seville, Spain.
| | | | | | | | | |
Collapse
|