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Stone JM, Morrison PD, Brugger S, Nottage J, Bhattacharyya S, Sumich A, Wilson D, Tunstall N, Feilding A, Brenneisen R, McGuire P, Murray RM, Ffytche DH. Communication breakdown: delta-9 tetrahydrocannabinol effects on pre-speech neural coherence. Mol Psychiatry 2012; 17:568-9. [PMID: 22042229 DOI: 10.1038/mp.2011.141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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152
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Bhattacharyya S, Sendt KV. Neuroimaging evidence for cannabinoid modulation of cognition and affect in man. Front Behav Neurosci 2012; 6:22. [PMID: 22654743 PMCID: PMC3360161 DOI: 10.3389/fnbeh.2012.00022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 05/05/2012] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
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153
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Kalpakidou AK, Allin MP, Walshe M, Giampietro V, Nam KW, McGuire P, Rifkin L, Murray RM, Nosarti C. Neonatal brain injury and neuroanatomy of memory processing following very preterm birth in adulthood: an fMRI study. PLoS One 2012; 7:e34858. [PMID: 22532832 PMCID: PMC3332056 DOI: 10.1371/journal.pone.0034858] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 03/08/2012] [Indexed: 11/18/2022] Open
Abstract
Altered functional neuroanatomy of high-order cognitive processing has been described in very preterm individuals (born before 33 weeks of gestation; VPT) compared to controls in childhood and adolescence. However, VPT birth may be accompanied by different types of adverse neonatal events and associated brain injury, the severity of which may have differential effects on brain development and subsequent neurodevelopmental outcome. We conducted a functional magnetic resonance imaging (fMRI) study to investigate how differing degrees of neonatal brain injury, detected by neonatal ultrasounds, affect the functional neuroanatomy of memory processing in VPT young adults. We used a verbal paired associates learning task, consisting of four encoding, four cued-recall and four baseline condition blocks. To further investigate whether differences in neural activation between the groups were modulated by structural brain changes, structural MRI data were also collected. We studied 12 VPT young adults with a history of periventricular haemorrhage with associated ventricular dilatation, 17 VPT individuals with a history of uncomplicated periventricular haemorrhage, 12 individuals with normal ultrasonographic findings, and 17 controls. Results of a linear trend analysis demonstrated that during completion of the paired associates learning task right frontal and right parietal brain activation decreased as the severity of neonatal brain injury increased. There were no statistically significant between-group differences in on-line task performance and participants' intelligence quotient (IQ) at assessment. This pattern of differential activation across the groups was observed particularly in the right middle frontal gyrus during encoding and in the right posterior cingulate gyrus during recall. Structural MRI data analysis revealed that grey matter volume in the right superior temporal gyrus, right cerebellum, left middle temporal gyrus, right globus pallidus and right medial frontal gyrus decreased with increasing severity of neonatal brain injury. However, the significant between-group functional neuroanatomical differences were not directly attributable to the detected structural regional differences.
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Affiliation(s)
- Anastasia K. Kalpakidou
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Matthew P. Allin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Muriel Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Kie-woo Nam
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Larry Rifkin
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
| | - Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom
- * E-mail:
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154
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Jones NA, Glyn SE, Akiyama S, Hill TDM, Hill AJ, Weston SE, Burnett MDA, Yamasaki Y, Stephens GJ, Whalley BJ, Williams CM. Cannabidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures. Seizure 2012; 21:344-52. [PMID: 22520455 DOI: 10.1016/j.seizure.2012.03.001] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 02/27/2012] [Accepted: 03/01/2012] [Indexed: 01/21/2023] Open
Abstract
Cannabis sativa has been associated with contradictory effects upon seizure states despite its medicinal use by numerous people with epilepsy. We have recently shown that the phytocannabinoid cannabidiol (CBD) reduces seizure severity and lethality in the well-established in vivo model of pentylenetetrazole-induced generalised seizures, suggesting that earlier, small-scale clinical trials examining CBD effects in people with epilepsy warrant renewed attention. Here, we report the effects of pure CBD (1, 10 and 100mg/kg) in two other established rodent seizure models, the acute pilocarpine model of temporal lobe seizure and the penicillin model of partial seizure. Seizure activity was video recorded and scored offline using model-specific seizure severity scales. In the pilocarpine model CBD (all doses) significantly reduced the percentage of animals experiencing the most severe seizures. In the penicillin model, CBD (≥ 10 mg/kg) significantly decreased the percentage mortality as a result of seizures; CBD (all doses) also decreased the percentage of animals experiencing the most severe tonic-clonic seizures. These results extend the anti-convulsant profile of CBD; when combined with a reported absence of psychoactive effects, this evidence strongly supports CBD as a therapeutic candidate for a diverse range of human epilepsies.
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Affiliation(s)
- Nicholas A Jones
- School of Pharmacy, University of Reading, Whiteknights, Reading RG6 6AJ, UK.
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155
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Bossong MG, Jager G, van Hell HH, Zuurman L, Jansma JM, Mehta MA, van Gerven JMA, Kahn RS, Ramsey NF. Effects of Δ9-Tetrahydrocannabinol Administration on Human Encoding and Recall Memory Function: A Pharmacological fMRI Study. J Cogn Neurosci 2012; 24:588-99. [DOI: 10.1162/jocn_a_00156] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Deficits in memory function are an incapacitating aspect of various psychiatric and neurological disorders. Animal studies have recently provided strong evidence for involvement of the endocannabinoid (eCB) system in memory function. Neuropsychological studies in humans have shown less convincing evidence but suggest that administration of cannabinoid substances affects encoding rather than recall of information. In this study, we examined the effects of perturbation of the eCB system on memory function during both encoding and recall. We performed a pharmacological MRI study with a placebo-controlled, crossover design, investigating the effects of Δ9-tetrahydrocannabinol (THC) inhalation on associative memory-related brain function in 13 healthy volunteers. Performance and brain activation during associative memory were assessed using a pictorial memory task, consisting of separate encoding and recall conditions. Administration of THC caused reductions in activity during encoding in the right insula, the right inferior frontal gyrus, and the left middle occipital gyrus and a network-wide increase in activity during recall, which was most prominent in bilateral cuneus and precuneus. THC administration did not affect task performance, but while during placebo recall activity significantly explained variance in performance, this effect disappeared after THC. These findings suggest eCB involvement in encoding of pictorial information. Increased precuneus activity could reflect impaired recall function, but the absence of THC effects on task performance suggests a compensatory mechanism. These results further emphasize the eCB system as a potential novel target for treatment of memory disorders and a promising target for development of new therapies to reduce memory deficits in humans.
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Affiliation(s)
| | - Gerry Jager
- 1University Medical Center Utrecht
- 2Wageningen University
| | | | - Lineke Zuurman
- 3Centre for Human Drug Research, Leiden, the Netherlands
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156
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van Hell HH, Jager G, Bossong MG, Brouwer A, Jansma JM, Zuurman L, van Gerven J, Kahn RS, Ramsey NF. Involvement of the endocannabinoid system in reward processing in the human brain. Psychopharmacology (Berl) 2012; 219:981-90. [PMID: 21822593 PMCID: PMC3266503 DOI: 10.1007/s00213-011-2428-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 07/25/2011] [Indexed: 11/30/2022]
Abstract
RATIONALE Disturbed reward processing in humans has been associated with a number of disorders, such as depression, addiction, and attention-deficit hyperactivity disorder. The endocannabinoid (eCB) system has been implicated in reward processing in animals, but in humans, the relation between eCB functioning and reward is less clear. OBJECTIVES The current study uses functional magnetic resonance imaging (fMRI) to investigate the role of the eCB system in reward processing in humans by examining the effect of the eCB agonist Δ(9)-tetrahydrocannabinol (THC) on reward-related brain activity. METHODS Eleven healthy males participated in a randomized placebo-controlled pharmacological fMRI study with administration of THC to challenge the eCB system. We compared anticipatory and feedback-related brain activity after placebo and THC, using a monetary incentive delay task. In this task, subjects are notified before each trial whether a correct response is rewarded ("reward trial") or not ("neutral trial"). RESULTS Subjects showed faster reaction times during reward trials compared to neutral trials, and this effect was not altered by THC. THC induced a widespread attenuation of the brain response to feedback in reward trials but not in neutral trials. Anticipatory brain activity was not affected. CONCLUSIONS These results suggest a role for the eCB system in the appreciation of rewards. The involvement of the eCB system in feedback processing may be relevant for disorders in which appreciation of natural rewards may be affected such as addiction.
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Affiliation(s)
- Hendrika H. van Hell
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Gerry Jager
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Matthijs G. Bossong
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Annelies Brouwer
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - J. Martijn Jansma
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | | | | | - René S. Kahn
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick F. Ramsey
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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157
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Palermo L, Bianchini F, Iaria G, Tanzilli A, Guariglia C. Assessing topographical orientation skills in cannabis users. ScientificWorldJournal 2012; 2012:137071. [PMID: 22272167 PMCID: PMC3259701 DOI: 10.1100/2012/137071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 11/17/2011] [Indexed: 11/26/2022] Open
Abstract
The long-term effects of cannabis on human cognition are still unclear, but, considering that cannabis is a widely used substance and, overall, its potential use in therapeutic interventions, it is important to evaluate them. We hypothesize that the discrepancies among studies could be attributed to the specific cognitive function investigated and that skills subserved by the hippocampus, such as the spatial orientation abilities and, specifically, the ability to form and use cognitive maps, should be more compromised than others. Indeed it has been showed that cannabis users have a reduced hippocampus and that the hippocampus is the brain region in which cannabis has the greatest effect since it contains the highest concentration of cannabinoid receptors. To test this hypothesis we asked 15 heavy cannabis users and 19 nonusers to perform a virtual navigational test, the CMT, that assesses the ability to form and use cognitive maps. We found that using cannabis has no effect on these hippocampus-dependent orientation skills. We discuss the implications of our findings and how they relate to evidence reported in the literature that the intervention of functional reorganization mechanisms in cannabis user allows them to cope with the cognitive demands of navigational tasks.
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Affiliation(s)
- Liana Palermo
- Dipartimento di Psicologia, "Sapienza" Università di Roma, 00185 Rome, Italy.
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158
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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.
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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
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159
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Saha S, Scott JG, Varghese D, Degenhardt L, Slade T, McGrath JJ. The association between delusional-like experiences, and tobacco, alcohol or cannabis use: a nationwide population-based survey. BMC Psychiatry 2011; 11:202. [PMID: 22204498 PMCID: PMC3313864 DOI: 10.1186/1471-244x-11-202] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 12/28/2011] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Previous population-based studies have found that delusional-like experiences (DLE) are prevalent in the community, and are associated with a wide range of mental health disorders including substance use. The aim of the study was to explore the association between DLE and three commonly used substances--tobacco, alcohol and cannabis. METHODS Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and substance use. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. RESULTS Of 8,773 participants, 8.4% (n=776) subjects endorsed one or more DLE. With respect to tobacco use, compared to nonusers, DLE were more common in those who (a) had daily use, (b) commenced usage aged 15 years or less, and (c) those who smoked heavily (23 or more cigarettes per day). Participants with cannabis use disorders were more likely to endorse DLE; this association was most prominent in those with an onset of 16 years or younger. In contrast, the pattern of association between DLE versus alcohol use or dependence was less consistent, however those with early onset alcohol use disorders were more likely to endorse DLE probe items. CONCLUSIONS While cannabis use disorders have been previously linked with DLE, our findings linking alcohol and tobacco use and DLE suggest that the influence of these substances on psychosis-related outcomes warrants closer scrutiny in longitudinal prospective studies.
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Affiliation(s)
- Sukanta Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia,The University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia,Department of Psychiatry, University of Queensland, St Lucia QLD, Australia
| | - Daniel Varghese
- Princess Alexandra Hospital, Woolloongabba, QLD 4102 Australia
| | - Louisa Degenhardt
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Department of Psychiatry, University of Queensland, St Lucia QLD, Australia,Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
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160
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Barkus E, Morrison PD, Vuletic D, Dickson JC, Ell PJ, Pilowsky LS, Brenneisen R, Holt DW, Powell J, Kapur S, Murray RM. Does intravenous Δ9-tetrahydrocannabinol increase dopamine release? A SPET study. J Psychopharmacol 2011; 25:1462-8. [PMID: 20851843 DOI: 10.1177/0269881110382465] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Intravenous (IV) Δ9-tetrahydrocannabinol (THC) induces transient psychotic symptoms in healthy subjects and in schizophrenic patients, but the psychotomimetic mechanism is unknown. One possibility is that THC stimulates dopamine (DA) release in the striatum. In this study we tested whether IV THC led to an increase in striatal DA release compared to placebo. We also investigated whether DA release and positive psychotic symptoms were related. Eleven healthy male volunteers completed two 123I-iodobenzamide ([123I]IBZM) single photon emission tomography (SPET) sessions and received IV THC (2.5 mg) or placebo in a randomized counterbalanced order, under double-blind conditions. Analysable data were obtained from nine participants. The Positive and Negative Syndrome Scale (PANSS) was used to rate psychotomimetic effects. Striatal binding index values were calculated using the occipital cortex as a reference region. Both the PANSS positive and general symptoms increased significantly at 30 min following IV THC. There were no significant differences in binding index in the caudate or putamen under THC compared to placebo conditions. Positive psychotic symptoms and DA release were unrelated. THC did not lead to a significant increase in DA release even though the dose was sufficient for participants to have psychotic symptoms. These findings do not support a central role for striatal DA in THC-elicited psychosis.
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Affiliation(s)
- Emma Barkus
- Institute of Psychiatry, Kings College London, London, UK.
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161
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Evidence for involvement of the insula in the psychotropic effects of THC in humans: a double-blind, randomized pharmacological MRI study. Int J Neuropsychopharmacol 2011; 14:1377-88. [PMID: 21489346 DOI: 10.1017/s1461145711000526] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The main reason for recreational use of cannabis is the 'high', the primary psychotropic effect of Δ9-tetrahydrocannabinol (THC). This psychoactive compound of cannabis induces a range of subjective, physical and mental reactions. The effect on heart rate is pronounced and complicates bloodflow-based neuroimaging of psychotropic effects of THC. In this study we investigated the effects of THC on baseline brain perfusion and activity in association with the induction of 'feeling high'. Twenty-three subjects participated in a pharmacological MRI study, where we applied arterial spin labelling (ASL) to measure perfusion, and resting-state functional MRI to assess blood oxygen level-dependent signal fluctuation as a measure of baseline brain activity. Feeling high was assessed with a visual analogue scale and was compared to the imaging measures. THC increased perfusion in the anterior cingulate cortex, superior frontal cortex, and insula, and reduced perfusion in the post-central and occipital gyrus. Baseline brain activity was altered, indicated by increased amplitude of fluctuations in resting-state functional MRI signal after THC administration in the insula, substantia nigra and cerebellum. Perfusion changes in frontal cortex were negatively correlated with ratings of feeling high, suggesting an interaction between cognitive control and subjective effects of THC. In conclusion, an acute THC challenge altered baseline brain perfusion and activity, especially in frontal brain areas involved in cognitive and emotional processes, and the insula, associated with interoceptive awareness. These changes may represent the THC-induced neurophysiological correlates of feeling high. The alterations in baseline brain perfusion and activity also have relevance for studies on task-related effects of THC on brain function.
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162
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van Leeuwen AP, Creemers HE, Greaves-Lord K, Verhulst FC, Ormel J, Huizink AC. Hypothalamic-pituitary-adrenal axis reactivity to social stress and adolescent cannabis use: the TRAILS study. Addiction 2011; 106:1484-92. [PMID: 21631618 DOI: 10.1111/j.1360-0443.2011.03448.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the relationship of life-time and repeated cannabis use with hypothalamic-pituitary-adrenal (HPA) axis reactivity to social stress in a general population sample of adolescents. DESIGN Adolescents who reported life-time or repeated cannabis use, life-time or repeated tobacco use and never use of either cannabis or tobacco were compared with respect to their HPA axis reactivity during the Groningen Social Stress Task (GSST), which was based on the Trier Social Stress Task. SETTING A large prospective population study of Dutch adolescents [the TRacking Adolescents' Individual Lives Survey (TRAILS) study]. PARTICIPANTS A total of 591 adolescents (51% male) who participated in the GSST, which was an additional measurement during the third assessment wave. MEASUREMENTS HPA axis stress-reactivity was indexed by four cortisol samples collected before, during and after the GSST. Furthermore, all adolescents in our study completed self-reported questionnaires on life-time and repeated cannabis and tobacco use. Models were adjusted for sex, recent alcohol use, experimental session risk status, socio-economic status, mood and time of the experimental session. FINDINGS Life-time cannabis users had significantly lower stress-reactivity levels when compared to abstainers [odds ratio (OR) = 0.68, confidence interval (CI) = 0.55-0.85, P < 0.01] and life-time tobacco users (OR = 0.79, CI = 0.64-0.98, P < 0.05). In addition, repeated cannabis users also exhibited lower stress-reactivity levels when compared to life-time ever users of either tobacco or cannabis (OR = 0.74, CI = 0.53-0.98, P < 0.05). CONCLUSIONS Lower hypothalamic-pituitary-adrenal-axis stress-reactivity in adolescents is related specifically to life-time and repeated cannabis use.
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Affiliation(s)
- Andrea Prince van Leeuwen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
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163
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Hermann D. Wirkung von Cannabinoiden auf das Gehirn: Ein Überblick über MRI Befunde. SUCHT-ZEITSCHRIFT FUR WISSENSCHAFT UND PRAXIS 2011. [DOI: 10.1024/0939-5911.a000108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ziel: Übersicht über aktuelle Magnetresonanztomographie (MRI) Studien zur Wirkung von Cannabis auf das Gehirn. Methodik: Systematische Literaturrecherche mit Pubmed. Ergebnisse: Es wurden 37 Originalarbeiten gefunden, von denen 97 % zwischen 2004 und 2010 publiziert wurden. Je sechs Studien zur Volumetrie und Konnektivität beschreiben minimale Veränderungen der Hirnstrukturen, vor allem in Hippocampus und Amygdala, sowie die Integrität der weißen Substanz betreffend. Zwei neurometabolische Studien mit 1H-MR-Spektroskopie zeigen Veränderungen im dorsolateralen präfrontalen Cortex (DLPFC) und den Basalganglien. In vier placebo-kontrollierten funktionellen MRI Studien (fMRI) verminderte THC die Aktivierung in Hirnregionen, die zur Inhibition und zum Lernen benötigt werden, und CBD hemmte die Angst-assoziierte Aktivierung der Amygdala. Weitere 19 fMRI-Studien an chronischen Cannabiskonsumenten ergaben widersprüchliche Ergebnisse bzgl. Arbeitsgedächtnis, hippocampalem Gedächtnis, Gewinn/Verlust-Erwartung, Cannabis Cues, Emotionen, Inhibition, Motorik und Aufmerksamkeit. Schlussfolgerungen: Ein belastbarer Informationszuwachs wurde vor allem durch die getrennte, plazebo-kontrollierte Verabreichung von THC oder CBD in fMRI-Studien erreicht. Die widersprüchlichen Ergebnisse in fMRI Hirnaktivierungs-Mustern von Cannabiskonsumenten zeigen eine veränderte neuronale Plastizität, ohne dass eine Aussage getroffen werden kann, ob dies günstige oder ungünstige Auswirkungen hat. Für zukünftige Studien ist eine Bestimmung von CBD und THC z. B. durch Haaranalyse dringend anzuraten.
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Affiliation(s)
- Derik Hermann
- Zentralinstitut für Seelische Gesundheit, Klinik für Abhängiges Verhalten und Suchtmedizin, Mannheim
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164
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Modulation of auditory and visual processing by delta-9-tetrahydrocannabinol and cannabidiol: an FMRI study. Neuropsychopharmacology 2011; 36:1340-8. [PMID: 21412224 PMCID: PMC3096803 DOI: 10.1038/npp.2011.17] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although the effects of cannabis on perception are well documented, little is known about their neural basis or how these may contribute to the formation of psychotic symptoms. We used functional magnetic resonance imaging (fMRI) to assess the effects of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) during visual and auditory processing in healthy volunteers. In total, 14 healthy volunteers were scanned on three occasions. Identical 10 mg THC, 600 mg CBD, and placebo capsules were allocated in a balanced double-blinded pseudo-randomized crossover design. Plasma levels of each substance, physiological parameters, and measures of psychopathology were taken at baseline and at regular intervals following ingestion of substances. Volunteers listened passively to words read and viewed a radial visual checkerboard in alternating blocks during fMRI scanning. Administration of THC was associated with increases in anxiety, intoxication, and positive psychotic symptoms, whereas CBD had no significant symptomatic effects. THC decreased activation relative to placebo in bilateral temporal cortices during auditory processing, and increased and decreased activation in different visual areas during visual processing. CBD was associated with activation in right temporal cortex during auditory processing, and when contrasted, THC and CBD had opposite effects in the right posterior superior temporal gyrus, the right-sided homolog to Wernicke's area. Moreover, the attenuation of activation in this area (maximum 61, -15, -2) by THC during auditory processing was correlated with its acute effect on psychotic symptoms. Single doses of THC and CBD differently modulate brain function in areas that process auditory and visual stimuli and relate to induced psychotic symptoms.
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165
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González-Pinto A, Alberich S, Barbeito S, Gutierrez M, Vega P, Ibáñez B, Haidar MK, Vieta E, Arango C. Cannabis and first-episode psychosis: different long-term outcomes depending on continued or discontinued use. Schizophr Bull 2011; 37:631-9. [PMID: 19915168 PMCID: PMC3080669 DOI: 10.1093/schbul/sbp126] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the influence of cannabis use on long-term outcome in patients with a first psychotic episode, comparing patients who have never used cannabis with (a) those who used cannabis before the first episode but stopped using it during follow-up and (b) those who used cannabis both before the first episode and during follow-up. METHODS Patients were studied following their first admission for psychosis. They were interviewed at years 1, 3, and 5. At follow-up after 8 years, functional outcome and alcohol and drug abuse were recorded. Patients were classified according to cannabis use: 25 had cannabis use before their first psychotic episode and continuous use during follow-up (CU), 27 had cannabis use before their first episode but stopped its use during follow-up (CUS), and 40 never used cannabis (NU). RESULTS The 3 groups did not differ significantly in symptoms or functional outcome at baseline or during short-term follow-up. The CUS group exhibited better long-term functional outcome compared with the other 2 groups and had fewer negative symptoms than the CU group, after adjusting for potential confounders. For the CUS group, the effect size was 1.26 (95% confidence interval [CI]=0.65 to 1.86) for functional outcome and -0.72 (95% CI=-1.27 to -0.14) for negative symptoms. All patients experienced improvements in positive symptoms during long-term follow-up. CONCLUSION Cannabis has a deleterious effect, but stopping use after the first psychotic episode contributes to a clear improvement in outcome. The positive effects of stopping cannabis use can be seen more clearly in the long term.
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Affiliation(s)
- Ana González-Pinto
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Olaguibel 29, Vitoria, Spain.
| | - Susana Alberich
- Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Sara Barbeito
- Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Miguel Gutierrez
- Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Patricia Vega
- Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Berta Ibáñez
- Basque Foundation for Health Innovation and Research, Vizcaya, BIOEF, CIBERESP, Sondica (Vizcaya), Spain
| | - Mahmoud Karim Haidar
- Centro de Investigación Biomédica en Red de Salud Mental, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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166
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James A, Hough M, James S, Winmill L, Burge L, Nijhawan S, Matthews PM, Zarei M. Greater white and grey matter changes associated with early cannabis use in adolescent-onset schizophrenia (AOS). Schizophr Res 2011; 128:91-7. [PMID: 21388791 DOI: 10.1016/j.schres.2011.02.014] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 02/15/2011] [Accepted: 02/15/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cannabis use is associated with a higher risk of schizophrenia, however, its specific long-term effect on the structure of the brain of adolescent-onset schizophrenic patients remains unclear. AIMS To study cognitive and structural (grey and white matter) changes in patients with adolescent-onset schizophrenia (AOS) with early cannabis use (CAN+ve) (more than 3 times/week for at least 6 months) and without cannabis use (CAN-ve) versus controls. METHOD An optimised voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) MRI study of 32 adolescents with DSM IV schizophrenia-16 CAN+ve and 16 CAN-ve, and 28 healthy adolescents. RESULTS Compared to CAN-ve subjects, CAN+ve subjects showed GM density loss in temporal fusiform gyrus, parahippocampal gyrus, ventral striatum, right middle temporal gyrus, insular cortex, precuneus, right paracingulate gyrus, dorsolateral prefrontal cortex, left postcentral gyrus, lateral occipital cortex and cerebellum. Similar group comparison showed decreased fractional anisotropy (FA) in particular in brain stem, internal capsule, corona radiata, superior and inferior longitudinal fasciculus in CAN+ve patients. No cognitive differences were apparent between CAN+ve and CAN-ve subjects, and both were impaired relative to controls. CONCLUSION Cannabis use in early adolescence increases WM and GM deficits in AOS, but does not appear to increase the cognitive deficit associated with this illness.
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Affiliation(s)
- A James
- Highfield Adolescent Unit, Warneford Hospital, Oxford, United Kingdom.
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167
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Casadio P, Fernandes C, Murray RM, Di Forti M. Cannabis use in young people: the risk for schizophrenia. Neurosci Biobehav Rev 2011; 35:1779-87. [PMID: 21530584 DOI: 10.1016/j.neubiorev.2011.04.007] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 03/09/2011] [Accepted: 04/06/2011] [Indexed: 12/13/2022]
Abstract
Cannabis is one of the most commonly used illicit drugs, and despite the widely held belief that it is a safe drug, its long-term use has potentially harmful consequences. To date, the research on the impact of its use has largely been epidemiological in nature and has consistently found that cannabis use is associated with schizophrenia outcomes later in life, even after controlling for several confounding factors. While the majority of users can continue their use without adverse effects, it is clear from studies of psychosis that some individuals are more vulnerable to its effects than others. In addiction, evidence from both epidemiological and animal studies indicates that cannabis use during adolescence carries particular risk. Further studies are warranted given the increase in the concentration of the main active ingredient (Δ(9)-tetrahydrocannabinol) in street preparations of cannabis and a decreasing age of first-time exposure to cannabis.
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Affiliation(s)
- Paola Casadio
- Mental Health Department, AUSL Ravenna, Via Baliatico 3, Faenza (RA), Italy.
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168
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Ledgerwood CJ, Greenwood SM, Brett RR, Pratt JA, Bushell TJ. Cannabidiol inhibits synaptic transmission in rat hippocampal cultures and slices via multiple receptor pathways. Br J Pharmacol 2011; 162:286-94. [PMID: 20825410 PMCID: PMC3012422 DOI: 10.1111/j.1476-5381.2010.01015.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 08/12/2010] [Accepted: 08/19/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Cannabidiol (CBD) has emerged as an interesting compound with therapeutic potential in several CNS disorders. However, whether it can modulate synaptic activity in the CNS remains unclear. Here, we have investigated whether CBD modulates synaptic transmission in rat hippocampal cultures and acute slices. EXPERIMENTAL APPROACH The effect of CBD on synaptic transmission was examined in rat hippocampal cultures and acute slices using whole cell patch clamp and standard extracellular recordings respectively. KEY RESULTS Cannabidiol decreased synaptic activity in hippocampal cultures in a concentration-dependent and Pertussis toxin-sensitive manner. The effects of CBD in culture were significantly reduced in the presence of the cannabinoid receptor (CB(1) ) inverse agonist, LY320135 but were unaffected by the 5-HT(1A) receptor antagonist, WAY100135. In hippocampal slices, CBD inhibited basal synaptic transmission, an effect that was abolished by the proposed CB(1) receptor antagonist, AM251, in addition to LY320135 and WAY100135. CONCLUSIONS AND IMPLICATIONS Cannabidiol reduces synaptic transmission in hippocampal in vitro preparations and we propose a role for both 5-HT(1A) and CB(1) receptors in these CBD-mediated effects. These data offer some mechanistic insights into the effects of CBD and emphasize that further investigations into the actions of CBD in the CNS are required in order to elucidate the full therapeutic potential of CBD.
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Affiliation(s)
- C J Ledgerwood
- Strathclyde Institute of Pharmacy and Biological Sciences, University of Strathclyde, Glasgow, UK
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169
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Baharnoori M, Bartholomeusz C, Boucher AA, Buchy L, Chaddock C, Chiliza B, Föcking M, Fornito A, Gallego JA, Hori H, Huf G, Jabbar GA, Kang SH, El Kissi Y, Merchán-Naranjo J, Modinos G, Abdel-Fadeel NA, Neubeck AK, Ng HP, Novak G, Owolabi O, Prata DP, Rao NP, Riecansky I, Smith DC, Souza RP, Thienel R, Trotman HD, Uchida H, Woodberry KA, O'Shea A, DeLisi LE. The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy: summaries of oral sessions. Schizophr Res 2010; 124:e1-62. [PMID: 20934307 PMCID: PMC4182935 DOI: 10.1016/j.schres.2010.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 08/30/2010] [Accepted: 09/01/2010] [Indexed: 01/06/2023]
Abstract
The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.
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Affiliation(s)
- Moogeh Baharnoori
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, Quebec, Canada H4H 1R3, phone (514) 761-6131 ext 3346,
| | - Cali Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Level 2-3, Alan Gilbert Building, 161 Barry St, Carlton South, Victoria 3053, Australia, phone +61 3 8344 1878, fax +61 3 9348 0469,
| | - Aurelie A. Boucher
- Brain and Mind Research Institute, 100 Mallett Street, Camperdown NSW 2050, Australia, phone +61 (0)2 9351 0948, fax +61 (0)2 9351 0652,
| | - Lisa Buchy
- Douglas Hospital Research Centre, 6875 LaSalle Blvd, Verdun, Québec, Canada, H4H 1R3 phone: 514-761-6131 x 3386, fax: 514-888-4064,
| | - Christopher Chaddock
- PO67, Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, phone 020 7848 0919, mobile 07734 867854 fax 020 7848 0976,
| | - Bonga Chiliza
- Department of Psychiatry, University of Stellenbosch, Tygerberg, 7505, South Africa, phone: +27 (0)21 9389227, fax +27 (0)21 9389738,
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland, phone +353 1 809 3857, fax +353 1 809 3741,
| | - Alex Fornito
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Downing Site, Downing St, Cambridge, UK, CB2 3EB, phone +44 (0) 1223 764670, fax +44 (0) 1223 336581,
| | - Juan A. Gallego
- The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd St, Glen Oaks, NY 11004, phone 718-470-8177, fax 718-343-1659,
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, NCNP, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, JAPAN, phone: +81 42 341 2711; fax: +81 42 346 1744,
| | - Gisele Huf
- National Institute of Quality Control in Health - Oswaldo Cruz Foundation.Av. Brasil 4365 Manguinhos Rio de Janeiro RJ BRAZIL 21045-900, phone + 55 21 38655112, fax + 55 21 38655139,
| | - Gul A. Jabbar
- Clinical Research Coordinator, Harvard Medical School Department of Psychiatry, 940 Belmont Street 2-B, Brockton, MA 02301, office (774) 826-1624, cell (845) 981-9514, fax (774) 286-1076,
| | - Shi Hyun Kang
- Seoul National Hospital, 30-1 Junggok3-dong Gwangjin-gu, Seoul, 143-711, Korea, phone +82-2-2204-0326, fax +82-2-2204-0394,
| | - Yousri El Kissi
- Psychiatry department, Farhat Hached Hospital. Ibn Jazzar Street, 4002 Sousse. Tunisia. phone + 216 98468626, fax + 216 73226702,
| | - Jessica Merchán-Naranjo
- Adolescent Unit. Department of Psychiatry. Hospital General Universitario Gregorio Marañón. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. C/Ibiza 43, C.P:28009, phone +34 914265005, fax +34 914265004,
| | - Gemma Modinos
- Department of Psychosis Studies (PO67), Institute of Psychiatry, King's College London, King's Health Partners, De Crespigny Park, SE5 8AF London, United Kingdo, phone +44 (0)20 78480917, fax +44 (0)20 78480976,
| | - Nashaat A.M. Abdel-Fadeel
- Minia University, Egypt, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, phone 617 953 0414, fax 617-998-5007, ,
| | - Anna-Karin Neubeck
- Project Manager at Karolinska Institute, Skinnarviksringen 12, 117 27 Stockholm, Sweden, phone +46708777908,
| | - Hsiao Piau Ng
- Singapore Bioimaging Consortium, A*STAR, Singapore; Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, phone 857-544-0192, fax 617-525-6150,
| | - Gabriela Novak
- University of Toronto, Medical Sciences Building, Room 4345, 1 King's College Circle, Toronto, Ontario, M5S 1A8, phone (416) 946-8219, fax (416) 971-2868,
| | - Olasunmbo.O. Owolabi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Science University of Ilorin, Ilorin, Nigeria, phone +2348030764811,
| | - Diana P. Prata
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK, phone +44(0)2078480917, fax +44(0)2078480976,
| | - Naren P. Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029 Karnataka, India, phone +91 9448342379,
| | - Igor Riecansky
- Address: Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Sienkiewiczova 1, 813 71 Bratislava, Slovakia, phone +421-2-52 92 62 76, fax +421-2-52 96 85 16,
| | - Darryl C. Smith
- 3336 Mt Pleasant St. NW #2, Washington, DC 20010, phone 202.494.3892,
| | - Renan P. Souza
- Centre for Addiction and Mental Health 250 College St R31 Toronto - Ontario - Canada M5T1R8, phone +14165358501 x4883, fax +14169794666,
| | - Renate Thienel
- Postdoctoral Research Fellow, PRC Brain and Mental Health, University of Newcastle, Mc Auley Centre Level 5, Mater Hospital, Edith Street, Waratah NSW 2298, phone +61 (2) 40335636,
| | - Hanan D. Trotman
- 36 Eagle Row, Atlanta, GA 30322, phone 404-727-8384, fax 404-727-1284,
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Psychopharmacology Research Program, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, phone +81.3.3353.1211(x62454), fax +81.3.5379.0187,
| | - Kristen A. Woodberry
- Landmark Center 2 East, 401 Park Drive, Boston, MA 02215, phone 617-998-5022, fax 617-998-5007,
| | - Anne O'Shea
- Coordinator of reports. Harvard Medical School, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1374, anne_o’
| | - Lynn E. DeLisi
- VA Boston Healthcare System and Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1355, fax 774-826-2721
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170
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Abstract
There is now compelling evidence that cannabis consumption might precipitate psychosis onset. The objective of the present study was to assess the role of individual sensitivity to the psychotogenic effect of cannabis in male patients with schizophrenia. The lifetime diagnosis, disease and substance-use history were determined using a standardized interview in 190 patients with schizophrenia. Of patients with lifetime cannabis use (n=121), 44 were characterized as Cannabis-sensitive (CS) patients if the onset of psychotic symptoms occurred within 1 month following the initiation of cannabis consumption, or following a marked rise of cannabis consumption, or marked aggravation of psychotic symptoms each time the subject used cannabis. Age at onset of psychosis was not different in patients with lifetime cannabis use compared to non-users. By contrast, the first psychotic episode occurred 2.6 yr earlier in CS compared to Non-cannabis-sensitive (NCS) patients (p=0.006). Moreover, a specific excess of family history of psychotic disorder was found in CS patients, but not of any other psychiatric disorder, as well as an earlier age at exposure to cannabis (16.7+/-2.5 yr, p=0.03). Sensitivity to psychotogenic effects of cannabis in schizophrenia patients could be related to both genetic vulnerability to schizophrenia and the influence of cannabis on brain maturation and could modulate the influence of cannabis on the onset of schizophrenia.
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171
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Affiliation(s)
- Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia.
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172
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Walter M, Wiesbeck GA, Riecher-Rössler A, Borgwardt SJ. Neural effects of heroin--relation to anxiety stress. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:816-7. [PMID: 20114068 DOI: 10.1016/j.pnpbp.2010.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 01/22/2010] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
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173
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Borsook D, Upadhyay J, Chudler EH, Becerra L. A key role of the basal ganglia in pain and analgesia--insights gained through human functional imaging. Mol Pain 2010; 6:27. [PMID: 20465845 PMCID: PMC2883978 DOI: 10.1186/1744-8069-6-27] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 05/13/2010] [Indexed: 01/18/2023] Open
Abstract
The basal ganglia (BG) are composed of several nuclei involved in neural processing related to the execution of motor, cognitive and emotional activities. Preclinical and clinical data have implicated a role for these structures in pain processing. Recently neuroimaging has added important information on BG activation in conditions of acute pain, chronic pain and as a result of drug effects. Our current understanding of alterations in cortical and sub-cortical regions in pain suggests that the BG are uniquely involved in thalamo-cortico-BG loops to integrate many aspects of pain. These include the integration of motor, emotional, autonomic and cognitive responses to pain.
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Affiliation(s)
- David Borsook
- PAIN Group, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
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174
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Abstract
OBJETIVO: Evidências de que o uso de cannabis prejudica funções cognitivas em humanos têm-se acumulado nas décadas recentes. O propósito desta revisão é o de atualizar o conhecimento nesta área com novos achados a partir da literatura mais recente. MÉTODO: As buscas na literatura foram realizadas utilizando-se o banco de dados Web of Science até fevereiro de 2010. Foram buscados os termos "cannabi*" ou "marijuana" e "cogniti*" ou "memory" ou "attention" ou "executive function", e os estudos em humanos foram revisados preferencialmente em relação aos estudos em animais. DISCUSSÃO: O uso de cannabis prejudica a memória, a atenção, o controle inibitório, as funções executivas e a tomada de decisões, tanto durante como após o período de intoxicação aguda, persistindo por horas, dias, semanas ou mais após o último uso. Os estudos de desafio farmacológico em humanos estão elucidando a natureza e os substratos neurais das alterações cognitivas associadas a vários canabinoides. O uso pesado ou de longo prazo de cannabis parece resultar em anormalidades cognitivas mais duradouras e possivelmente em alterações cerebrais estruturais. Efeitos cognitivos adversos maiores estão associados ao uso de cannabis quando este começa no início da adolescência. CONCLUSÃO: O sistema canabinoide endógeno está envolvido nos mecanismos de regulação neural que modulam os processos subjacentes a uma gama de funções cognitivas que estão prejudicadas pela cannabis. Os déficits em usuários humanos muito provavelmente refletem, portanto, neuroadaptações e o funcionamento alterado do sistema canabinoide endógeno.
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Affiliation(s)
- Nadia Solowij
- University of Wollongong, Austrália; Schizophrenia Research Institute, Austrália
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175
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Smieskova R, Fusar-Poli P, Allen P, Bendfeldt K, Stieglitz RD, Drewe J, Radue EW, McGuire PK, Riecher-Rössler A, Borgwardt SJ. Neuroimaging predictors of transition to psychosis--a systematic review and meta-analysis. Neurosci Biobehav Rev 2010; 34:1207-22. [PMID: 20144653 DOI: 10.1016/j.neubiorev.2010.01.016] [Citation(s) in RCA: 242] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 01/29/2010] [Accepted: 01/31/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In early stage psychosis research the identification of neurobiological correlates of vulnerability to schizophrenia is an important hurdle. METHODS We systematically reviewed the neuroimaging publications on high-risk subjects with subsequent transition to psychosis (HR-T) and conducted a meta-analysis calculating the effect size Cohen's d. RESULTS Out of 30 identified studies 25 met the inclusion criteria. Structural (s)MRI studies showed small to medium effect sizes of decreased prefrontal, cingulate, insular and cerebellar gray matter volume in HR-T compared to high-risk subjects without transition (HR-NT). Meta-analysis revealed relatively larger whole brain volumes in HR-T compared to HR-NT subjects (mean Cohen's d 0.36, 95% CI 0.27-0. 46). Compared to HR-NT, HR-T subjects showed in functional imaging studies reduced brain activation in prefrontal cortex, reduced neuronal density, and increased membrane turnover in frontal and cingulate cortex with medium to large effect sizes. CONCLUSIONS Despite methodological differences between studies, structural and neurochemical abnormalities in prefrontal, anterior cingulate, medial temporal and cerebellar cortex might be predictive for development of psychosis within HR subjects.
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Affiliation(s)
- R Smieskova
- Psychiatric Outpatient Department, Psychiatric University Clinics, Basel, Switzerland
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176
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Bhattacharyya S, Morrison PD, Fusar-Poli P, Martin-Santos R, Borgwardt S, Winton-Brown T, Nosarti C, O' Carroll CM, Seal M, Allen P, Mehta MA, Stone JM, Tunstall N, Giampietro V, Kapur S, Murray RM, Zuardi AW, Crippa JA, Atakan Z, McGuire PK. Opposite effects of delta-9-tetrahydrocannabinol and cannabidiol on human brain function and psychopathology. Neuropsychopharmacology 2010; 35:764-74. [PMID: 19924114 PMCID: PMC3055598 DOI: 10.1038/npp.2009.184] [Citation(s) in RCA: 469] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Delta-9-tetrahydrocannabinol (Delta-9-THC) and Cannabidiol (CBD), the two main ingredients of the Cannabis sativa plant have distinct symptomatic and behavioral effects. We used functional magnetic resonance imaging (fMRI) in healthy volunteers to examine whether Delta-9-THC and CBD had opposite effects on regional brain function. We then assessed whether pretreatment with CBD can prevent the acute psychotic symptoms induced by Delta-9-THC. Fifteen healthy men with minimal earlier exposure to cannabis were scanned while performing a verbal memory task, a response inhibition task, a sensory processing task, and when viewing fearful faces. Subjects were scanned on three occasions, each preceded by oral administration of Delta-9-THC, CBD, or placebo. BOLD responses were measured using fMRI. In a second experiment, six healthy volunteers were administered Delta-9-THC intravenously on two occasions, after placebo or CBD pretreatment to examine whether CBD could block the psychotic symptoms induced by Delta-9-THC. Delta-9-THC and CBD had opposite effects on activation relative to placebo in the striatum during verbal recall, in the hippocampus during the response inhibition task, in the amygdala when subjects viewed fearful faces, in the superior temporal cortex when subjects listened to speech, and in the occipital cortex during visual processing. In the second experiment, pretreatment with CBD prevented the acute induction of psychotic symptoms by Delta-9-tetrahydrocannabinol. Delta-9-THC and CBD can have opposite effects on regional brain function, which may underlie their different symptomatic and behavioral effects, and CBD's ability to block the psychotogenic effects of Delta-9-THC.
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Affiliation(s)
- Sagnik Bhattacharyya
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK.
| | - Paul D Morrison
- Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Paolo Fusar-Poli
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK,Section of Psychiatry, Department of Health Sciences, University of Pavia, Pavia, Italy
| | - Rocio Martin-Santos
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK,Department of Psychiatry, Institut of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - Stefan Borgwardt
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK,Psychiatric Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Toby Winton-Brown
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Chiara Nosarti
- Cognition Schizophrenia and Imaging (CSI) Laboratory, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | | | - Marc Seal
- Melbourne Neuropsychiatry Centre, The University of Melbourne, National Neuroscience Facility, Carlton South, VIC, Australia
| | - Paul Allen
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Mitul A Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, KCL, London, UK
| | - James M Stone
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Nigel Tunstall
- Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Vincent Giampietro
- Department of Biostatistics, Institute of Psychiatry, King's College London, London, UK
| | - Shitij Kapur
- Section on Schizophrenia, Imaging and Therapeutics, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Robin M Murray
- Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Antonio W Zuardi
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil,INCT Translational Medicine, Ribeirão Preto, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil,INCT Translational Medicine, Ribeirão Preto, Brazil
| | - Zerrin Atakan
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Philip K McGuire
- Section of Neuroimaging, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, London, UK
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177
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Jones NA, Hill AJ, Smith I, Bevan SA, Williams CM, Whalley BJ, Stephens GJ. Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo. J Pharmacol Exp Ther 2009; 332:569-77. [PMID: 19906779 DOI: 10.1124/jpet.109.159145] [Citation(s) in RCA: 230] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Plant-derived cannabinoids (phytocannabinoids) are compounds with emerging therapeutic potential. Early studies suggested that cannabidiol (CBD) has anticonvulsant properties in animal models and reduced seizure frequency in limited human trials. Here, we examine the antiepileptiform and antiseizure potential of CBD using in vitro electrophysiology and an in vivo animal seizure model, respectively. CBD (0.01-100 muM) effects were assessed in vitro using the Mg(2+)-free and 4-aminopyridine (4-AP) models of epileptiform activity in hippocampal brain slices via multielectrode array recordings. In the Mg(2+)-free model, CBD decreased epileptiform local field potential (LFP) burst amplitude [in CA1 and dentate gyrus (DG) regions] and burst duration (in all regions) and increased burst frequency (in all regions). In the 4-AP model, CBD decreased LFP burst amplitude (in CA1 only at 100 muM CBD), burst duration (in CA3 and DG), and burst frequency (in all regions). CBD (1, 10, and 100 mg/kg) effects were also examined in vivo using the pentylenetetrazole model of generalized seizures. CBD (100 mg/kg) exerted clear anticonvulsant effects with significant decreases in incidence of severe seizures and mortality compared with vehicle-treated animals. Finally, CBD acted with only low affinity at cannabinoid CB(1) receptors and displayed no agonist activity in [(35)S]guanosine 5'-O-(3-thio)triphosphate assays in cortical membranes. These findings suggest that CBD acts, potentially in a CB(1) receptor-independent manner, to inhibit epileptiform activity in vitro and seizure severity in vivo. Thus, we demonstrate the potential of CBD as a novel antiepileptic drug in the unmet clinical need associated with generalized seizures.
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Affiliation(s)
- Nicholas A Jones
- School of Pharmacy, University of Reading, Whiteknights, Reading RG6 6AJ, UK
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178
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Degenhardt L, Hall WD, Lynskey M, McGrath J, McLaren J, Calabria B, Whiteford H, Vos T. Should burden of disease estimates include cannabis use as a risk factor for psychosis? PLoS Med 2009; 6:e1000133. [PMID: 19787023 PMCID: PMC2741573 DOI: 10.1371/journal.pmed.1000133] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Louise Degenhardt and colleagues discuss the evidence and the debate about whether Global Burden of Disease estimates should include cannabis use as a risk factor for psychosis.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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179
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Abstract
The earliest stages of delusion are characterized by an overabundance of meaningful coincidences impinging on the sufferer's existing worldview. Successive events are seen by him as pointing to, and then confirming, a fundamentally new reality that takes him over and engulfs his everyday life. Research over the last 4 decades has revealed the importance of dopamine (DA), D2 receptors, and the basal ganglia in psychotic thinking. Recent work has implicated the aberrant reward learning initiated by the excess release of striatal DA in the attribution of excessive importance or "salience" to insignificant stimuli and events. But our knowledge of what is happening beyond D2 receptors has remained scant. The gap is especially apparent at the cellular and microcircuit levels, encompassing the plastic changes, which are believed to be essential for new learning, and whose processes may go awry in major mental illness. Now new pharmacological findings are advancing our understanding of information processing and learning within the striatum. DA has an important role in setting the strength of individual striatal connections, but it does not act in isolation. Two other modulator systems are critical, the endocannabinoids and adenosine. Thus, at medium spiny neurons belonging to the indirect pathway, D2 stimulation evokes endocannabinoid-mediated depression of cortical inputs. Adenosine acting at A2A receptors elicits the opposite effect. Remarkably, drugs that target the endocannabinoid and purinergic systems also have pro- or antipsychotic properties. Here, we discuss how the 3 modulators regulate learning within the striatum and how their dysfunction may lead to delusional thinking.
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Affiliation(s)
- Paul D Morrison
- Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
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