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Lorenzetti V, McTavish E, Broyd S, van Hell H, Thomson D, Ganella E, Kottaram AR, Beale C, Martin J, Galettis P, Solowij N, Greenwood LM. Daily Cannabidiol Administration for 10 Weeks Modulates Hippocampal and Amygdalar Resting-State Functional Connectivity in Cannabis Users: A Functional Magnetic Resonance Imaging Open-Label Clinical Trial. Cannabis Cannabinoid Res 2024; 9:e1108-e1121. [PMID: 37603080 DOI: 10.1089/can.2022.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Introduction: Cannabis use is associated with brain functional changes in regions implicated in prominent neuroscientific theories of addiction. Emerging evidence suggests that cannabidiol (CBD) is neuroprotective and may reverse structural brain changes associated with prolonged heavy cannabis use. In this study, we examine how an ∼10-week exposure of CBD in cannabis users affected resting-state functional connectivity in brain regions functionally altered by cannabis use. Materials and Methods: Eighteen people who use cannabis took part in a ∼10 weeks open-label pragmatic trial of self-administered daily 200 mg CBD in capsules. They were not required to change their cannabis exposure patterns. Participants were assessed at baseline and post-CBD exposure with structural magnetic resonance imaging (MRI) and a functional MRI resting-state task (eyes closed). Seed-based connectivity analyses were run to examine changes in the functional connectivity of a priori regions-the hippocampus and the amygdala. We explored if connectivity changes were associated with cannabinoid exposure (i.e., cumulative cannabis dosage over trial, and plasma CBD concentrations and Δ9-tetrahydrocannabinol (THC) plasma metabolites postexposure), and mental health (i.e., severity of anxiety, depression, and positive psychotic symptom scores), accounting for cigarette exposure in the past month, alcohol standard drinks in the past month and cumulative CBD dose during the trial. Results: Functional connectivity significantly decreased pre-to-post the CBD trial between the anterior hippocampus and precentral gyrus, with a strong effect size (d=1.73). Functional connectivity increased between the amygdala and the lingual gyrus pre-to-post the CBD trial, with a strong effect size (d=1.19). There were no correlations with cannabinoids or mental health symptom scores. Discussion: Prolonged CBD exposure may restore/reduce functional connectivity differences reported in cannabis users. These new findings warrant replication in a larger sample, using robust methodologies-double-blind and placebo-controlled-and in the most vulnerable people who use cannabis, including those with more severe forms of Cannabis Use Disorder and experiencing worse mental health outcomes (e.g., psychosis, depression).
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Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Samantha Broyd
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Hendrika van Hell
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Diny Thomson
- Turner Institute for Brain and Mental Health, School of Psychological Science, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Eleni Ganella
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Carlton South, Victoria, Australia
- Orygen, the National Center of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Akhil Raja Kottaram
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Carlton South, Victoria, Australia
| | - Camilla Beale
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jennifer Martin
- John Hunter Hospital, Newcastle, New South Wales, Australia
- Center for Drug Repurposing and Medicines Research, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Peter Galettis
- Center for Drug Repurposing and Medicines Research, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Lisa-Marie Greenwood
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
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Audi D, Hajeer S, Saab MB, Saab L, Harati H, Desoutter A, Al Ahmar E, Estephan E. Effects of Cannabis Use on Neurocognition: A Scoping Review of MRI Studies. J Psychoactive Drugs 2024:1-17. [PMID: 38944688 DOI: 10.1080/02791072.2024.2372377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/06/2024] [Indexed: 07/01/2024]
Abstract
Cannabis is one of the most commonly utilized recreational drugs. However, increasing evidence from the literature suggests harmful implications on cognition. Thus, the main aim of the current review is to summarize literature findings pertaining to the impact of cannabis on neurocognitive skills, focusing on the imaging biomarkers provided by MRI. Two reviewers navigated the literature independently using four main search engines including PubMed and Cochrane. Articles were first evaluated through their title and abstract, followed by full-text assessment. Study characteristics and findings were extracted, and the studies' quality was appraised. 47 articles were included. The majority of the studies were of a case-control design (66%), and the most studied neurocognitive skill was memory (40.4%). With task-based fMRI being the most commonly utilized MRI technique, findings have shown significantly varying decreased and increased neuronal activity within brain regions associated with the cognitive tasks performed. Results suggest that cannabis users are significantly suffering from cognitive deficits. The major significance of this review is attributed to highlighting the role of MRI. Future research needs to delve more into validating the negative effects of cannabis, to enable stakeholders to take action to limit cannabis usage, to foster public health and wellbeing.
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Affiliation(s)
- Dima Audi
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Shorouk Hajeer
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Marie-Belle Saab
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Pedagogy, Lebanese University, Furn-El-Chebbak, Lebanon
| | - Lea Saab
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Hayat Harati
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Muscat University, Muscat, Sultanate of Oman
| | | | - Elie Al Ahmar
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- School of Engineering, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Elias Estephan
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- LBN, University Montpellier, Montpellier, France
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DeGregorio MW, Kao CJ, Wurz GT. Complexity of Translating Analytics to Recent Cannabis Use and Impairment. J AOAC Int 2024; 107:493-505. [PMID: 38410076 DOI: 10.1093/jaoacint/qsae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
While current analytical methodologies can readily identify cannabis use, definitively establishing recent use within the impairment window has proven to be far more complex, requiring a new approach. Recent studies have shown no direct relationship between impairment and Δ9-tetra-hydrocannabinol (Δ9-THC) concentrations in blood or saliva, making legal "per se" Δ9-THC limits scientifically unjustified. Current methods that focus on Δ9-THC and/or metabolite concentrations in blood, saliva, urine, or exhaled breath can lead to false-positive results for recent use due to the persistence of Δ9-THC well outside of the typical 3-4 h window of potential impairment following cannabis inhalation. There is also the issue of impairment due to other intoxicating substances-just because a subject exhibits signs of impairment and cannabis use is detected does not rule out the involvement of other drugs. Compounding the matter is the increasing popularity of hemp-derived cannabidiol (CBD) products following passage of the 2018 Farm Bill, which legalized industrial hemp in the United States. Many of these products contain varying levels of Δ9-THC, which can lead to false-positive tests for cannabis use. Furthermore, hemp-derived CBD is used to synthesize Δ8-THC, which possesses psychoactive properties similar to Δ9-THC and is surrounded by legal controversy. For accuracy, analytical methods must be able to distinguish the various THC isomers, which have identical masses and exhibit immunological cross-reactivity. A new testing approach has been developed based on exhaled breath and blood sampling that incorporates kinetic changes and the presence of key cannabinoids to detect recent cannabis use within the impairment window without the false-positive results seen with other methods. The complexity of determining recent cannabis use that may lead to impairment demands such a comprehensive method so that irresponsible users can be accurately detected without falsely accusing responsible users who may unjustly suffer harsh, life-changing consequences.
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Affiliation(s)
- Michael W DeGregorio
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
- Professor Emeritus, University of California, Davis, One Shields Avenue, Davis, CA 95616, United States
| | - Chiao-Jung Kao
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
| | - Gregory T Wurz
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
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Oscoz-Irurozqui M, Almodóvar-Payá C, Guardiola-Ripoll M, Guerrero-Pedraza A, Hostalet N, Salvador R, Carrión MI, Maristany T, Pomarol-Clotet E, Fatjó-Vilas M. Cannabis Use and Endocannabinoid Receptor Genes: A Pilot Study on Their Interaction on Brain Activity in First-Episode Psychosis. Int J Mol Sci 2023; 24:ijms24087501. [PMID: 37108689 PMCID: PMC10142622 DOI: 10.3390/ijms24087501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
The role of both cannabis use and genetic background has been shown in the risk for psychosis. However, the effect of the interplay between cannabis and variability at the endocannabinoid receptor genes on the neurobiological underpinnings of psychosis remains inconclusive. Through a case-only design, including patients with a first-episode of psychosis (n = 40) classified as cannabis users (50%) and non-users (50%), we aimed to evaluate the interaction between cannabis use and common genetic variants at the endocannabinoid receptor genes on brain activity. Genetic variability was assessed by genotyping two Single Nucleotide Polymorphisms (SNP) at the cannabinoid receptor type 1 gene (CNR1; rs1049353) and cannabinoid receptor type 2 gene (CNR2; rs2501431). Functional Magnetic Resonance Imaging (fMRI) data were obtained while performing the n-back task. Gene × cannabis interaction models evidenced a combined effect of CNR1 and CNR2 genotypes and cannabis use on brain activity in different brain areas, such as the caudate nucleus, the cingulate cortex and the orbitofrontal cortex. These findings suggest a joint role of cannabis use and cannabinoid receptor genetic background on brain function in first-episode psychosis, possibly through the impact on brain areas relevant to the reward circuit.
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Affiliation(s)
- Maitane Oscoz-Irurozqui
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Salud Mental Errenteria-Osakidetza, Av Galtzaraborda 69-75, 20100 Errenteria, Guipúzcoa, Spain
| | - Carmen Almodóvar-Payá
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Maria Guardiola-Ripoll
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Amalia Guerrero-Pedraza
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Hospital Benito Menni CASM, C/Doctor Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain
| | - Noemí Hostalet
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | | | - Teresa Maristany
- Diagnostic Imaging Department, Hospital Sant Joan de Déu Research Foundation, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Mar Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Avinguda Diagonal, 643, 08028 Barcelona, Spain
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Springer SD, Spooner RK, Schantell M, Arif Y, Frenzel MR, Eastman JA, Wilson TW. Regular recreational Cannabis users exhibit altered neural oscillatory dynamics during attention reorientation. Psychol Med 2023; 53:1205-1214. [PMID: 34889178 PMCID: PMC9250753 DOI: 10.1017/s0033291721002671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cannabis is the most widely used illicit drug in the United States and is often associated with changes in attention function, which may ultimately impact numerous other cognitive faculties (e.g. memory, executive function). Importantly, despite the increasing rates of cannabis use and widespread legalization in the United States, the neural mechanisms underlying attentional dysfunction in chronic users are poorly understood. METHODS We used magnetoencephalography (MEG) and a modified Posner cueing task in 21 regular cannabis users and 32 demographically matched non-user controls. MEG data were imaged in the time-frequency domain using a beamformer and peak voxel time series were extracted to quantify the oscillatory dynamics underlying use-related aberrations in attentional reorienting, as well as the impact on spontaneous neural activity immediately preceding stimulus onset. RESULTS Behavioral performance on the task (e.g. reaction time) was similar between regular cannabis users and non-user controls. However, the neural data indicated robust theta-band synchronizations across a distributed network during attentional reorienting, with activity in the bilateral inferior frontal gyri being markedly stronger in users relative to controls (p's < 0.036). Additionally, we observed significantly reduced spontaneous theta activity across this distributed network during the pre-stimulus baseline in cannabis users relative to controls (p's < 0.020). CONCLUSIONS Despite similar performance on the task, we observed specific alterations in the neural dynamics serving attentional reorienting in regular cannabis users compared to controls. These data suggest that regular cannabis users may employ compensatory processing in the prefrontal cortices to efficiently reorient their attention relative to non-user controls.
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Affiliation(s)
- Seth D. Springer
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rachel K. Spooner
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michaela R. Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jacob A. Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Kayir H, Ruffolo J, McCunn P, Khokhar JY. The Relationship Between Cannabis, Cognition, and Schizophrenia: It's Complicated. Curr Top Behav Neurosci 2023; 63:437-461. [PMID: 36318403 DOI: 10.1007/7854_2022_396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The consequences of cannabis use, especially in the context of schizophrenia, have gained increased importance with the legalization of cannabis in North America and across the globe. Cannabis use has multifaceted impacts on cognition in schizophrenia patients and healthy subjects. Healthy subjects, particularly those who initiated cannabis use at earlier ages and used high-potency cannabis for longer durations, exhibited poorer cognition mainly in working memory and attention. Cannabis use in schizophrenia has been associated with symptom exacerbation, longer and more frequent psychotic episodes, and poorer treatment outcomes. However, cannabis-using patients have better overall cognitive performance compared to patients who were not cannabis users. Interestingly, these effects were only apparent in lifetime cannabis users, but not in current (or within last 6 months) users. Moreover, higher frequency and earlier age of cannabis use initiation (i.e., before 17 years of age) were associated with better cognitive performance, although they had an earlier illness onset. Three possible hypotheses seem to come forward to explain this paradox. First, some components of cannabis may have antipsychotic or cognitive-enhancing properties. Secondly, chronic cannabis use may alter endocannabinoid signaling in the brain which could be a protective factor for developing psychosis or cognitive impairments. A third explanation could be their representation of a phenotypically distinct patient group with more intact cognitive functioning and less neurodevelopmental pathology. Multiple factors need to be considered to understand the complex relationship between cannabis, cognitive function, and schizophrenia. In short, age at initiation, duration and rate of cannabis use, abstinence duration, co-use of substances and alcohol, prescribed medications, relative cannabinoid composition and potency of cannabis, presence of genetic and environmental vulnerability factors are prominent contributors to the variability in outcomes. Animal studies support the disruptive effects of Δ9-tetrahydrocannabinol (THC) administration during adolescence on attention and memory performance. They provide insights about interaction of cannabinoid receptors with other neurotransmitter systems, such as GABA and glutamate, and other regulatory molecules, such as PSD95 and synaptophysin. Cannabidiol (CBD), on the other hand, can improve cognitive deficits seen in neurodevelopmental and chemically-induced animal models of schizophrenia. Future studies focusing on bridging the translational gaps between human and animal studies, through the use of translationally relevant methods of exposure (e.g., vaping), consistent behavioral assessments, and congruent circuit interrogations (e.g., imaging) will help to further clarify this complex picture.
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Affiliation(s)
- Hakan Kayir
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jessica Ruffolo
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Patrick McCunn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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7
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Dykukha I, Essner U, Schreiber H, Raithel LM, Penner IK. Effects of Sativex Ⓡ on cognitive function in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2022; 68:104173. [PMID: 36174323 DOI: 10.1016/j.msard.2022.104173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive impairment is a common manifestation of multiple sclerosis (MS). OBJECTIVE To assess by systematic review and meta-analysis available evidence regarding the impact of nabiximols oromucosal spray on cognition in patients with MS. METHODS A systematic literature search of clinical studies (all types, any comparator) that measured cognitive function in patients with MS spasticity treated with nabiximols. Meta-analysis for cognitive endpoints was not possible due to heterogenous measurement instruments and outcomes. Meta-analysis was performed for adverse events (AEs) of special interest (cognition disorders) reported in randomized controlled trials (RCTs) of nabiximols versus placebo in patients with MS (with or without spasticity). Certainty of evidence and risk of bias were assessed. RESULTS Seven clinical studies (three RCTs) directly assessing cognitive function were included in the qualitative analysis. There was no consistent evidence to suggest that nabiximols causes cognitive impairment as assessed by a range of specific psychometric instruments across cognitive domains. Thirteen double-blind, placebo-controlled RCTs (nabiximols, n = 964; placebo, n = 904) were included in the meta-analysis of cognitive AEs. Most cognitive AEs (30 of 32 events, 93.8%) reported with nabiximols in MS patients occurred with not in-label use, i.e., dosage >12 sprays per day and/or not administered primarily for treatment of spasticity. CONCLUSIONS Within the limitations of the review, we can conclude that no detrimental effects of nabiximols on cognitive function were observed in patients with MS spasticity during up to 12 months follow-up and that cognitive AEs were rare and occurred only when nabiximols was not used according to its approved label.
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Affiliation(s)
- Igor Dykukha
- Medical Affairs, Almirall Hermal GmbH, Reinbek, Germany
| | - Ute Essner
- O. Meany Consultancy GmbH, Hamburg, Germany
| | - Herbert Schreiber
- Neurological Practice Center, Neuropoint Academy, NTD & Neurosys, Ulm, Germany
| | - Lina Marie Raithel
- COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany
| | - Iris-Katharina Penner
- Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
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8
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Stypulkowski K, Thayer RE. Long-Term Recreational Cannabis Use Is Associated With Lower Executive Function and Processing Speed in a Pilot Sample of Older Adults. J Geriatr Psychiatry Neurol 2022; 35:740-746. [PMID: 34583547 PMCID: PMC8958184 DOI: 10.1177/08919887211049130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
More older adults are using cannabis for recreational and/or medical purposes, but most studies examining cognitive function and cannabis use do not include older adults. The current small pilot study sought to compare cognitive function and emotional functioning among adults age 60 and older who were regular, primarily recreational cannabis users (n = 28) and nonusers (n = 10). A bimodal distribution was observed among cannabis users such that they had either initiated regular use more recently ("short-term" users; ≤7 years, n = 13) or earlier in life ("long-term" users; ≥19 years, n = 15). Nonusers, short-term, and long-term users were not different in depression, anxiety, or emotion regulation, or alcohol use. Nonusers scored significantly higher than long-term users in executive function. Short-term users scored significantly higher than long-term users in executive function, processing speed, and general cognition. Additionally, greater recent cannabis use frequency was negatively associated with working memory. The current findings suggest that short-term recreational cannabis use does not result in differences in cognitive performance compared to nonusers, which may indicate that short-term use is relatively benign in older adults. However, longer duration of use is associated with poorer processing speed and executive functioning, and more recent cannabis use is associated with poorer working memory, which may impact older adults' overall cognitive functioning.
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Affiliation(s)
| | - Rachel E. Thayer
- Psychology Department, University of Colorado Colorado Springs, CO, USA
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9
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Sorkhou M, Rabin RA, Rabin JS, Kloiber S, McIntyre RS, George TP. Effects of 28 days of cannabis abstinence on cognition in major depressive disorder: A pilot study. Am J Addict 2022; 31:454-462. [PMID: 35690891 DOI: 10.1111/ajad.13305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cannabis is a widely used substance that may impair select cognitive domains, including attention and memory. Problematic cannabis use is a common clinical problem among patients with major depressive disorder (MDD). Few studies have investigated the effects of cannabis abstinence on cognition in MDD. Thus, our study aimed to determine whether a 28-day period of cannabis abstinence is associated with improvements in cognition in patients with MDD and comorbid cannabis use disorder (CUD). METHODS We evaluated the effects of 28 days of cannabis abstinence on cognition in MDD patients with comorbid CUD facilitated by contingency management, motivational interviewing, psychoeducation, and coping-skills training (N = 11). Primary outcomes included Baseline to Day 28 changes in verbal memory and learning, while secondary outcomes included Baseline to Day 28 changes in working memory, visuospatial working memory (VSWM), visual search speed, mental flexibility, response inhibition, attention, manual dexterity, and fine motor movement. RESULTS Eight participants (72.7%) met the pre-specified criteria for cannabis abstinence and three participants significantly reduced their cannabis use (≥90%). Visual search speed, selective attention, and VSWM improved over the study period. These improvements were not associated with changes in cannabis metabolite levels from baseline to endpoint. DISCUSSION AND CONCLUSIONS Our findings suggest that 28 days of cannabis abstinence may improve select cognitive domains in patients with MDD and comorbid CUD. SCIENTIFIC SIGNIFICANCE This is the first study to longitudinally examine the effects of cannabis on cognition in MDD. CLINICAL TRIAL Effects of Cannabis Abstinence on Symptoms and Cognition in Depression (NCT03624933; https://www. CLINICALTRIALS gov).
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Affiliation(s)
- Maryam Sorkhou
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Rachel A Rabin
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Stefan Kloiber
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Adult Psychiatry and Health Systems Division, CAMH, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Mood Disorders Psychopharmacology Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Tony P George
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Addictions Divisions, Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
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10
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Wurz GT, DeGregorio MW. Indeterminacy of cannabis impairment and ∆ 9-tetrahydrocannabinol (∆ 9-THC) levels in blood and breath. Sci Rep 2022; 12:8323. [PMID: 35585089 PMCID: PMC9117256 DOI: 10.1038/s41598-022-11481-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022] Open
Abstract
Previous investigators have found no clear relationship between specific blood concentrations of ∆9-tetrahydrocannabinol (∆9-THC) and impairment, and thus no scientific justification for use of legal “per se” ∆9-THC blood concentration limits. Analyzing blood from 30 subjects showed ∆9-THC concentrations that exceeded 5 ng/mL in 16 of the 30 subjects following a 12-h period of abstinence in the absence of any impairment. In blood and exhaled breath samples collected from a group of 34 subjects at baseline prior to smoking, increasing breath ∆9-THC levels were correlated with increasing blood levels (P < 0.0001) in the absence of impairment, suggesting that single measurements of ∆9-THC in breath, as in blood, are not related to impairment. When post-smoking duration of impairment was compared to baseline ∆9-THC blood concentrations, subjects with the highest baseline ∆9-THC levels tended to have the shortest duration of impairment. It was further shown that subjects with the shortest duration of impairment also had the lowest incidence of horizontal gaze nystagmus at 3 h post-smoking compared to subjects with the longest duration of impairment (P < 0.05). Finally, analysis of breath samples from a group of 44 subjects revealed the presence of transient cannabinoids such as cannabigerol, cannabichromene, and ∆9-tetrahydrocannabivarin during the peak impairment window, suggesting that these compounds may be key indicators of recent cannabis use through inhalation. In conclusion, these results provide further evidence that single measurements of ∆9-THC in blood, and now in exhaled breath, do not correlate with impairment following inhalation, and that other cannabinoids may be key indicators of recent cannabis inhalation.
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Affiliation(s)
- Gregory T Wurz
- RCU Labs, Inc., 408 Sunrise Avenue, Roseville, CA, 95661-4123, USA.,Cancer Immunotherapy Research Institute, 408 Sunrise Avenue, Roseville, CA, 95661, USA
| | - Michael W DeGregorio
- RCU Labs, Inc., 408 Sunrise Avenue, Roseville, CA, 95661-4123, USA. .,Cancer Immunotherapy Research Institute, 408 Sunrise Avenue, Roseville, CA, 95661, USA.
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11
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Lawn W, Fernandez-Vinson N, Mokrysz C, Hogg G, Lees R, Trinci K, Petrilli K, Borissova A, Ofori S, Waters S, Michór P, Wall MB, Freeman TP, Curran HV. The CannTeen study: verbal episodic memory, spatial working memory, and response inhibition in adolescent and adult cannabis users and age-matched controls. Psychopharmacology (Berl) 2022; 239:1629-1641. [PMID: 35486121 PMCID: PMC9110435 DOI: 10.1007/s00213-022-06143-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/07/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND Preclinical and human studies suggest that adolescent cannabis use may be associated with worse cognitive outcomes than adult cannabis use. We investigated the associations between chronic cannabis use and cognitive function in adolescent and adult cannabis users and controls. We hypothesised user-status would be negatively associated with cognitive function and this relationship would be stronger in adolescents than adults. METHODS As part of the 'CannTeen' project, this cross-sectional study assessed cognitive performance in adolescent cannabis users (n = 76; 16-17-year-olds), adolescent controls (n = 63), adult cannabis users (n = 71; 26-29-year-olds) and adult controls (n = 64). Users used cannabis 1-7 days/week. Adolescent and adult cannabis users were matched on cannabis use frequency (4 days/week) and time since last use (2.5 days). Verbal episodic memory (VEM) was assessed using the prose recall task, spatial working memory (SWM) was assessed using the spatial n-back task, and response inhibition was assessed with the stop-signal task. Primary outcome variables were: delayed recall, 3-back discriminability, and stop signal reaction time, respectively. RESULTS Users had worse VEM than controls (F(1,268) = 7.423, p = 0.007). There were no significant differences between user-groups on SWM or response inhibition. Null differences were supported by Bayesian analyses. No significant interactions between age-group and user-group were found for VEM, SWM, or response inhibition. CONCLUSIONS Consistent with previous research, there was an association between chronic cannabis use and poorer VEM, but chronic cannabis use was not associated with SWM or response inhibition. We did not find evidence for heightened adolescent vulnerability to cannabis-related cognitive impairment.
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Affiliation(s)
- W Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK.
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - N Fernandez-Vinson
- Clinical Psychopharmacology Unit, University College London, London, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - G Hogg
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - K Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - K Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - A Borissova
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - S Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - S Waters
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - P Michór
- School of Life Sciences, University of Warwick, Coventry, UK
| | - M B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK
- Invicro London, Hammersmith Hospital, Burlington Danes Building, Du Cane Road, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
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12
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Kroon E, Kuhns LN, Kaag AM, Filbey F, Cousijn J. The role of sex in the association between cannabis use and working memory-related brain activity. J Neurosci Res 2022; 100:1347-1358. [PMID: 35293008 PMCID: PMC9311233 DOI: 10.1002/jnr.25041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/18/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022]
Abstract
Although cannabis use patterns differ between men and women, studies on sex differences on the effects of cannabis on the brain and cognitive control are largely lacking. Working memory (WM) is a component of cognitive control believed to be involved in the development and maintenance of addiction. In this study, we evaluated the association between cannabis use and WM (load) related brain activity in a large sample, enabling us to assess sex effects in this association. The brain activity of 104 frequent cannabis users (63% men) and 85 controls (53% men) was recorded during an N‐back WM task. Behavioral results showed a significant interaction between WM load and group for both accuracy and reaction time, with cannabis users showing a relatively larger decrease in performance with increasing WM load. Cannabis users compared to controls showed a relatively smaller reduction in WM (load) related activity in the precuneus and posterior cingulate cortex at higher WM load. This WM (load) related activity was not associated with performance nor cannabis use and related problems. An exploratory analysis showed higher WM‐related activity in the superior frontal gyrus in men compared to women. While cannabis users showed higher WM (load) related activity in central nodes of the default mode network, this was not directly attributable to group specific worsening of performance under higher cognitive load. Further research is necessary to assess whether observed group differences increase with higher cognitive load, how group differences relate to measures of cannabis use, and how sex affects these group differences.
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Affiliation(s)
- Emese Kroon
- Neuroscience of Addiction Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands
| | - Lauren N Kuhns
- Neuroscience of Addiction Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands
| | - Anne Marije Kaag
- The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Francesca Filbey
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Janna Cousijn
- Neuroscience of Addiction Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
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13
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Ramaekers JG, Theunissen EL, van Ruitenbeek P, Mason NL. Cannabis Use and Neuroadaptation: A Call for Δ 9 -Tetrahydrocannabinol Challenge Studies. Front Psychiatry 2022; 13:870750. [PMID: 35492732 PMCID: PMC9046729 DOI: 10.3389/fpsyt.2022.870750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022] Open
Abstract
Currently, the assessment of the neurobehavioral consequences of repeated cannabis use is restricted to studies in which brain function of chronic cannabis users is compared to that of non-cannabis using controls. The assumption of such studies is that changes in brain function of chronic users are caused by repeated and prolonged exposure to acute cannabis intoxication. However, differences in brain function between chronic cannabis users and non-users might also arise from confounding factors such as polydrug use, alcohol use, withdrawal, economic status, or lifestyle conditions. We propose a methodology that highlights the relevance of acute Δ9-tetrahydrocannabinol (THC) dosing studies for a direct assessment of neuroadaptations in chronic cannabis users. The approach includes quantification of neurochemical, receptor, and functional brain network changes in response to an acute cannabis challenge, as well as stratification of cannabis using groups ranging from occasional to cannabis-dependent individuals. The methodology allows for an evaluation of THC induced neuroadaptive and neurocognitive changes across cannabis use history, that can inform neurobiological models on reward driven, compulsive cannabis use.
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Affiliation(s)
- Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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14
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Context dependent differences in working memory related brain activity in heavy cannabis users. Psychopharmacology (Berl) 2022; 239:1373-1385. [PMID: 34448889 PMCID: PMC9110519 DOI: 10.1007/s00213-021-05956-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE Compromised cognitive control in cannabis use-tempting situations is thought to play a key role in the development of cannabis use disorders. However, little is known about how exposure to cannabis cues and contexts may influence cognitive control and the underlying neural mechanisms in cannabis users. OBJECTIVES Working memory (WM) is an attention reliant executive function central to cognitive control. In this study, we investigated how distracting cannabis words affected WM load-dependent performance and related brain activity in near-daily cannabis users (N = 36) relative to controls (N = 33). METHODS Brain activity was recorded during a novel N-back flanker WM task with neutral and cannabis flankers added as task-irrelevant distractors. RESULTS On a behavioural level, WM performance did not differ between groups, and the presence of cannabis flankers did not affect performance. However, in cannabis users compared to controls, the presence of cannabis flankers reduced WM load-related activity in multiple regions, including the insula, thalamus, superior parietal lobe and supramarginal gyrus. CONCLUSIONS The group specificity of these effects suggest that cannabis users might differ from controls in the way they process cannabis-related cues and that cannabis cue exposure could interfere with other cognitive processes under cognitively demanding circumstances. Future studies should focus on the role of context in cognitive control-related processes like WM and attention to further elucidate potential cognitive impairments in heavy cannabis users and how these relate to loss of control over drug seeking itself.
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15
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Binkowska AA, Jakubowska N, Krystecka K, Galant N, Piotrowska-Cyplik A, Brzezicka A. Theta and Alpha Oscillatory Activity During Working Memory Maintenance in Long-Term Cannabis Users: The Importance of the Polydrug Use Context. Front Hum Neurosci 2021; 15:740277. [PMID: 34733146 PMCID: PMC8558244 DOI: 10.3389/fnhum.2021.740277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Impairments in various subdomains of memory have been associated with chronic cannabis use, but less is known about their neural underpinnings, especially in the domain of the brain's oscillatory activity. Aims: To investigate neural oscillatory activity supporting working memory (WM) in regular cannabis users and non-using controls. We focused our analyses on frontal midline theta and posterior alpha asymmetry as oscillatory fingerprints for the WM's maintenance process. Methods: 30 non-using controls (CG) and 57 regular cannabis users-27 exclusive cannabis users (CU) and 30 polydrug cannabis users (PU) completed a Sternberg modified WM task with a concurrent electroencephalography recording. Theta, alpha and beta frequency bands were examined during WM maintenance. Results: When compared to non-using controls, the PU group displayed increased frontal midline theta (FMT) power during WM maintenance, which was positively correlated with RT. The posterior alpha asymmetry during the maintenance phase, on the other hand, was negatively correlated with RT in the CU group. WM performance did not differ between groups. Conclusions: Both groups of cannabis users (CU and PU), when compared to the control group, displayed differences in oscillatory activity during WM maintenance, unique for each group (in CU posterior alpha and in PU FMT correlated with performance). We interpret those differences as a reflection of compensatory strategies, as there were no differences between groups in task performance. Understanding the psychophysiological processes in regular cannabis users may provide insight on how chronic use may affect neural networks underlying cognitive processes, however, a polydrug use context (i.e., combining cannabis with other illegal substances) seems to be an important factor.
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Affiliation(s)
| | - Natalia Jakubowska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Polish-Japanese Academy of Information Technology, Warsaw, Poland
| | | | | | | | - Aneta Brzezicka
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
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16
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Bechtel S, Lazar V, Albuisson E, Schwan R, Laprévote V, Bernardin F, Schwitzer T. Assessment of neuropsychological impairments in regular cannabis users. Encephale 2021; 48:132-138. [PMID: 34092379 DOI: 10.1016/j.encep.2021.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cannabis is the most widely used illicit drug in the world. It is responsible for cognitive dysfunction of memory, speed of information processing, attention, and executive functions. Cognitive performance depends on the level of study, tolerance, and duration of abstinence from cannabis use. This study analyses cognitive function in a large population of regular cannabis consumers taking into account level of education. METHODS A battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery was performed on a population of 58 cannabis users categorized into two groups according to their level of education with a threshold of 12 years of study, and 25 non-users. RESULTS In Attention Switching Task percent correct trials, significant differences were found between the group of cannabis smokers with less than 12 years of study and the non-smoker group (P=0.022), and between the cannabis users with more than 12 years of study and the non-smoker group (P=0.008). A significantly lower performance in the Rapid Visual Information Processing (Mean latency, Probability of hit, Total hits, Total misses, Correct rejections) was found in the cannabis users with less than 12 years of study compared with the non-user group. CONCLUSION In our population, chronic cannabis users presented divided and sustained attention and working memory disorders. Rapid Visual Information Processing performance may be influenced by education level in cannabis smokers.
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Affiliation(s)
- S Bechtel
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France
| | - V Lazar
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France
| | - E Albuisson
- Unité de méthodologie, DRCI, BIOBASE, département MPI, data management et statistique UMDS, CHRU-Nancy, 54000 Nancy, France; Université de Lorraine, Faculté de Médecine, Département du Grand Est de Recherche en Soins Primaires : DEGERESP, 54000 Nancy, France; CNRS, IECL, université de Lorraine, 54000 Nancy, France
| | - R Schwan
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France; Maison des addictions, CHRU Nancy, Nancy, France; IADI, U1254, INSERM, Université de Lorraine, CHRU de Nancy Brabois, Nancy, France
| | - V Laprévote
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, département de psychiatrie, centre hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France
| | - F Bernardin
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, département de psychiatrie, centre hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France
| | - T Schwitzer
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue du Docteur Archambault, 54521 Laxou, France; IADI, U1254, INSERM, Université de Lorraine, CHRU de Nancy Brabois, Nancy, France.
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17
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Blest-Hopley G, O'Neill A, Wilson R, Giampietro V, Bhattacharyya S. Disrupted parahippocampal and midbrain function underlie slower verbal learning in adolescent-onset regular cannabis use. Psychopharmacology (Berl) 2021; 238:1315-1331. [PMID: 31814047 PMCID: PMC8062355 DOI: 10.1007/s00213-019-05407-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/18/2019] [Indexed: 11/18/2022]
Abstract
RATIONALE Prolonged use of cannabis, the most widely used illicit drug worldwide, has been consistently associated with impairment in memory and verbal learning. Although the neurophysiological underpinnings of these impairments have been investigated previously using functional magnetic resonance imaging (fMRI), while performing memory tasks, the results of these studies have been inconsistent and no clear picture has emerged yet. Furthermore, no previous studies have investigated trial-by-trial learning. OBJECTIVES We aimed to investigate the neural underpinnings of impaired verbal learning in cannabis users as estimated over repeated learning trials. METHODS We studied 21 adolescent-onset regular cannabis users and 21 non-users using fMRI performed at least 12 h after last cannabis use, while they performed a paired associate verbal learning task that allowed us to examine trial-by-trial learning. Brain activation during repeated verbal encoding and recall conditions of the task was indexed using the blood oxygen level-dependent haemodynamic response fMRI signal. RESULTS There was a significant improvement in recall score over repeated trials indicating learning occurring across the two groups of participants. However, learning was significantly slower in cannabis users compared to non-users (p = 0.032, partial eta-squared = 0.108). While learning verbal stimuli over repeated encoding blocks, non-users displayed progressive increase in recruitment of the midbrain, parahippocampal gyrus and thalamus (p = 0.00939, partial eta-squared = 0.180). In contrast, cannabis users displayed a greater but disrupted activation pattern in these regions, which showed a stronger correlation with new word-pairs learnt over the same blocks in cannabis users than in non-users. CONCLUSIONS These results suggest that disrupted medial temporal and midbrain function underlie slower learning in adolescent-onset cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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18
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Morie KP, Potenza MN. A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory. Front Psychiatry 2021; 12:657371. [PMID: 33967859 PMCID: PMC8100188 DOI: 10.3389/fpsyt.2021.657371] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 01/26/2023] Open
Abstract
Cannabis is commonly used, and use may be increasing in the setting of increasing legalization and social acceptance. The scope of the effects of cannabis products, including varieties with higher or lower levels of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD), on domains related to addictive behavior deserves attention, particularly as legalization continues. Cannabis use may impact neural underpinnings of cognitive functions linked to propensities to engage in addictive behaviors. Here we consider these neurocognitive processes within the framework of the dual-process model of addictions. In this mini-review, we describe data on the relationships between two main constituents of cannabis (THC and CBD) and neural correlates of reward processing, inhibitory control and working memory.
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Affiliation(s)
- Kristen P. Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
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19
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Sorkhou M, Bedder RH, George TP. The Behavioral Sequelae of Cannabis Use in Healthy People: A Systematic Review. Front Psychiatry 2021; 12:630247. [PMID: 33664685 PMCID: PMC7920961 DOI: 10.3389/fpsyt.2021.630247] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Cannabis is known to have a broad range of effects on behavior, including experiencing a "high" and tranquility/relaxation. However, there are several adverse behavioral sequalae that can arise from cannabis use, depending on frequency of use, potency (e.g., THC content), age of onset, and cumulative exposure. This systematic review examined evidence for cannabis-related adverse behavioral sequalae in otherwise healthy human subjects. Methods: Following PRISMA guidelines, we conducted a systematic review of cross-sectional and longitudinal studies from 1990 to 2020 that identified cannabis-related adverse behavioral outcomes in subjects without psychiatric and medical co-morbidities from PubMed and PsychInfo searches. Key search terms included "cannabis" OR "tetrahydrocannabinol" OR "cannabidiol" OR "marijuana" AND "anxiety" OR "depression" OR "psychosis" OR "schizophrenia" "OR "IQ" OR "memory" OR "attention" OR "impulsivity" OR "cognition" OR "education" OR "occupation". Results: Our search detected a total of 2,870 studies, from which we extracted 124 relevant studies from the literature on cannabis effects in the non-clinical population. Effects of cannabis on several behavioral sequelae including cognition, motivation, impulsivity, mood, anxiety, psychosis intelligence, and psychosocial functioning were identified. The preponderance of the evidence suggests that frequency of cannabis use, THC (but not CBD) content, age of onset, and cumulative cannabis exposure can all contribute to these adverse outcomes in individuals without a pre-existing medical condition or psychiatric disorder. The strongest evidence for the negative effects of cannabis are for psychosis and psychosocial functioning. Conclusions: Although more research is needed to determine risk factors for development of adverse behavioral sequelae of cannabis use, these findings underline the importance of understanding vulnerability to the adverse effects of cannabis, which has implications for prevention and treatment of problematic cannabis use.
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Affiliation(s)
- Maryam Sorkhou
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Rachel H Bedder
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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20
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Wallace AL, Maple KE, Barr AT, Lisdahl KM. BOLD responses to inhibition in cannabis-using adolescents and emerging adults after 2 weeks of monitored cannabis abstinence. Psychopharmacology (Berl) 2020; 237:3259-3268. [PMID: 32715317 PMCID: PMC7572837 DOI: 10.1007/s00213-020-05608-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Previous studies have suggested that chronic cannabis use has been associated with increased blood oxygen level-dependent (BOLD) response during a response inhibition task; however, these studies primarily included males. OBJECTIVES We investigated whether gender moderated the effects of cannabis use on BOLD response and behavioral performance during a Go-NoGo task in adolescents and young adults following 2 weeks of monitored abstinence. METHODS Participants included 77 16-26-year olds (MJ = 36, controls = 41). An emotion-based Go-NoGo task required participants to inhibit their response during a calm face. A whole-brain analysis looked at differences between cannabis group, gender, and their interaction. RESULTS Significant greater BOLD responses were observed in cannabis users compared with that in controls in the left frontal cortex, left cingulate cortex, and the left thalamus during correct response inhibitions; gender did not moderate these effects. CONCLUSION Supporting previous research, cannabis users showed greater BOLD responses in core areas associated with response inhibition during a Go-NoGo task, even after a minimum of 2 weeks of abstinence.
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Affiliation(s)
- Alexander L Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Kristin E Maple
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Alicia T Barr
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
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21
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Klugah-Brown B, Di X, Zweerings J, Mathiak K, Becker B, Biswal B. Common and separable neural alterations in substance use disorders: A coordinate-based meta-analyses of functional neuroimaging studies in humans. Hum Brain Mapp 2020; 41:4459-4477. [PMID: 32964613 PMCID: PMC7555084 DOI: 10.1002/hbm.25085] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
Delineating common and separable neural alterations in substance use disorders (SUD) is imperative to understand the neurobiological basis of the addictive process and to inform substance‐specific treatment strategies. Given numerous functional MRI (fMRI) studies in different SUDs, a meta‐analysis could provide an opportunity to determine robust shared and substance‐specific alterations. The present study employed a coordinate‐based meta‐analysis covering fMRI studies in individuals with addictive cocaine, cannabis, alcohol, and nicotine use. The primary meta‐analysis demonstrated common alterations in primary dorsal striatal, and frontal circuits engaged in reward/salience processing, habit formation, and executive control across different substances and task‐paradigms. Subsequent sub‐analyses revealed substance‐specific alterations in frontal and limbic regions, with marked frontal and insula‐thalamic alterations in alcohol and nicotine use disorders respectively. Examining task‐specific alterations across substances revealed pronounced frontal alterations during cognitive processes yet stronger striatal alterations during reward‐related processes. Finally, an exploratory meta‐analysis revealed that neurofunctional alterations in striatal and frontal reward processing regions can already be determined with a high probability in studies with subjects with comparably short durations of use. Together the findings emphasize the role of dysregulations in frontostriatal circuits and dissociable contributions of these systems in the domains of reward‐related and cognitive processes which may contribute to substance‐specific behavioral alterations.
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Affiliation(s)
- Benjamin Klugah-Brown
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,JARA Translational Brain Medicine, RWTH Aachen, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,JARA Translational Brain Medicine, RWTH Aachen, Aachen, Germany
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bharat Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
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22
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Kallianpur KJ, Birn R, Ndhlovu LC, Souza SA, Mitchell B, Paul R, Chow DC, Kohorn L, Shikuma CM. Impact of Cannabis Use on Brain Structure and Function in Suppressed HIV Infection. JOURNAL OF BEHAVIORAL AND BRAIN SCIENCE 2020; 10:344-370. [PMID: 32968547 DOI: 10.4236/jbbs.2020.108022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Brain atrophy and cognitive deficits persist among individuals with suppressed HIV disease. The impact of cannabis use is unknown. METHODS HIV+ and HIV- participants underwent cross-sectional magnetic resonance imaging and neuropsychological testing. Lifetime frequency, duration (years), and recency of cannabis use were self-reported. Relationships of cannabis use to resting-state functional connectivity (RSFC) and to 9 regional brain volumes were assessed with corrections for multiple comparisons. Peripheral blood cytokines and monocyte subsets were measured in the HIV+ group and examined in relation to cannabis exposure. RESULTS We evaluated 52 HIV+ [50.8 ± 7.1 years old; 100% on antiretroviral therapy ≥ 3 months; 83% with plasma viral load < 50 copies/mL] and 55 HIV- [54.0 ± 7.5 years old] individuals. Among HIV+ participants, recent cannabis use (within 12 months) was associated with diminished RSFC, including of occipital cortex, controlling for age. Duration of use correlated negatively with volumes of all regions (most strikingly the nucleus accumbens) independently of recent use and intracranial volume. Recent use was associated with larger caudate and white matter volumes and lower soluble vascular cell adhesion molecule-1 and monocyte chemoattractant protein-1 concentrations. Duration of use correlated positively with psychomotor speed. Use > 10 times/lifetime was linked to more somatic symptoms, better executive function, and lower CD14+CD16++ monocyte count. CONCLUSION HIV+ individuals demonstrated opposing associations with cannabis. Recent use may weaken RSFC and prolonged consumption may exacerbate atrophy of the accumbens and other brain regions. More frequent or recent cannabis use may reduce the inflammation and CD14+CD16++ monocytes that facilitate HIV neuroinvasion. HIV-specific cannabis studies are necessary.
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Affiliation(s)
- Kalpana J Kallianpur
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii-Manoa, Honolulu, HI, USA
- Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, USA
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Rasmus Birn
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Lishomwa C Ndhlovu
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii-Manoa, Honolulu, HI, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Scott A Souza
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
- The Queen's Medical Center, Honolulu, HI, USA
| | - Brooks Mitchell
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St Louis, St. Louis, MO, USA
| | - Dominic C Chow
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Lindsay Kohorn
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Cecilia M Shikuma
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
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23
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Ogunbiyi MO, Hindocha C, Freeman TP, Bloomfield MAP. Acute and chronic effects of Δ 9-tetrahydrocannabinol (THC) on cerebral blood flow: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109900. [PMID: 32109508 DOI: 10.1016/j.pnpbp.2020.109900] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 12/12/2022]
Abstract
Acute and chronic exposure to cannabis and its main psychoactive component, Δ9-tetrahydrocannabinol (THC), is associated with changes in brain function and cerebral blood flow (CBF). We therefore sought to systematically review the literature on the effects of THC on CBF following PRISMA guidelines. Studies assessing the acute and chronic effects of THC on CBF, perfusion and volume were searched in the PubMed database between January 1972 and June 2019. We included thirty-four studies, which altogether investigated 1259 humans and 28 animals. Acute and chronic THC exposure have contrasting and regionally specific effects on CBF. While acute THC causes an overall increase in CBF in the anterior cingulate cortex, frontal cortex and insula, in a dose-dependent manner, chronic cannabis use results in an overall reduction in CBF, especially in the prefrontal cortex, which may be reversed upon prolonged abstinence from the drug. Future studies should focus on standardised methodology and longitudinal assessment to strengthen our understanding of the region-specific effects of THC on CBF and its clinical and functional significance.
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Affiliation(s)
- M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK; The Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK; The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK.
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24
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Noorbakhsh S, Afzali MH, Boers E, Conrod PJ. Cognitive Function Impairments Linked to Alcohol and Cannabis Use During Adolescence: A Study of Gender Differences. Front Hum Neurosci 2020; 14:95. [PMID: 32317950 PMCID: PMC7154290 DOI: 10.3389/fnhum.2020.00095] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/02/2020] [Indexed: 11/13/2022] Open
Abstract
Major neurocognitive changes occur during adolescence, making this phase one of the most critical developmental periods of life. Furthermore, this phase in life is also the time in which youth substance use begins. Several studies have demonstrated the differential associations of alcohol and cannabis use concerning the neurocognitive functioning of both males and females. Past and contemporary literature on gender-specific effects in neuroscience of addiction is predominantly based on cross-sectional datasets and data that is limited in terms of measurement variability. Given the importance of gender-specific effects in addiction studies, and in order to address the two above-mentioned gaps in the literature, the present study aimed to compare neurocognitive functioning of male and female adolescents in the context of cannabis and alcohol use, while employing a longitudinal design with multiple repeated measurements. Participants were 3,826 high school students (47% female; mean age, 12.7), who were recruited from 31 high schools in the greater Montreal area. Participants were requested to complete annual surveys for five consecutive years, from 7th to 11th grade, assessing their alcohol/cannabis use and neurocognitive functioning (working memory, delayed recall memory, perceptual reasoning, and inhibition control). The analytical strategy focused on the longitudinal association between each predictor (female, male) and each of the outcomes (domains of neurocognitive functioning). Multilevel linear models assessed the association of alcohol and cannabis consumption and the four domains of neurocognitive functioning. Results revealed a gender by within-subject interaction, suggesting a weaker effect of yearly fluctuation of cannabis use on working memory among males compared to females. Our findings suggest a different pattern of neurocognitive impairment of female and male working memory after using cannabis over the course of adolescence. Early initiation of cannabis use potentially results in more spatial working memory deficits in female adolescents. This may negatively influence young females' capacity in academic settings and lead to significant impairment in adulthood, which critically decreases the individual's quality of life.
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Affiliation(s)
- Simasadat Noorbakhsh
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Mohammad H Afzali
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Elroy Boers
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Patricia J Conrod
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
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25
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Deconstructing the neurobiology of cannabis use disorder. Nat Neurosci 2020; 23:600-610. [PMID: 32251385 DOI: 10.1038/s41593-020-0611-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/13/2020] [Indexed: 12/20/2022]
Abstract
There have been dramatic changes worldwide in the attitudes toward and consumption of recreational and medical cannabis. Cannabinoid receptors, which mediate the actions of cannabis, are abundantly expressed in brain regions known to mediate neural processes underlying reward, cognition, emotional regulation and stress responsivity relevant to addiction vulnerability. Despite debates regarding potential pathological consequences of cannabis use, cannabis use disorder is a clinical diagnosis with high prevalence in the general population and that often has its genesis in adolescence and in vulnerable individuals associated with psychiatric comorbidity, genetic and environmental factors. Integrated information from human and animal studies is beginning to expand insights regarding neurobiological systems associated with cannabis use disorder, which often share common neural characteristics with other substance use disorders, that could inform prevention and treatment strategies.
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26
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Zhao W, Zimmermann K, Zhou X, Zhou F, Fu M, Dernbach C, Scheele D, Weber B, Eckstein M, Hurlemann R, Kendrick KM, Becker B. Impaired cognitive performance under psychosocial stress in cannabis-dependent men is associated with attenuated precuneus activity. J Psychiatry Neurosci 2020; 45:88-97. [PMID: 31509368 PMCID: PMC7828906 DOI: 10.1503/jpn.190039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Deficient regulation of stress plays an important role in the escalation of substance use, addiction and relapse. Accumulating evidence suggests dysregulations in cognitive and reward-related processes and the underlying neural circuitry in cannabis dependence. However, despite the important regulatory role of the endocannabinoid system in the stress response, associations between chronic cannabis use and altered stress processing at the neural level have not been systematically examined. METHODS Against this background, the present functional MRI study examined psychosocial stress processing in cannabis-dependent men (n = 28) and matched controls (n = 23) using an established stress-induction paradigm (Montreal Imaging Stress Task) that combines computerized (adaptive) mental arithmetic challenges with social evaluative threat. RESULTS During psychosocial stress exposure, but not the no-stress condition, cannabis users demonstrated impaired performance relative to controls. In contrast, levels of experienced stress and cardiovascular stress responsivity did not differ from controls. Functional MRI data revealed that stress-induced performance deteriorations in cannabis users was accompanied by decreased precuneus activity and increased connectivity of this region with the superior frontal gyrus. LIMITATIONS Only male cannabis-dependent users were examined; the generalizability in female users remains to be determined. CONCLUSION Together, the present findings provide first evidence for exaggerated stress-induced cognitive performance deteriorations in cannabis users. The neural data suggest that deficient stress-related recruitment of the precuneus may be associated with the deterioration of performance at the behavioural level.
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Affiliation(s)
- Weihua Zhao
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Kaeli Zimmermann
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Xinqi Zhou
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Feng Zhou
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Meina Fu
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Christian Dernbach
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Dirk Scheele
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Bernd Weber
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Monika Eckstein
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - René Hurlemann
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Keith M. Kendrick
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
| | - Benjamin Becker
- From the Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China (Zhao, Zhou, Zhou, Fu, Kendrick, Becker); the Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany (Zimmermann, Dernbach, Scheele, Hurlemann); the Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany (Weber); the Department of NeuroCognition, Life and Brain Center, Bonn, Germany (Weber); and the Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Heidelberg, Germany (Eckstein)
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27
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A Systematic Review of Human Neuroimaging Evidence of Memory-Related Functional Alterations Associated with Cannabis Use Complemented with Preclinical and Human Evidence of Memory Performance Alterations. Brain Sci 2020; 10:brainsci10020102. [PMID: 32069958 PMCID: PMC7071506 DOI: 10.3390/brainsci10020102] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Cannabis has been associated with deficits in memory performance. However, the neural correlates that may underpin impairments remain unclear. We carried out a systematic review of functional magnetic resonance imaging (fMRI) studies investigating brain functional alterations in cannabis users (CU) compared to nonusing controls while performing memory tasks, complemented with focused narrative reviews of relevant preclinical and human studies. Twelve studies employing fMRI were identified finding functional brain activation during memory tasks altered in CU. Memory performance studies showed CU performed worse particularly during verbal memory tasks. Longitudinal studies suggest that cannabis use may have a causal role in memory deficits. Preclinical studies have not provided conclusive evidence of memory deficits following cannabinoid exposure, although they have shown evidence of cannabinoid-induced structural and histological alteration. Memory performance deficits may be related to cannabis use, with lower performance possibly underpinned by altered functional activation. Memory impairments may be associated with the level of cannabis exposure and use of cannabis during developmentally sensitive periods, with possible improvement following cessation of cannabis use.
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Abstract
As an increasing number of states legalize cannabis use for recreational and/or medical purposes, it is increasingly important to understand the neural and cognitive consequences of recreational cannabis use in adolescent consumers. Adolescence is marked by ongoing neuromaturational processes, making this a particularly vulnerable period, particularly regarding exposure to drugs, including cannabis. This review highlights evidence from studies documenting the neural impact of cannabis use in adolescence and explores mediating factors related to cannabis use.
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Affiliation(s)
- Yasmin Mashhoon
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, Mclean Hospital, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Kelly A Sagar
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Staci A Gruber
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA.
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29
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Burggren AC, Shirazi A, Ginder N, London ED. Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:563-579. [PMID: 31365275 PMCID: PMC7027431 DOI: 10.1080/00952990.2019.1634086] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Background: Cannabis is the most widely used illicit substance worldwide, and legalization for recreational and medical purposes has substantially increased its availability and use in the United States.Objectives: Decades of research have suggested that recreational cannabis use confers risk for cognitive impairment across various domains, and structural and functional differences in the brain have been linked to early and heavy cannabis use.Methods: With substantial evidence for the role of the endocannabinoid system in neural development and understanding that brain development continues into early adulthood, the rising use of cannabis in adolescents and young adults raises major concerns. Yet some formulations of cannabinoid compounds are FDA-approved for medical uses, including applications in children.Results: Potential effects on the trajectory of brain morphology and cognition, therefore, should be considered. The goal of this review is to update and consolidate relevant findings in order to inform attitudes and public policy regarding the recreational and medical use of cannabis and cannabinoid compounds.Conclusions: The findings point to considerations for age limits and guidelines for use.
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Affiliation(s)
- Alison C Burggren
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Anaheed Shirazi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
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30
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Sarne Y. Beneficial and deleterious effects of cannabinoids in the brain: the case of ultra-low dose THC. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:551-562. [PMID: 30864864 DOI: 10.1080/00952990.2019.1578366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article reviews the neurocognitive advantages and drawbacks of cannabinoid substances, and discusses the possible physiological mechanisms that underlie their dual activity. The article further reviews the neurocognitive effects of ultra-low doses of ∆9-tetrahydrocannabinol (THC; 3-4 orders of magnitude lower than the conventional doses) in mice, and proposes such low doses of THC as a possible remedy for various brain injuries and for the treatment of age-related cognitive decline.
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Affiliation(s)
- Yosef Sarne
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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31
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Cohen K, Weizman A, Weinstein A. Positive and Negative Effects of Cannabis and Cannabinoids on Health. Clin Pharmacol Ther 2019; 105:1139-1147. [DOI: 10.1002/cpt.1381] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Koby Cohen
- Department of Behavioral ScienceAriel University, Science Park Ariel Israel
| | | | - Aviv Weinstein
- Department of Behavioral ScienceAriel University, Science Park Ariel Israel
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32
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Owens MM, McNally S, Petker T, Amlung MT, Balodis IM, Sweet LH, MacKillop J. Urinary tetrahydrocannabinol is associated with poorer working memory performance and alterations in associated brain activity. Neuropsychopharmacology 2019; 44:613-619. [PMID: 30644440 PMCID: PMC6333822 DOI: 10.1038/s41386-018-0240-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/11/2018] [Indexed: 12/21/2022]
Abstract
Worldwide, cannabis is one of the most widely used psychoactive substances and cannabis use has been implicated in poorer performance in several cognitive domains, including working memory (WM). However, the neural mechanisms underlying these WM decrements are not well understood and the current study investigated the association of cannabis involvement with WM performance and associated neural activation in the Human Connectome Project (N = 1038). Multiple indicators of cannabis involvement were examined in relation to behavioral performance and brain activity in a visual N-back task using functional magnetic resonance imaging. A positive urine drug screen for tetrahydocannabinol (THC+ status), the principal psychoactive constituent in cannabis, was associated with worse WM performance and differential brain response in areas previously linked to WM performance. Furthermore, decreases in blood-activation-level-dependent (BOLD) signal in WM task-positive brain regions and increases in task-negative regions mediated the relationship between THC+ status and WM performance. In contrast, WM performance and BOLD response during the N-back task were not associated with total lifetime cannabis use, age of first use, or other indicators of involvement, suggesting that the effects of cannabis on WM were short-term residual effects, rather than long-term persistent effects. These findings elucidate differential influences of cannabis involvement on neurocognition and have significant potential implications for occupational performance in diverse settings.
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Affiliation(s)
- Max M Owens
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA, 30602, USA
| | - Shannon McNally
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA, 30602, USA
| | - Tashia Petker
- Michael G. DeGroote Centre for Medicinal Cannabis Research and Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton/McMaster University, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada
| | - Michael T Amlung
- Michael G. DeGroote Centre for Medicinal Cannabis Research and Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton/McMaster University, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada
| | - Iris M Balodis
- Michael G. DeGroote Centre for Medicinal Cannabis Research and Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton/McMaster University, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA, 30602, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-A1, Providence, RI, 02912, USA
| | - James MacKillop
- Michael G. DeGroote Centre for Medicinal Cannabis Research and Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton/McMaster University, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada.
- Homewood Research Institute, Riverslea Building, 150 Delhi Street, Guelph, ON, N1E 6K9, Canada.
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33
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Sagar KA, Gruber SA. Interactions between recreational cannabis use and cognitive function: lessons from functional magnetic resonance imaging. Ann N Y Acad Sci 2018; 1451:42-70. [PMID: 30426517 DOI: 10.1111/nyas.13990] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 10/13/2018] [Accepted: 10/19/2018] [Indexed: 12/28/2022]
Abstract
Cannabis use is becoming increasingly popular as a growing number of states pass legislation to legalize cannabis and cannabis-derived products for recreational and/or medical purposes. Given the widespread use of cannabis, it is critical to understand the neural consequences related to cannabis use. In this review, we focus on evidence from functional magnetic resonance imaging studies that document acute and residual alterations in brain function during tasks spanning a variety of cognitive domains: executive function, attention and working memory, memory, motor skills, error monitoring, and reward and affective processing. Although it is clear that cannabis affects brain function, the findings are somewhat inconsistent; variables that potentially affect study outcomes are outlined, including a discussion of the impact of chronological age and age of cannabis onset as well as length of abstinence at the time of assessment, which are important considerations when measuring cannabis use patterns. Inherent differences between recreational/adult cannabis use versus use for medical purposes are also discussed, given their importance to public policy decisions.
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Affiliation(s)
- Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Boston University School of Medicine, Boston, Massachusetts
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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34
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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35
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Ma L, Steinberg JL, Bjork JM, Keyser-Marcus L, Vassileva J, Zhu M, Ganapathy V, Wang Q, Boone EL, Ferré S, Bickel WK, Gerard Moeller F. Fronto-striatal effective connectivity of working memory in adults with cannabis use disorder. Psychiatry Res Neuroimaging 2018; 278:21-34. [PMID: 29957349 PMCID: PMC6953485 DOI: 10.1016/j.pscychresns.2018.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 10/14/2022]
Abstract
Previous working memory (WM) studies found that relative to controls, subjects with cannabis use disorder (CUD) showed greater brain activation in some regions (e.g., left [L] and right [R] ventrolateral prefrontal cortex [VLPFC], and L dorsolateral prefrontal cortex [L-DLPFC]), and lower activation in other regions (e.g., R-DLPFC). In this study, effective connectivity (EC) analysis was applied to functional magnetic resonance imaging data acquired from 23 CUD subjects and 23 controls (two groups matched for sociodemographic factors and substance use history) while performing an n-back WM task with interleaved 2-back and 0-back periods. A 2-back minus 0-back modulator was defined to measure the modulatory changes of EC corresponding to the 2-back relative to 0-back conditions. Compared to the controls, the CUD group showed smaller modulatory change in the R-DLPFC to L-caudate pathway, and greater modulatory changes in L-DLPFC to L-caudate, R-DLPFC to R-caudate, and R-VLPFC to L-caudate pathways. Based on previous fMRI studies consistently suggesting that greater brain activations are related to a compensatory mechanism for cannabis neural effects (less regional brain activations), the smaller modulatory change in the R-DLPFC to L-caudate EC may be compensated by the larger modulatory changes in the other prefrontal-striatal ECs in the CUD individuals.
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Affiliation(s)
- Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Radiology, Virginia Commonwealth University (VCU), Richmond, VA, USA.
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Lori Keyser-Marcus
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Min Zhu
- Radiology Department, Mu Dang Jiang Medical University, Mu Dang Jiang, Hei Long Jiang, China
| | - Venkatesh Ganapathy
- Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Qin Wang
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Edward L Boone
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Sergi Ferré
- Integrative Neurobiology Section, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA; Department of Pharmacology & Toxicology, VCU, Richmond, VA, USA; Department of Neurology, VCU, Richmond, VA, USA
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36
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Sagar KA, Gruber SA. Marijuana matters: reviewing the impact of marijuana on cognition, brain structure and function, & exploring policy implications and barriers to research. Int Rev Psychiatry 2018; 30:251-267. [PMID: 29966459 PMCID: PMC6455965 DOI: 10.1080/09540261.2018.1460334] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The neurobiologic effects of cannabis, commonly referred to as 'marijuana' (MJ), have been studied for decades. The impact of recreational MJ use on cognition and measures of brain function and structure is outlined, and variables influencing study results are discussed, including age of the consumer, patterns of MJ use, variations in MJ potency, and the presence of additional cannabinoids. Although evidence suggests that chronic, heavy recreational MJ use is related to cognitive decrements and neural changes, particularly when use begins in adolescence, findings from studies of recreational MJ users may not be applicable to medical marijuana (MMJ) patients given differences in demographic variables, product selection, and reasons for use. Although additional research is needed to fully understand the impact of MJ and individual cannabinoids on the brain, current findings are beginning to inform public policy, including considerations for age limits, potential limits for some cannabinoids, and guidelines for use. However, barriers continue to impede researchers' ability to conduct studies that will guide policy change and provide vital information to consumers and patients regarding best practices and safest methods for use. The need for information is critical, as legalization of MJ for medical and recreational use is increasingly widespread.
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Affiliation(s)
- Kelly A. Sagar
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Boston University School of Medicine, 72 E Concord St Boston, MA, 02118
| | - Staci A. Gruber
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Corresponding Author Information Address: McLean Hospital, 115 Mill Street, Belmont, MA 02478, Telephone: 617-855-2762, Fax: 617-855-3713,
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37
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Lovell ME, Bruno R, Johnston J, Matthews A, McGregor I, Allsop DJ, Lintzeris N. Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users. Addict Behav 2018; 79:178-188. [PMID: 29291509 DOI: 10.1016/j.addbeh.2017.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/17/2017] [Accepted: 12/07/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cannabis intoxication adversely affects health, yet persistent effects following short-term abstinence in long-term cannabis users are unclear. This matched-subjects, cross-sectional study compared health outcomes of long-term cannabis and long-term tobacco-only users, relative to population norms. METHODS Nineteen long-term (mean 32.3years of use, mean age 55.7years), abstinent (mean 15h) cannabis users and 16 long-term tobacco users (mean 37.1years of use, mean age 52.9years), matched for age, educational attainment, and lifetime tobacco consumption, were compared on measures of learning and memory, response inhibition, information-processing, sustained attention, executive control, and mental and physical health. RESULTS Cannabis users exhibited poorer overall learning and delayed recall and greater interference and forgetting than tobacco users, and exhibited poorer recall than norms. Inhibition and executive control were similar between groups, but cannabis users had slower reaction times during information processing and sustained attention tasks. Cannabis users had superior health satisfaction and psychological, somatic, and general health than tobacco users and had similar mental and physical health to norms whilst tobacco users had greater stress, role limitations from emotional problems, and poorer health satisfaction. CONCLUSIONS Long-term cannabis users may exhibit deficits in some cognitive domains despite short-term abstinence and may therefore benefit from interventions to improve cognitive performance. Tobacco alone may contribute to adverse mental and physical health outcomes, which requires appropriate control in future studies.
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Affiliation(s)
- M E Lovell
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia.
| | - R Bruno
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - J Johnston
- University Centre for Rural Health - North Coast, University of Sydney, Lismore, New South Wales 2480, Australia
| | - A Matthews
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - I McGregor
- Lambert Initiative for Cannabinoid Therapeutics, School of Psychology, Brain and Mind Centre, University of Sydney, New South Wales 2006, Australia
| | - D J Allsop
- Lambert Initiative for Cannabinoid Therapeutics, School of Psychology, Brain and Mind Centre, University of Sydney, New South Wales 2006, Australia
| | - N Lintzeris
- Discipline of Addictive Medicine, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006, Australia; The Langton Centre, South East Sydney Local Health District (SESLHD), Drug and Alcohol Services, 2010, Australia
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38
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Blest-Hopley G, Giampietro V, Bhattacharyya S. Residual effects of cannabis use in adolescent and adult brains - A meta-analysis of fMRI studies. Neurosci Biobehav Rev 2018. [PMID: 29535069 DOI: 10.1016/j.neubiorev.2018.03.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While numerous studies have investigated the residual effects of cannabis use on human brain function, results of these studies have been inconsistent. Using meta-analytic approaches we summarize the effects of prolonged cannabis exposure on human brain function as measured using task-based functional MRI (fMRI) across studies employing a range of cognitive activation tasks comparing regular cannabis users with non-users. Separate meta-analyses were carried out for studies investigating adult and adolescent cannabis users. Systematic literature search identified 20 manuscripts (13 adult and 7 adolescent studies) meeting study inclusion criteria. Adult analyses compared 530 cannabis users to 580 healthy controls while adolescent analyses compared 219 cannabis users to 224 healthy controls. In adult cannabis users brain activation was increased in the superior and posterior transverse temporal and inferior frontal gyri and decreased in the striate area, insula and middle temporal gyrus. In adolescent cannabis users, activation was increased in the inferior parietal gyrus and putamen compared to healthy controls. Functional alteration in these areas may reflect compensatory neuroadaptive changes in cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, PO Box 089, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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39
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Yanes JA, Riedel MC, Ray KL, Kirkland AE, Bird RT, Boeving ER, Reid MA, Gonzalez R, Robinson JL, Laird AR, Sutherland MT. Neuroimaging meta-analysis of cannabis use studies reveals convergent functional alterations in brain regions supporting cognitive control and reward processing. J Psychopharmacol 2018; 32:283-295. [PMID: 29338547 PMCID: PMC5858977 DOI: 10.1177/0269881117744995] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lagging behind rapid changes to state laws, societal views, and medical practice is the scientific investigation of cannabis's impact on the human brain. While several brain imaging studies have contributed important insight into neurobiological alterations linked with cannabis use, our understanding remains limited. Here, we sought to delineate those brain regions that consistently demonstrate functional alterations among cannabis users versus non-users across neuroimaging studies using the activation likelihood estimation meta-analysis framework. In ancillary analyses, we characterized task-related brain networks that co-activate with cannabis-affected regions using data archived in a large neuroimaging repository, and then determined which psychological processes may be disrupted via functional decoding techniques. When considering convergent alterations among users, decreased activation was observed in the anterior cingulate cortex, which co-activated with frontal, parietal, and limbic areas and was linked with cognitive control processes. Similarly, decreased activation was observed in the dorsolateral prefrontal cortex, which co-activated with frontal and occipital areas and linked with attention-related processes. Conversely, increased activation among users was observed in the striatum, which co-activated with frontal, parietal, and other limbic areas and linked with reward processing. These meta-analytic outcomes indicate that cannabis use is linked with differential, region-specific effects across the brain.
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Affiliation(s)
- Julio A Yanes
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Michael C Riedel
- Center for Imaging Science, Florida International University, Miami, FL, USA
| | - Kimberly L Ray
- Imaging Research Center, University of California Davis, Sacramento, CA, USA
| | - Anna E Kirkland
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Ryan T Bird
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Emily R Boeving
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
| | - Meredith A Reid
- Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Raul Gonzalez
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Jennifer L Robinson
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Angela R Laird
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Physics, Florida International University, Miami, FL, USA
| | - Matthew T Sutherland
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
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40
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Cohen K, Weinstein A. The Effects of Cannabinoids on Executive Functions: Evidence from Cannabis and Synthetic Cannabinoids-A Systematic Review. Brain Sci 2018; 8:brainsci8030040. [PMID: 29495540 PMCID: PMC5870358 DOI: 10.3390/brainsci8030040] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/08/2018] [Accepted: 02/24/2018] [Indexed: 12/21/2022] Open
Abstract
Background—Cannabis is the most popular illicit drug in the Western world. Repeated cannabis use has been associated with short and long-term range of adverse effects. Recently, new types of designer-drugs containing synthetic cannabinoids have been widespread. These synthetic cannabinoid drugs are associated with undesired adverse effects similar to those seen with cannabis use, yet, in more severe and long-lasting forms. Method—A literature search was conducted using electronic bibliographic databases up to 31 December 2017. Specific search strategies were employed using multiple keywords (e.g., “synthetic cannabinoids AND cognition,” “cannabis AND cognition” and “cannabinoids AND cognition”). Results—The search has yielded 160 eligible studies including 37 preclinical studies (5 attention, 25 short-term memory, 7 cognitive flexibility) and 44 human studies (16 attention, 15 working memory, 13 cognitive flexibility). Both pre-clinical and clinical studies demonstrated an association between synthetic cannabinoids and executive-function impairment either after acute or repeated consumptions. These deficits differ in severity depending on several factors including the type of drug, dose of use, quantity, age of onset and duration of use. Conclusions—Understanding the nature of the impaired executive function following consumption of synthetic cannabinoids is crucial in view of the increasing use of these drugs.
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Affiliation(s)
- Koby Cohen
- Department of Behavioral Science, Ariel University, Ariel 40700, Israel.
| | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Ariel 40700, Israel.
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41
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Lorkiewicz SA, Ventura AS, Heeren TC, Winter MR, Walley AY, Sullivan M, Samet JH, Saitz R. Lifetime marijuana and alcohol use, and cognitive dysfunction in people with human immunodeficiency virus infection. Subst Abus 2017; 39:116-123. [PMID: 29058572 DOI: 10.1080/08897077.2017.1391925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Substance use is common among people with human immunodeficiency virus (HIV) infection. Alcohol, marijuana, and HIV can have negative effects on cognition. Associations between current and lifetime marijuana and alcohol use and cognitive dysfunction in people with HIV infection were examined. METHODS Some 215 HIV-infected adults with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance dependence or ever injection drug use were studied. In adjusted cross-sectional regression analyses associations were assessed between current marijuana use, current heavy alcohol use, lifetime marijuana use, lifetime alcohol use, duration of heavy alcohol use (the independent variables), and 3 measures of cognitive dysfunction (dependent variables): both the (i) memory and (ii) attention domains from the Montreal Cognitive Assessment (MoCA) and the (iii) 4-item cognitive function scale (CF4) from the Medical Outcomes Study HIV Health Survey (MOS-HIV). Analyses were adjusted for demographics, primary language, depressive symptoms, anxiety, comorbidities, antiretroviral therapy, hepatitis C virus (ever), duration of HIV infection (years), HIV-viral load (log copies/mL), CD4 cell count, lifetime and recent cocaine use, and recent illicit and prescribed opioid use. RESULTS Current marijuana use was significantly and negatively associated with the MOS-HIV CF4 score (adjusted mean difference = -0.40, P = .01). Current marijuana use was not significantly associated with either MoCA score. Lifetime marijuana use and current heavy and lifetime alcohol use and duration of heavy alcohol use were not associated with any measure of cognitive dysfunction. CONCLUSION Current marijuana use was associated with one measure of cognitive dysfunction, but there was not a consistent pattern of association with lifetime marijuana use or alcohol use and measures of cognitive dysfunction. Understanding the mechanism by which marijuana, with and without alcohol, are associated with worse cognition warrants larger, longer studies with more precise and diverse measurements of cognitive function.
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Affiliation(s)
- Sara A Lorkiewicz
- a Graduate Medical Sciences, Boston University School of Medicine , Boston , Massachusetts , USA
| | - Alicia S Ventura
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Timothy C Heeren
- c Department of Biostatistics , Boston University School of Public Health , Boston , Massachusetts , USA
| | - Michael R Winter
- d Data Coordinating Center , Boston University School of Public Health , Boston , Massachusetts , USA
| | - Alexander Y Walley
- e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Meg Sullivan
- f Section of Infectious Diseases , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Jeffrey H Samet
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Richard Saitz
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
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John WS, Martin TJ, Solingapuram Sai KK, Nader SH, Gage HD, Mintz A, Nader MA. Chronic Δ 9-THC in Rhesus Monkeys: Effects on Cognitive Performance and Dopamine D2/D3 Receptor Availability. J Pharmacol Exp Ther 2017; 364:300-310. [PMID: 29203575 DOI: 10.1124/jpet.117.244194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/30/2017] [Indexed: 01/24/2023] Open
Abstract
Cannabis-related impairments to cognitive function may represent novel therapeutic targets for cannabis-use disorder, although the nature, persistence, and reversibility of such deficits remain unclear. Adult male rhesus monkeys (N = 6) responded in the morning on tasks designed to assess different cognitive domains using the Cambridge Neuropsychological Test Automated Battery (CANTAB) touchscreens followed by responding maintained under a fixed-ratio (FR) 10 schedule of food presentation in different operant chambers. First, the acute effects of Δ9-tetrahydrocannabinol (THC; 0.01-0.56 mg/kg, i.v.) on cognitive performance, FR responding, and body temperature were determined. Next, THC (1.0-2.0 mg/kg, s.c.) was administered daily after FR 10 sessions for 12 weeks, during which the residual effects of THC (i.e., 22 hours after administration) on cognition were examined and the acute effects of THC were redetermined. In a subgroup of monkeys, dopamine D2/D3 receptor availability was assessed after 4 weeks of chronic THC exposure and compared with drug-naive controls using positron emission tomography and [11C]-raclopride (N = 4/group). Acute THC pretreatments dose-dependently decreased FR responding and body temperature, and impairment to cognitive performance was task specific. During chronic treatment, THC produced persistent residual impairment only to working memory; tolerance differentially developed to acute cognitive impairments. There was recovery from residual cognitive impairments to working memory within 2 weeks of abstinence. Compared with controls, D2/D3 receptor availability was not altered during chronic THC treatment. In conclusion, THC-induced disruptions in cognition were task-specific, as was tolerance development, and not related to changes in D2/D3 receptor availability. Intervention strategies for cannabis-use disorder that enhance working memory performance may facilitate positive treatment outcomes.
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Affiliation(s)
- William S John
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Thomas J Martin
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kiran Kumar Solingapuram Sai
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Susan H Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - H Donald Gage
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Akiva Mintz
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael A Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
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Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, Sherif M, McGuire P, D'Souza DC. Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology 2017. [PMID: 28634109 DOI: 10.1016/j.neuropharm.2017.06.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Prospective epidemiological studies have consistently demonstrated that cannabis use is associated with an increased subsequent risk of both psychotic symptoms and schizophrenia-like psychoses. Early onset of use, daily use of high-potency cannabis, and synthetic cannabinoids carry the greatest risk. The risk-increasing effects are not explained by shared genetic predisposition between schizophrenia and cannabis use. Experimental studies in healthy humans show that cannabis and its active ingredient, delta-9-tetrahydrocannabinol (THC), can produce transient, dose-dependent, psychotic symptoms, as well as an array of psychosis-relevant behavioral, cognitive and psychophysiological effects; the psychotogenic effects can be ameliorated by cannabidiol (CBD). Findings from structural imaging studies in cannabis users have been inconsistent but functional MRI studies have linked the psychotomimetic and cognitive effects of THC to activation in brain regions implicated in psychosis. Human PET studies have shown that acute administration of THC weakly releases dopamine in the striatum but that chronic users are characterised by low striatal dopamine. We are beginning to understand how cannabis use impacts on the endocannabinoid system but there is much still to learn about the biological mechanisms underlying how cannabis increases risk of psychosis. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
| | - A Englund
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - A Abi-Dargham
- Department of Psychiatry, School of Medicine, Stony Brook University, New York, USA
| | - D A Lewis
- Department of Psychiatry, University of Pittsburg, PA, USA
| | - M Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - C Davies
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - M Sherif
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| | - P McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - D C D'Souza
- Department of Psychiatry, Yale University School of Medicine, CT, USA
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Mizrahi R, Watts JJ, Tseng KY. Mechanisms contributing to cognitive deficits in cannabis users. Neuropharmacology 2017; 124:84-88. [PMID: 28414051 DOI: 10.1016/j.neuropharm.2017.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/13/2017] [Indexed: 12/19/2022]
Abstract
Studies from preclinical animal models indicate that sustained activation of CB1 receptor signaling is a major contributing factor for the onset of cognitive deficits associated to chronic cannabis use, in particular within the working memory and decision-making domains. Yet, very few studies have been designed to directly assess the role of CB1 receptors in mediating the effects of cannabis on human brain function. This perspective review article provides an overview of current state of knowledge on possible neurobiological mechanisms accounting for the detrimental effects of chronic cannabis use on cognition and related changes in brain structure and functional connectivity. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- Romina Mizrahi
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Jeremy J Watts
- Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Kuei Y Tseng
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University, North Chicago, IL, USA.
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Ratano P, Palmery M, Trezza V, Campolongo P. Cannabinoid Modulation of Memory Consolidation in Rats: Beyond the Role of Cannabinoid Receptor Subtype 1. Front Pharmacol 2017; 8:200. [PMID: 28446875 PMCID: PMC5388693 DOI: 10.3389/fphar.2017.00200] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/28/2017] [Indexed: 12/30/2022] Open
Abstract
The effects induced by exogenous manipulation of endocannabinoid neurotransmission on emotion and memory are often contradictory. Among the different factors involved, of particular interest is the binding affinity of endocannabinoids, and their analogs, for other receptor families beyond cannabinoid receptors, such as the peroxisome proliferator-activated receptors (PPARs), and the transient receptor potential cation channel subfamily V member 1 (TRPV1). The aim of this study was to investigate which receptor subtype mediates cannabinoid effects on memory consolidation for emotionally arousing experiences. We tested two cannabinoid compounds with different pharmacological properties in the inhibitory avoidance task, and evaluated whether the observed effects are mediated by cannabinoid, PPARα or TRPV1 receptor activation. We found that the synthetic cannabinoid agonist WIN55,212-2 and the FAAH inhibitor URB597 both enhanced memory consolidation for inhibitory avoidance training. WIN55,212-22 effects on memory consolidation were predominantly mediated by CB1 receptor activation but CB2 receptors were involved as well. The URB597-induced memory enhancement was dependent on the activation not only of CB1 and CB2 receptors but, notwithstanding, PPAR-α and TRPV1 receptors were involved as well. Our findings drive beyond the classical hypothesis centered on the unique role of CB1 receptor activation for cannabinoid effects on memory, and reveal new insights in the neural mechanisms of memory consolidation.
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Affiliation(s)
- Patrizia Ratano
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
| | - Maura Palmery
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
| | - Viviana Trezza
- Department of Science, Section of Biomedical Sciences and Technologies, Roma Tre UniversityRome, Italy
| | - Patrizia Campolongo
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
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The effects of synthetic cannabinoids on executive function. Psychopharmacology (Berl) 2017; 234:1121-1134. [PMID: 28160034 DOI: 10.1007/s00213-017-4546-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/23/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS There is a growing use of novel psychoactive substances (NPSs) including synthetic cannabinoids. Synthetic cannabinoid products have effects similar to those of natural cannabis but the new synthetic cannabinoids are more potent and dangerous and their use has resulted in various adverse effects. The purpose of the study was to assess whether persistent use of synthetic cannabinoids is associating with impairments of executive function in chronic users. METHODS A total of 38 synthetic cannabinoids users, 43 recreational cannabis users, and 41 non-user subjects were studied in two centers in Hungary and Israel. Computerized cognitive function tests, the classical Stroop word-color task, n-back task, and a free-recall memory task were used. RESULTS Synthetic cannabinoid users performed significantly worse than both recreational and non-cannabis users on the n-back task (less accuracy), the Stroop task (overall slow responses and less accuracy), and the long-term memory task (less word recall). Additionally, they have also shown higher ratings of depression and anxiety compared with both recreational and non-users groups. DISCUSSION This study showed impairment of executive function in synthetic cannabinoid users compared with recreational users of cannabis and non-users. This may have major implications for our understanding of the long-term consequences of synthetic cannabinoid based drugs.
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Caballero A, Granberg R, Tseng KY. Mechanisms contributing to prefrontal cortex maturation during adolescence. Neurosci Biobehav Rev 2016; 70:4-12. [PMID: 27235076 DOI: 10.1016/j.neubiorev.2016.05.013] [Citation(s) in RCA: 199] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 12/17/2022]
Abstract
Adolescence is defined as a transitional period between childhood and adulthood characterized by changes in social interaction and acquisition of mature cognitive abilities. These changes have been associated with the maturation of brain regions involved in the control of motivation, emotion, and cognition. Among these regions, the protracted development of the human prefrontal cortex during adolescence has been proposed to underlie the maturation of cognitive functions and the regulation of affective responses. Studies in animal models allow us to test the causal contribution of specific neural processes in the development of the prefrontal cortex and the acquisition of adult behavior. This review summarizes the cellular and synaptic mechanisms occurring in the rodent prefrontal cortex during adolescence as a model for understanding the changes underlying human prefrontal development.
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Affiliation(s)
- Adriana Caballero
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Rachel Granberg
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Kuei Y Tseng
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA.
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Schoeler T, Kambeitz J, Behlke I, Murray R, Bhattacharyya S. The effects of cannabis on memory function in users with and without a psychotic disorder: findings from a combined meta-analysis. Psychol Med 2016; 46:177-188. [PMID: 26353818 DOI: 10.1017/s0033291715001646] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Effect of cannabis use on memory function is a contentious issue, with effects being different in healthy individuals and patients with psychosis. METHOD Employing a meta-analytic approach we investigated the effects of cannabis use on memory function in patients with psychosis and healthy individuals, and the effect of diagnosis, memory dimension and moderating factors. A total of 88 studies were identified through a systematic literature search, investigating healthy (n = 7697) and psychotic (n = 3261) individuals. Standardized mean differences between the cannabis user and non-user groups on memory tasks were estimated using random-effects models and the effect-size statistic Cohen's d. Effects of potential moderating factors were tested using mixed-effects models and subgroup analyses. RESULTS We found that cannabis use was associated with significantly (p ⩽ 0.05) impaired global (d = 0.27) and prospective memory (d = 0.61), verbal immediate (d = 0.40) and delayed (d = 0.36) recall as well as visual recognition (d = 0.41) in healthy individuals, but a better global memory (d = -0.11), visual immediate recall (d = -0.73) and recognition (d = -0.42) in patients. Lower depression scores and younger age appeared to attenuate the effects of cannabis on memory. Cannabis-using patients had lower levels of depression and were younger compared with non-using patients, whilst healthy cannabis-users had higher depression scores than age-matched non-users. Longer duration of abstinence from cannabis reduced the effects on memory in healthy and patient users. CONCLUSIONS These results suggest that cannabis use is associated with a significant domain-specific impairment in memory in healthy individuals but not in cannabis-using patients, suggesting that they may represent a less developmentally impaired subgroup of psychotic patients.
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Affiliation(s)
- T Schoeler
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - J Kambeitz
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - I Behlke
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - R Murray
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - S Bhattacharyya
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
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Becker MP, Collins PF, Lim KO, Muetzel RL, Luciana M. Longitudinal changes in white matter microstructure after heavy cannabis use. Dev Cogn Neurosci 2015; 16:23-35. [PMID: 26602958 PMCID: PMC4691379 DOI: 10.1016/j.dcn.2015.10.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/03/2015] [Accepted: 10/06/2015] [Indexed: 11/28/2022] Open
Abstract
Diffusion tensor imaging (DTI) studies of cannabis users report alterations in brain white matter microstructure, primarily based on cross-sectional research, and etiology of the alterations remains unclear. We report findings from longitudinal voxelwise analyses of DTI data collected at baseline and at a 2-year follow-up on 23 young adult (18-20 years old at baseline) regular cannabis users and 23 age-, sex-, and IQ-matched non-using controls with limited substance use histories. Onset of cannabis use was prior to age 17. Cannabis users displayed reduced longitudinal growth in fractional anisotropy in the central and parietal regions of the right and left superior longitudinal fasciculus, in white matter adjacent to the left superior frontal gyrus, in the left corticospinal tract, and in the right anterior thalamic radiation lateral to the genu of the corpus callosum, along with less longitudinal reduction of radial diffusion in the right central/posterior superior longitudinal fasciculus, corticospinal tract, and posterior cingulum. Greater amounts of cannabis use were correlated with reduced longitudinal growth in FA as was relatively impaired performance on a measure of verbal learning. These findings suggest that continued heavy cannabis use during adolescence and young adulthood alters ongoing development of white matter microstructure, contributing to functional impairment.
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Affiliation(s)
- Mary P Becker
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN 55455, United States; Center for Neurobehavioral Development, University of Minnesota, 717 Delaware Street SE, Ste. 333, Minneapolis, MN 55414, United States.
| | - Paul F Collins
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN 55455, United States; Center for Neurobehavioral Development, University of Minnesota, 717 Delaware Street SE, Ste. 333, Minneapolis, MN 55414, United States
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue South, Minneapolis, MN 55454, United States
| | - R L Muetzel
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN 55455, United States
| | - M Luciana
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN 55455, United States; Center for Neurobehavioral Development, University of Minnesota, 717 Delaware Street SE, Ste. 333, Minneapolis, MN 55414, United States
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Cortical thinness and volume differences associated with marijuana abuse in emerging adults. Drug Alcohol Depend 2015; 155:275-83. [PMID: 26249265 PMCID: PMC4581973 DOI: 10.1016/j.drugalcdep.2015.06.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/14/2015] [Accepted: 06/09/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. METHODS Fifteen MJ users (age 21.8±3.6, 2 females) and 15 non-user (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. RESULTS Whole brain CT analysis did not result in significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group differences. CONCLUSIONS RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing.
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