1
|
Chester LA, Englund A, Chesney E, Oliver D, Wilson J, Sovi S, Dickens AM, Oresic M, Linderman T, Hodsoll J, Minichino A, Strang J, Murray RM, Freeman TP, McGuire P. Effects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Plasma Endocannabinoid Levels in Healthy Volunteers: A Randomized Double-Blind Four-Arm Crossover Study. Cannabis Cannabinoid Res 2024; 9:188-198. [PMID: 36493386 PMCID: PMC10874814 DOI: 10.1089/can.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The effects of cannabis are thought to be mediated by interactions between its constituents and the endocannabinoid system. Delta-9-tetrahydrocannabinol (THC) binds to central cannabinoid receptors, while cannabidiol (CBD) may influence endocannabinoid function without directly acting on cannabinoid receptors. We examined the effects of THC coadministered with different doses of CBD on plasma levels of endocannabinoids in healthy volunteers. Methods: In a randomized, double-blind, four-arm crossover study, healthy volunteers (n=46) inhaled cannabis vapor containing 10 mg THC plus either 0, 10, 20, or 30 mg CBD, in four experimental sessions. The median time between sessions was 14 days (IQR=20). Blood samples were taken precannabis inhalation and at 0-, 5-, 15-, and 90-min postinhalation. Plasma concentrations of THC, CBD, anandamide, 2-arachidonoylglycerol (2-AG), and related noncannabinoid lipids were measured using liquid chromatography-mass spectrometry. Results: Administration of cannabis induced acute increases in plasma concentrations of anandamide (+18.0%, 0.042 ng/mL [95%CI: 0.023-0.062]), and the noncannabinoid ethanolamides, docosatetraenylethanolamide (DEA; +35.8%, 0.012 ng/mL [95%CI: 0.008-0.016]), oleoylethanolamide (+16.1%, 0.184 ng/mL [95%CI: 0.076-0.293]), and N-arachidonoyl-L-serine (+25.1%, 0.011 ng/mL [95%CI: 0.004-0.017]) (p<0.05). CBD had no significant effect on the plasma concentration of anandamide, 2-AG or related noncannabinoid lipids at any of three doses used. Over the four sessions, there were progressive decreases in the preinhalation concentrations of anandamide and DEA, from 0.254 ng/mL [95%CI: 0.223-0.286] to 0.194 ng/mL [95%CI: 0.163-0.226], and from 0.039 ng/mL [95%CI: 0.032-0.045] to 0.027 ng/mL [95%CI: 0.020-0.034] (p<0.05), respectively. Discussion: THC induced acute increases in plasma levels of anandamide and noncannabinoid ethanolamides, but there was no evidence that these effects were influenced by the coadministration of CBD. It is possible that such effects may be evident with higher doses of CBD or after chronic administration. The progressive reduction in pretreatment anandamide and DEA levels across sessions may be related to repeated exposure to THC or participants becoming less anxious about the testing procedure and requires further investigation. The study was registered on clinicaltrials.gov (NCT05170217).
Collapse
Affiliation(s)
- Lucy A. Chester
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amir Englund
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Edward Chesney
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dominic Oliver
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, New South Wales, Australia
| | - Simina Sovi
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alex M. Dickens
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland
| | - Matej Oresic
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tuomas Linderman
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amedeo Minichino
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - John Strang
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tom P. Freeman
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| |
Collapse
|
2
|
Costello H, Husain M, Roiser JP. Apathy and Motivation: Biological Basis and Drug Treatment. Annu Rev Pharmacol Toxicol 2024; 64:313-338. [PMID: 37585659 DOI: 10.1146/annurev-pharmtox-022423-014645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Apathy is a disabling syndrome associated with poor functional outcomes that is common across a broad range of neurological and psychiatric conditions. Currently, there are no established therapies specifically for the condition, and safe and effective treatments are urgently needed. Advances in the understanding of motivation and goal-directed behavior in humans and animals have shed light on the cognitive and neurobiological mechanisms contributing to apathy, providing an important foundation for the development of new treatments. Here, we review the cognitive components, neural circuitry, and pharmacology of apathy and motivation, highlighting converging evidence of shared transdiagnostic mechanisms. Though no pharmacological treatments have yet been licensed, we summarize trials of existing and novel compounds to date, identifying several promising candidates for clinical use and avenues of future drug development.
Collapse
Affiliation(s)
- Harry Costello
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom;
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences and Department of Experimental Psychology, Oxford University, Oxford, United Kingdom
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom;
| |
Collapse
|
3
|
Freels TG, Westbrook SR, Zamberletti E, Kuyat JR, Wright HR, Malena AN, Melville MW, Brown AM, Glodosky NC, Ginder DE, Klappenbach CM, Delevich KM, Rubino T, McLaughlin RJ. Sex Differences in Response-Contingent Cannabis Vapor Administration During Adolescence Mediate Enduring Effects on Behavioral Flexibility and Prefrontal Microglia Activation in Rats. Cannabis Cannabinoid Res 2024. [PMID: 38190273 DOI: 10.1089/can.2023.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Introduction: Cannabis is the most used illicit drug in the United States. With many states passing legislation to permit its recreational use, there is concern that cannabis use among adolescents could increase dramatically in the coming years. Historically, it has been difficult to model real-world cannabis use to investigate the causal relationship between cannabis use in adolescence and behavioral and neurobiological effects in adulthood. Materials and Methods: We used a response-contingent vapor administration model to investigate long-term effects of cannabis use during adolescence on the medial prefrontal cortex (mPFC) and mPFC-dependent behaviors in male and female rats. Results: Adolescent (35- to 55-day-old) female rats had significantly higher rates of responding for vaporized Δ9-tetrahydrocannabinol (THC)-dominant cannabis extract (CANTHC) compared with adolescent males. In adulthood (70-110 days old), female, but not male, CANTHC rats also took more trials to reach criterion and made more regressive errors in an automated attentional set-shifting task compared with vehicle rats, thereby indicating sex differences in behavioral flexibility impairments. Notably, sex-treatment interactions were not observed when rats of each sex were exposed to a noncontingent CANTHC vapor dosing regimen that approximated CANTHC vapor deliveries earned by females. No differences were observed in effort-based decision making in either sex. In the mPFC, female (but not male) CANTHC rats displayed more reactive microglia with no changes in myelin basic protein expression or dendritic spine density. Conclusion: Altogether, these data reveal important sex differences in rates of responding for CANTHC vapor in adolescence that may confer enduring alterations to mPFC structure and function and suggest that there may be subtle differences in the effects of response-contingent versus noncontingent cannabis exposure that should be systematically examined in future studies.
Collapse
Affiliation(s)
- Timothy G Freels
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Sara R Westbrook
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Erica Zamberletti
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy
| | - Jacqulyn R Kuyat
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Hayden R Wright
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Alexandra N Malena
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Max W Melville
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Amanda M Brown
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Nicholas C Glodosky
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Darren E Ginder
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Courtney M Klappenbach
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Kristen M Delevich
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
| | - Tiziana Rubino
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy
| | - Ryan J McLaughlin
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, USA
- Department of Psychology, Washington State University, Pullman, Washington, USA
| |
Collapse
|
4
|
Abraham AD, Wiley JL, Marusich JA. Experimenter administered Δ 9-THC decreases nicotine self-administration in a rat model. Pharmacol Biochem Behav 2023; 231:173632. [PMID: 37690617 PMCID: PMC10543614 DOI: 10.1016/j.pbb.2023.173632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The co-use of nicotine and cannabis has been steadily rising in the United States. Rodent studies suggest that delta-9-tetrahydrocannabinol (THC) could increase addictive qualities of nicotine, but whether repeated THC exposure alters self-administration of nicotine has not been tested. We hypothesized that THC would increase the reinforcing effects of nicotine and alter nicotine intake. METHODS Adult male and female Sprague-Dawley rats were treated with THC (0, 3, 30 mg/kg) daily for 14 days prior to and during training for intravenous self-administration of nicotine. Rats were allowed to self-administer nicotine for several weeks, then tested for sensitivity to nicotine dose through multiple determinations of a nicotine dose-effect curve with or without THC pretreatment. A separate set of rats were trained on fixed ratio responding for sucrose and assessed for THC effects on behavior. RESULTS Post-session THC decreased nicotine self-administration in male and female rats throughout acquisition and maintenance and increased the latency to stable rates of nicotine intake during acquisition. Post-session THC shifted nicotine dose-effect curves downward, and pre-session THC suppressed responding at higher nicotine doses. Unlike nicotine, responding for sucrose was not affected by post-session THC. Pre-session THC decreased responding for sucrose, particularly for THC-naïve rats. CONCLUSIONS Repeated post-session THC decreased nicotine-taking behaviors but did not alter sucrose responding. Thus, post-session THC may alter sensitivity to nicotine. Pre-session THC treatment decreased lever pressing in both sucrose and nicotine studies, indicating this effect was nonspecific. These studies show that THC modulates patterns of nicotine intake in rat models.
Collapse
Affiliation(s)
- Antony D Abraham
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC 27709, USA
| | - Jenny L Wiley
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC 27709, USA
| | - Julie A Marusich
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC 27709, USA.
| |
Collapse
|
5
|
Lawn W, Trinci K, Mokrysz C, Borissova A, Ofori S, Petrilli K, Bloomfield M, Haniff ZR, Hall D, Fernandez‐Vinson N, Wang S, Englund A, Chesney E, Wall MB, Freeman TP, Curran HV. The acute effects of cannabis with and without cannabidiol in adults and adolescents: A randomised, double-blind, placebo-controlled, crossover experiment. Addiction 2023; 118:1282-1294. [PMID: 36750134 PMCID: PMC10481756 DOI: 10.1111/add.16154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND AIMS Long-term harms of cannabis may be exacerbated in adolescence, but little is known about the acute effects of cannabis in adolescents. We aimed to (i) compare the acute effects of cannabis in adolescent and adult cannabis users and (ii) determine if cannabidiol (CBD) acutely modulates the effects of delta-9-tetrahydocannabinol (THC). DESIGN Randomised, double-blind, placebo-controlled, crossover experiment. The experiment was registered on ClinicalTrials.gov (NCT04851392). SETTING Laboratory in London, United Kingdom. PARTICIPANTS Twenty-four adolescents (12 women, 16- to 17-year-olds) and 24 adults (12 women, 26- to 29-year-olds) who used cannabis 0.5-3 days/week and were matched on cannabis use frequency (mean = 1.5 days/week). INTERVENTION We administered three weight-adjusted vaporised cannabis flower preparations: 'THC' (8 mg THC for 75 kg person); 'THC + CBD' (8 mg THC and 24 mg CBD for 75 kg person); and 'PLA' (matched placebo). MEASUREMENTS Primary outcomes were (i) subjective 'feel drug effect'; (ii) verbal episodic memory (delayed prose recall); and (iii) psychotomimetic effect (Psychotomimetic States Inventory). FINDINGS Compared with 'PLA', 'THC' and 'THC + CBD' significantly (P < 0.001) increased 'feel drug effect' (mean difference [MD] = 6.3, 95% CI = 5.3-7.2; MD = 6.8, 95% CI = 6.0-7.7), impaired verbal episodic memory (MD = -2.7, 95% CI = -4.1 to -1.4; MD = -2.9, 95% CI = -4.1 to -1.7) and increased psychotomimetic effects (MD = 7.8, 95% CI = 2.8-12.7; MD = 10.8, 95% CI = 6.2-15.4). There was no evidence that adolescents differed from adults in their responses to cannabis (interaction P ≥ 0.4). Bayesian analyses supported equivalent effects of cannabis in adolescents and adults (Bayes factor [BF01 ] >3). There was no evidence that CBD significantly modulated the acute effects of THC. CONCLUSIONS Adolescent cannabis users are neither more resilient nor more vulnerable than adult cannabis users to the acute psychotomimetic, verbal memory-impairing or subjective effects of cannabis. Furthermore, in adolescents and adults, vaporised cannabidiol does not mitigate the acute harms caused by delta-9-tetrahydocannabinol.
Collapse
Affiliation(s)
- Will Lawn
- Department of Psychology, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Anna Borissova
- Department of Neuroimaging, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College HospitalLondonUK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Michael Bloomfield
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College HospitalLondonUK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of PsychiatryUniversity College LondonLondonUK
| | - Zarah R. Haniff
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Daniel Hall
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Natalia Fernandez‐Vinson
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Simiao Wang
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Amir Englund
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Edward Chesney
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Matthew B. Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- Invicro LondonBurlington Danes Building, Hammersmith Hospital, Du Cane RoadLondonUK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - H. Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| |
Collapse
|
6
|
Beckenstrom AC, Coloma PM, Dawson GR, Finlayson AK, Malik A, Post A, Steiner MA, Potenza MN. Use of experimental medicine approaches for the development of novel psychiatric treatments based on orexin receptor modulation. Neurosci Biobehav Rev 2023; 147:105107. [PMID: 36828161 PMCID: PMC10165155 DOI: 10.1016/j.neubiorev.2023.105107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
Despite progress in understanding the pathological mechanisms underlying psychiatric disorders, translation from animal models into clinical use remains a significant bottleneck. Preclinical studies have implicated the orexin neuropeptide system as a potential target for psychiatric disorders through its role in regulating emotional, cognitive, and behavioral processes. Clinical studies are investigating orexin modulation in addiction and mood disorders. Here we review performance-outcome measures (POMs) arising from experimental medicine research methods which may show promise as markers of efficacy of orexin receptor modulators in humans. POMs provide objective measures of brain function, complementing patient-reported or clinician-observed symptom evaluation, and aid the translation from preclinical to clinical research. Significant challenges include the development, validation, and operationalization of these measures. We suggest that collaborative networks comprising clinical practitioners, academics, individuals working in the pharmaceutical industry, drug regulators, patients, patient advocacy groups, and other relevant stakeholders may provide infrastructure to facilitate validation of experimental medicine approaches in translational research and in the implementation of these approaches in real-world clinical practice.
Collapse
Affiliation(s)
- Amy C Beckenstrom
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK.
| | - Preciosa M Coloma
- Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, Allschwil 4123, Switzerland
| | - Gerard R Dawson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Ailidh K Finlayson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK; Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
| | - Asad Malik
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Anke Post
- Corlieve Therapeutics, Swiss Innovation Park, Hegenheimermattweg 167A, 4123 Allschwil, Switzerland
| | | | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, Yale School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA; Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; The Wu Tsai Institute, Yale University, 100 College St, New Haven, CT 06510, USA
| |
Collapse
|
7
|
Abstract
Cannabis exerts an indirect effect on dopamine (DA) output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure, and thus may be associated with aberrant effort-based decision making. The "amotivation syndrome" hypothesis suggests that regular cannabis use results in impaired capacity for goal-directed behavior. However, investigations of this hypothesis have used divergent methodology and have not controlled for key confounding variables. The present study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25; 68% meeting criteria for Cannabis Use Disorder) and noncannabis using (n = 22) students completed the Effort Expenditure for Rewards Task (EEfRT). In generalized estimating equation models, reward magnitude, reward probability, and expected value predicted greater likelihood of selecting a high-effort trial. Furthermore, past-month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a high-effort trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, distress tolerance, income, and delay discounting. The results provide preliminary evidence suggesting that college students who use cannabis are more likely to expend effort to obtain reward, even after controlling for the magnitude of the reward and the probability of reward receipt. Thus, these results do not support the amotivational syndrome hypothesis. Future research with a larger sample is required to evaluate possible associations between cannabis use and patterns of real-world effortful behavior over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
8
|
Skumlien M, Freeman TP, Hall D, Mokrysz C, Wall MB, Ofori S, Petrilli K, Trinci K, Borissova A, Fernandez-Vinson N, Langley C, Sahakian BJ, Curran HV, Lawn W. The Effects of Acute Cannabis With and Without Cannabidiol on Neural Reward Anticipation in Adults and Adolescents. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:219-229. [PMID: 36642667 DOI: 10.1016/j.bpsc.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adolescents may respond differently to cannabis than adults, yet no previous functional magnetic resonance imaging study has examined acute cannabis effects in this age group. In this study, we investigated the neural correlates of reward anticipation after acute exposure to cannabis in adolescents and adults. METHODS This was a double-blind, placebo-controlled, randomized, crossover experiment. Forty-seven adolescents (n = 24, 12 females, ages 16-17 years) and adults (n = 23, 11 females, ages 26-29 years) matched on cannabis use frequency (0.5-3 days/week) completed the Monetary Incentive Delay task during functional magnetic resonance imaging after inhaling cannabis with 0.107 mg/kg Δ⁹-tetrahydrocannabinol ("THC") (8 mg THC for a 75-kg person) or with THC plus 0.320 mg/kg cannabidiol ("THC+CBD") (24 mg CBD for a 75-kg person), or placebo cannabis. We investigated reward anticipation activity with whole-brain analyses and region of interest analyses in the right and left ventral striatum, right and left anterior cingulate cortex, and right insula. RESULTS THC reduced anticipation activity compared with placebo in the right (p = .005, d= 0.49) and left (p = .003, d = 0.50) ventral striatum and the right insula (p = .01, d = 0.42). THC+CBD reduced activity compared with placebo in the right ventral striatum (p = .01, d = 0.41) and right insula (p = .002, d = 0.49). There were no differences between "THC" and "THC+CBD" conditions and no significant drug by age group interaction effect, supported by Bayesian analyses. There were no significant effects in the whole-brain analyses. CONCLUSIONS In weekly cannabis users, cannabis suppresses the brain's anticipatory reward response to money, and CBD does not modulate this effect. Furthermore, the adolescent reward circuitry is not differentially sensitive to acute effects of cannabis on reward anticipation.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom.
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom
| | - Daniel Hall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Invicro, London, United Kingdom; Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom
| | - Katie Trinci
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Natalia Fernandez-Vinson
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
9
|
Freels TG, Westbrook SR, Wright HR, Kuyat JR, Zamberletti E, Malena AM, Melville MW, Brown AM, Glodosky NC, Ginder DE, Klappenbach CM, Delevich KM, Rubino T, McLaughlin RJ. Sex differences in adolescent cannabis vapor self-administration mediate enduring effects on behavioral flexibility and prefrontal microglia activation in rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.21.524468. [PMID: 36711651 PMCID: PMC9882275 DOI: 10.1101/2023.01.21.524468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cannabis is the most used illicit drug in the United States. With many states passing legislation to permit its recreational use, there is concern that cannabis use among adolescents could increase dramatically in the coming years. Historically, it has been difficult to model real-world cannabis use to investigate the causal relationship between cannabis use in adolescence and behavioral and neurobiological effects in adulthood. To this end, we used a novel volitional vapor administration model to investigate long-term effects of cannabis use during adolescence on the medial prefrontal cortex (mPFC) and mPFC-dependent behaviors in male and female rats. Adolescent (35-55 day old) female rats had significantly higher rates of responding for vaporized Δ9-tetrahydrocannabinol (THC)-dominant cannabis extract (CANTHC) compared to adolescent males. In adulthood (70-110 day old), female, but not male, CANTHC rats also took more trials to reach criterion and made more regressive errors in an automated attentional set-shifting task compared to vehicle rats. Similar set-shifting deficits were observed in males when they were exposed to a non-contingent CANTHC vapor dosing regimen that approximated CANTHC self-administration rates in females. No differences were observed in effort-based decision making in either sex. In the mPFC, female (but not male) CANTHC rats displayed more reactive microglia with no significant changes in myelin basic protein expression or dendritic spine density. Together, these data reveal important sex differences in rates of cannabis vapor self-administration in adolescence that confer enduring alterations to mPFC structure and function. Importantly, female-specific deficits in behavioral flexibility appear to be driven by elevated rates of CANTHC self-administration as opposed to a sex difference in the effects of CANTHC vapor per se.
Collapse
Affiliation(s)
- Timothy G. Freels
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Sara R. Westbrook
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Hayden R. Wright
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Jacqulyn R. Kuyat
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Erica Zamberletti
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy
| | - Alexandra M. Malena
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Max W. Melville
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Amanda M. Brown
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | | | - Darren E. Ginder
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Courtney M. Klappenbach
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Kristen M. Delevich
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Tiziana Rubino
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy
| | - Ryan J. McLaughlin
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
- Department of Psychology, Washington State University, Pullman, WA, USA
| |
Collapse
|
10
|
Skumlien M, Mokrysz C, Freeman TP, Valton V, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Giugliano M, Clisu D, Langley C, Sahakian BJ, Curran HV, Lawn W. Anhedonia, Apathy, Pleasure, and Effort-Based Decision-Making in Adult and Adolescent Cannabis Users and Controls. Int J Neuropsychopharmacol 2023; 26:9-19. [PMID: 35999024 PMCID: PMC9850660 DOI: 10.1093/ijnp/pyac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cannabis use may be linked with anhedonia and apathy. However, previous studies have shown mixed results, and few have examined the association between cannabis use and specific reward sub-processes. Adolescents may be more vulnerable than adults to harmful effects of cannabis. This study investigated (1) the association between non-acute cannabis use and apathy, anhedonia, pleasure, and effort-based decision-making for reward; and (2) whether these relationships were moderated by age group. METHODS We used data from the "CannTeen" study. Participants were 274 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 d/wk use in the past 3 months) and gender- and age-matched controls. Anhedonia was measured with the Snaith-Hamilton Pleasure Scale (n = 274), and apathy was measured with the Apathy Evaluation Scale (n = 215). Effort-based decision-making for reward was measured with the Physical Effort task (n = 139), and subjective wanting and liking of rewards was measured with the novel Real Reward Pleasure task (n = 137). RESULTS Controls had higher levels of anhedonia than cannabis users (F1,258 = 5.35, P = .02, η p2 = .02). There were no other significant effects of user-group and no significant user-group*age-group interactions. Null findings were supported by post hoc Bayesian analyses. CONCLUSION Our results suggest that cannabis use at a frequency of 3 to 4 d/wk is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents. Cannabis users had lower anhedonia than controls, albeit at a small effect size. These findings are not consistent with the hypothesis that non-acute cannabis use is associated with amotivation.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Vincent Valton
- Institute of Cognitive Neuroscience, Division of Psychology and Language Sciences, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | | | - Rachel Lees
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Manuela Giugliano
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Denisa Clisu
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| |
Collapse
|
11
|
Morissette SB, Blessing A, Russell P, Hale W. Cannabis use disorder uniquely predicts educational impairment in college students over and above other mental health disorders. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 36595591 DOI: 10.1080/07448481.2022.2155058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/20/2022] [Accepted: 09/25/2022] [Indexed: 06/17/2023]
Abstract
Objective: The impact of cannabis use disorder (CUD) on education functioning and GPA was examined within the context of co-occurring alcohol use disorder (AUD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Participants: Undergraduates (N = 210) who reported using cannabis within the past six months were recruited. Methods: Hierarchical multiple regression analyses were used to determine whether CUD symptom severity and presence of probable CUD diagnosis predicted educational impairment and current GPA, over and above other mental health conditions. Results: CUD symptom severity, but not probable CUD, significantly predicted greater educational impairment, over and above probable PTSD and MDD, which were also significant predictors. CUD symptom severity, but not probable CUD, significantly predicted lower GPA. Conclusion: In addition to other common mental health conditions, CUD may be an important area of assessment and intervention for university counseling centers to foster student academic success.
Collapse
Affiliation(s)
| | - Alexis Blessing
- The University of Texas at San Antonio, San Antonio, Texas, USA
| | | | - Willie Hale
- The University of Texas at San Antonio, San Antonio, Texas, USA
| |
Collapse
|
12
|
Johnstone S, Lowe DJE, Kozak-Bidzinski K, Sanches M, Castle DJ, Rabin JS, Rabin RA, George TP. Neurocognitive moderation of repetitive transcranial magnetic stimulation (rTMS) effects on cannabis use in schizophrenia: a preliminary analysis. SCHIZOPHRENIA 2022; 8:99. [PMCID: PMC9668838 DOI: 10.1038/s41537-022-00303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022]
Abstract
AbstractRepetitive transcranial magnetic stimulation (rTMS) is a promising treatment for cannabis use disorder in schizophrenia; however, gaps in the literature remain as to the potential role of neurocognitive functioning in treatment response. We evaluated the moderating role of select cognitive functions including baseline executive functioning, verbal memory, and sustained attention, and we explore the mediating role of changes in task performance on changes in cannabis use in both active and sham rTMS groups. Participants underwent high-frequency (20 Hz) rTMS applied to the bilateral dorsolateral prefrontal cortex 5x/week for 4 weeks. Weekly self-report of cannabis use and semi-quantitative urinary carboxy-tetrahydrocannabinol levels were recorded. A neurocognitive battery assessing verbal memory, visuospatial working memory, verbal working memory, sustained attention, delayed discounting, and complex planning was administered pre- and post-treatment. Better baseline performance on tasks assessing sustained attention, delayed discounting, and complex planning moderated the extent to which participants in the active group reduced cannabis use. There were no significant indirect pathways between treatment, changes in neuropsychological performance, and changes in cannabis use; however, active rTMS improved complex planning and sustained attention. These preliminary findings suggest that there is a moderating role of sustained attention, delayed discounting, and complex planning on the effects of rTMS on cannabis use. Further, mediation models suggest rTMS may exert direct effects on cannabis use independent of its effects on cognitive functioning in people with SCZ. Trial Registration: clinicaltrials.gov: NCT03189810.
Collapse
|
13
|
Does cannabidiol make cannabis safer? A randomised, double-blind, cross-over trial of cannabis with four different CBD:THC ratios. Neuropsychopharmacology 2022; 48:869-876. [PMID: 36380220 PMCID: PMC10156730 DOI: 10.1038/s41386-022-01478-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
As countries adopt more permissive cannabis policies, it is increasingly important to identify strategies that can reduce the harmful effects of cannabis use. This study aimed to determine if increasing the CBD content of cannabis can reduce its harmful effects. Forty-six healthy, infrequent cannabis users participated in a double-blind, within-subject, randomised trial of cannabis preparations varying in CBD content. There was an initial baseline visit followed by four drug administration visits, in which participants inhaled vaporised cannabis containing 10 mg THC and either 0 mg (0:1 CBD:THC), 10 mg (1:1), 20 mg (2:1), or 30 mg (3:1) CBD, in a randomised, counter-balanced order. The primary outcome was change in delayed verbal recall on the Hopkins Verbal Learning Task. Secondary outcomes included change in severity of psychotic symptoms (e.g., Positive and Negative Syndrome Scale [PANSS] positive subscale), plus further cognitive, subjective, pleasurable, pharmacological and physiological effects. Serial plasma concentrations of THC and CBD were measured. THC (0:1) was associated with impaired delayed verbal recall (t(45) = 3.399, d = 0.50, p = 0.001) and induced positive psychotic symptoms on the PANSS (t(45) = -4.709, d = 0.69, p = 2.41 × 10-5). These effects were not significantly modulated by any dose of CBD. Furthermore, there was no evidence of CBD modulating the effects of THC on other cognitive, psychotic, subjective, pleasurable, and physiological measures. There was a dose-response relationship between CBD dose and plasma CBD concentration, with no effect on plasma THC concentrations. At CBD:THC ratios most common in medicinal and recreational cannabis products, we found no evidence that CBD protects against the acute adverse effects of cannabis. This should be considered in health policy and safety decisions about medicinal and recreational cannabis.
Collapse
|
14
|
The Role of Reduced Motivational Salience in a Survey Study on Cannabis Use Pre-Post Legalization in Patients with Schizophrenia. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
15
|
Neutral CB1 Receptor Antagonists as Pharmacotherapies for Substance Use Disorders: Rationale, Evidence, and Challenge. Cells 2022; 11:cells11203262. [PMID: 36291128 PMCID: PMC9600259 DOI: 10.3390/cells11203262] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Cannabinoid receptor 1 (CB1R) has been one of the major targets in medication development for treating substance use disorders (SUDs). Early studies indicated that rimonabant, a selective CB1R antagonist with an inverse agonist profile, was highly promising as a therapeutic for SUDs. However, its adverse side effects, such as depression and suicidality, led to its withdrawal from clinical trials worldwide in 2008. Consequently, much research interest shifted to developing neutral CB1R antagonists based on the recognition that rimonabant’s side effects may be related to its inverse agonist profile. In this article, we first review rimonabant’s research background as a potential pharmacotherapy for SUDs. Then, we discuss the possible mechanisms underlying its therapeutic anti-addictive effects versus its adverse effects. Lastly, we discuss the rationale for developing neutral CB1R antagonists as potential treatments for SUDs, the supporting evidence in recent research, and the challenges of this strategy. We conclude that developing neutral CB1R antagonists without inverse agonist profile may represent attractive strategies for the treatment of SUDs.
Collapse
|
16
|
Murray CH, Glazer JE, Lee R, Nusslock R, de Wit H. Δ9-THC reduces reward-related brain activity in healthy adults. Psychopharmacology (Berl) 2022; 239:2829-2840. [PMID: 35612654 PMCID: PMC10560585 DOI: 10.1007/s00213-022-06164-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE Greater availability of cannabis in the USA has raised concerns about adverse effects of the drug, including possible amotivational states. Lack of motivation may be assessed by examining acute effects of cannabinoids on reward processing. OBJECTIVES This study examined single doses of delta-9-tetrahydrocannabinol (∆9-THC; 7.5, 15 mg oral) in healthy adults using a version of the monetary incentive delay (MID) task adapted for electroencephalography (EEG; e-MID) in a within-subjects, double blind design. METHODS Two phases of reward processing were examined: anticipation, which occurs with presentation of cues that indicate upcoming reward, punishment, or neutral conditions, and outcome, which occurs with feedback indicating hits or misses. During anticipation, we measured two event-related potential (ERP) components: the P300, which measures attention and motivation, and the LPP, which measures affective processing. During outcome processing, we measured P300 and LPP, as well as the RewP, which measures outcome evaluation. RESULTS We found that ∆9-THC modulated outcome processing, but not reward anticipation. Specifically, both doses of ∆9-THC (7.5 and 15 mg) reduced RewP amplitudes after outcome feedback (hits and misses) relative to placebo. ∆9-THC (15 mg) also reduced P300 and LPP amplitudes following hits compared to misses, relative to both placebo and 7.5 mg ∆9-THC. CONCLUSIONS These findings suggest that ∆9-THC dampens responses to both reward and loss feedback, which may reflect an "amotivational" state. Future studies are needed to determine generalizability of this effect, such as its pharmacological specificity and its specificity to monetary vs other types of reward.
Collapse
Affiliation(s)
- Conor H Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - James E Glazer
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA.
| |
Collapse
|
17
|
Kluger BM, Huang AP, Miyasaki JM. Cannabinoids in movement disorders. Parkinsonism Relat Disord 2022; 102:124-130. [PMID: 36038457 DOI: 10.1016/j.parkreldis.2022.08.014] [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] [Received: 07/16/2021] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION On the basis of both scientific progress and popular lore, there is growing optimism in the therapeutic potential of cannabis (marijuana) and cannabinoid-based chemicals for movement disorders. There is also notable skepticism regarding the scientific basis for this therapeutic optimism and significant concerns regarding the safety and regulation of cannabinoid products, particularly those available without prescription. METHODS In recognition of the high interest and controversial nature of this subject, the meeting committee of the International Parkinson and Movement Disorders Society arranged for a talk on cannabis at the 2019 annual meeting's Controversies in Movement Disorders plenary session. This paper summarizes the highlights of this session. RESULTS The endocannabinoid system is strongly tied to motor function and dysfunction, with basic research suggesting several promising therapeutic targets related to cannabinoids for movement disorders. Clinical research on cannabinoids for motor and nonmotor symptoms in Parkinson's disease, Huntington's disease, Tourette's syndrome, dystonia, and other movement disorders to date are promising at best and inconclusive or negative at worst. Research in other populations suggest efficacy for common symptoms like pain. While social campaigns against recreational cannabinoid use focus on cognitive changes in adolescents, the long-term sequelae of regulated medical use in older adults with movement disorders is unknown. The overall risks of cannabinoids may be similar to other commonly used medications and include falls and apathy. CONCLUSION Further research is greatly needed to better understand the actual clinical benefits and long-term side effects of medical cannabis products for movement disorders indications and populations.
Collapse
Affiliation(s)
- Benzi M Kluger
- Departments of Neurology and Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Andrew P Huang
- Departments of Neurology and Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Janis M Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
18
|
Vele KC, Cavalli JM, Cservenka A. Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension. J Clin Exp Neuropsychol 2022; 44:146-162. [PMID: 35767680 DOI: 10.1080/13803395.2022.2093335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Amotivational syndrome is a term used to refer to lack of motivation and passive personality related to chronic cannabis use. Given mixed findings, the current study aimed to replicate and extend previous research on frequent cannabis use, motivated behavior, and self-reported apathy. METHOD Cannabis users (on average, ≥3 days/week of cannabis use over the past year), and healthy controls (≤1 day/month of cannabis use over the past year) completed the Apathy Evaluation Scale (AES), and the Effort Expenditure for Rewards Task (EEfRT). Repeated measures analysis of covariance was used to 1) examine the effects of group, reward magnitude, probability, and their interaction on hard task selections on the EEfRT, and 2) examine between-group differences on the AES, controlling for alcohol use and depressive symptoms. RESULTS There were significant main effects of reward magnitude, probability, and an interaction between reward magnitude and probability on hard task selection (p's < 0.05). Specifically, as reward magnitude and probability of winning the reward increased, participants were more likely to select hard tasks on the EEfRT. Relative to healthy controls, cannabis users were significantly more likely to select hard tasks on the EEfRT (F(1,56) = 6.49, p = 0.014, ηp2 = 0.10). When controlling for alcohol use and depressive symptoms, no significant group differences in self-reported apathy were present (p = 0.46). CONCLUSIONS Cannabis users exhibit a greater likelihood of exerting more effort for reward, suggesting enhanced motivation relative to healthy controls. Thus, the current results do not support amotivational syndrome in adult frequent cannabis users. Despite some harms of long-term cannabis use, amotivation may not be among them.
Collapse
Affiliation(s)
- Kimberly C Vele
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| | - Jessica M Cavalli
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| | - Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| |
Collapse
|
19
|
Wall MB, Freeman TP, Hindocha C, Demetriou L, Ertl N, Freeman AM, Jones AP, Lawn W, Pope R, Mokrysz C, Solomons D, Statton B, Walker HR, Yamamori Y, Yang Z, Yim JL, Nutt DJ, Howes OD, Curran HV, Bloomfield MA. Individual and combined effects of cannabidiol and Δ 9-tetrahydrocannabinol on striato-cortical connectivity in the human brain. J Psychopharmacol 2022; 36:732-744. [PMID: 35596578 PMCID: PMC9150138 DOI: 10.1177/02698811221092506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the two major constituents of cannabis with contrasting mechanisms of action. THC is the major psychoactive, addiction-promoting, and psychotomimetic compound, while CBD may have opposite effects. The brain effects of these drugs alone and in combination are poorly understood. In particular, the striatum is implicated in the pathophysiology of several psychiatric disorders, but it is unclear how THC and CBD influence striato-cortical connectivity. AIMS To examine effects of THC, CBD, and THC + CBD on functional connectivity of striatal sub-divisions (associative, limbic and sensorimotor). METHOD Resting-state functional Magnetic Resonance Imaging (fMRI) was used across two within-subjects, placebo-controlled, double-blind studies, with a unified analysis approach. RESULTS Study 1 (N = 17; inhaled cannabis containing 8 mg THC, 8 mg THC + 10 mg CBD or placebo) showed strong disruptive effects of both THC and THC + CBD on connectivity in the associative and sensorimotor networks, but a specific effect of THC in the limbic striatum network which was not present in the THC + CBD condition. In Study 2 (N = 23, oral 600 mg CBD, placebo), CBD increased connectivity in the associative network, but produced only relatively minor disruptions in the limbic and sensorimotor networks. OUTCOMES THC strongly disrupts striato-cortical networks, but this effect is mitigated by co-administration of CBD in the limbic striatum network. Oral CBD administered has a more complex effect profile of relative increases and decreases in connectivity. The insula emerges as a key region affected by cannabinoid-induced changes in functional connectivity, with potential implications for understanding cannabis-related disorders, and the development of cannabinoid therapeutics.
Collapse
Affiliation(s)
- Matthew B Wall
- Invicro London, London, UK.,Clinical Psychopharmacology Unit, University College London, London, UK.,Faculty of Medicine, Imperial College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK.,Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Lysia Demetriou
- Invicro London, London, UK.,Faculty of Medicine, Imperial College London, London, UK.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Natalie Ertl
- Invicro London, London, UK.,Faculty of Medicine, Imperial College London, London, UK
| | - Abigail M Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rebecca Pope
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Ben Statton
- MRC London Institute of Medical Sciences, London, UK
| | - Hannah R Walker
- Division of Psychiatry, University College London, London, UK
| | - Yumeya Yamamori
- Division of Psychiatry, University College London, London, UK
| | - Zixu Yang
- Faculty of Medicine, Imperial College London, London, UK
| | - Jocelyn Ll Yim
- Division of Psychiatry, University College London, London, UK
| | - David J Nutt
- Faculty of Medicine, Imperial College London, London, UK
| | - Oliver D Howes
- MRC London Institute of Medical Sciences, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | |
Collapse
|
20
|
Rosen AS, Hirst RB, Brown C, Arastu S, Hedbabny K. Eyewitness Recall, Lineup Identification, and Verbal and Visual Memory Among Chronic Cannabis Users After a Minimum of 24‐Hours Abstinence. APPLIED COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1002/acp.3962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Rayna B. Hirst
- Department of Psychology Palo Alto University United States
| | - Colin Brown
- Department of Psychology Palo Alto University United States
| | - Sana Arastu
- Department of Psychology Palo Alto University United States
| | | |
Collapse
|
21
|
Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010523. [PMID: 35010782 PMCID: PMC8744706 DOI: 10.3390/ijerph19010523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
Abstract
Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.
Collapse
|
22
|
Wardle MC, Pabon E, Webber HE, de Wit H. Delta-9-tetrahydrocannabinol reduces willingness to exert effort in women. Psychopharmacology (Berl) 2022; 239:1487-1497. [PMID: 35102424 PMCID: PMC8803458 DOI: 10.1007/s00213-021-06032-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of cannabis has been clinically associated with decreased motivation to engage in normally rewarding activities. However, evidence from previous controlled studies is mixed. METHOD In this study, we examined the effects of acute delta-9-tetrahydrocannabinol (THC) versus placebo on a task measuring willingness to exert effort for rewards. This is a secondary analysis of a larger study examining interactions between ovarian hormones and THC. In this within-subjects study, oral THC and placebo were administered under double-blind conditions in counterbalanced order to healthy young adult (M age = 24 years) women with previous cannabis experience who were not regular users. Forty subjects completed three 4-h sessions with PL, 7.5 and 15 mg THC, while an additional 18 completed only PL and 15 mg THC sessions (design abridged due to pandemic). At each session, they completed a task consisting of making repeated choices between a hard and an easy task, which were worth varying amounts of money at varying probabilities. RESULTS THC dose-dependently decreased hard task choices (drug effect, b = - 0.79, SE = 0.29, z = - 2.67, p < 0.01), especially at moderate to high expected values of reward (drug × probability × amount interaction, b = 0.77, SE = 0.38, z = 1.99, p = 0.04). THC also slowed task performance (drug effect, b = 0.01, SE = 0.005, t(5.24) = 2.11, p = 0.04), but the effect of THC on choice was still significant after controlling for this psychomotor slowing. CONCLUSIONS These findings support the idea that cannabis acutely reduces motivation to earn non-drug rewards. Still to be determined are the neurochemical mechanisms underlying this effect.
Collapse
Affiliation(s)
- Margaret C. Wardle
- Department of Psychology, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL 60607 USA
| | - Elisa Pabon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| | - Heather E. Webber
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| |
Collapse
|
23
|
Abstract
BACKGROUND Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing. AIMS We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine. METHODS This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis RESULTS: There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC. CONCLUSIONS There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.
Collapse
|
24
|
Skumlien M, Langley C, Lawn W, Voon V, Curran HV, Roiser JP, Sahakian BJ. The acute and non-acute effects of cannabis on reward processing: A systematic review. Neurosci Biobehav Rev 2021; 130:512-528. [PMID: 34509513 DOI: 10.1016/j.neubiorev.2021.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/11/2021] [Accepted: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Cannabis use has historically been thought to cause amotivation, but the relationship between cannabis and apathy, anhedonia, and reward processing remains poorly characterised. In this systematic review, we evaluated whether cannabis exposure acutely and/or non-acutely was associated with altered reward processing using questionnaire, behavioural, or functional neuroimaging measures. Questionnaire studies demonstrated greater anhedonia in adolescent cannabis users, and some indication of greater apathy in young adult cannabis users. Behavioural studies yielded some evidence of reduced reward learning in adolescent cannabis users, though there were too few studies in this category for reliable conclusions. Finally, longitudinal and acute functional neuroimaging studies showed an association between cannabis and blunted neural responses to reward, which did not emerge consistently in cross-sectional studies. The current results suggest that cannabis use is associated with specific impairments in reward and motivation. Future large-scale, longitudinal studies which use multiple behavioural and neuroimaging measures of reward processing may further clarify the impact of cannabis use on motivational and reward processes, and neural networks.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | | | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | | |
Collapse
|
25
|
Minichino A, Jackson MA, Francesconi M, Steves CJ, Menni C, Burnet PWJ, Lennox BR. Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort. Mol Psychiatry 2021; 26:6269-6276. [PMID: 34002020 PMCID: PMC8760063 DOI: 10.1038/s41380-021-01147-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 02/02/2023]
Abstract
Anhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2 ± 7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (β = -0.37; 95%CI: -0.71 to -0.03; P = 0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (β = -0.13; 95%CI: -0.24 to -0.01; P = 0.03), as was the total effect (β = -0.38; 95%CI: -0.72 to -0.04; P = 0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (β = -0.25; 95%CI: -0.60 to 0.09; P = 0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.
Collapse
Affiliation(s)
| | | | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
| | | | - Belinda R Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| |
Collapse
|
26
|
Mokrysz C, Shaban NDC, Freeman TP, Lawn W, Pope RA, Hindocha C, Freeman A, Wall MB, Bloomfield MAP, Morgan CJA, Nutt DJ, Curran HV. Acute effects of cannabis on speech illusions and psychotic-like symptoms: two studies testing the moderating effects of cannabidiol and adolescence. Psychol Med 2021; 51:2134-2142. [PMID: 32340632 DOI: 10.1017/s0033291720001038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Acute cannabis administration can produce transient psychotic-like effects in healthy individuals. However, the mechanisms through which this occurs and which factors predict vulnerability remain unclear. We investigate whether cannabis inhalation leads to psychotic-like symptoms and speech illusion; and whether cannabidiol (CBD) blunts such effects (study 1) and adolescence heightens such effects (study 2). METHODS Two double-blind placebo-controlled studies, assessing speech illusion in a white noise task, and psychotic-like symptoms on the Psychotomimetic States Inventory (PSI). Study 1 compared effects of Cann-CBD (cannabis containing Δ-9-tetrahydrocannabinol (THC) and negligible levels of CBD) with Cann+CBD (cannabis containing THC and CBD) in 17 adults. Study 2 compared effects of Cann-CBD in 20 adolescents and 20 adults. All participants were healthy individuals who currently used cannabis. RESULTS In study 1, relative to placebo, both Cann-CBD and Cann+CBD increased PSI scores but not speech illusion. No differences between Cann-CBD and Cann+CBD emerged. In study 2, relative to placebo, Cann-CBD increased PSI scores and incidence of speech illusion, with the odds of experiencing speech illusion 3.1 (95% CIs 1.3-7.2) times higher after Cann-CBD. No age group differences were found for speech illusion, but adults showed heightened effects on the PSI. CONCLUSIONS Inhalation of cannabis reliably increases psychotic-like symptoms in healthy cannabis users and may increase the incidence of speech illusion. CBD did not influence psychotic-like effects of cannabis. Adolescents may be less vulnerable to acute psychotic-like effects of cannabis than adults.
Collapse
Affiliation(s)
- Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rebecca A Pope
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Abigail Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK
- Invicro, Burlington Danes Building, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
- Division of Brain Sciences, Imperial College London, London, UK
| | - Michael A P Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, UK
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
- Division of Psychiatry, Translational Psychiatry Research Group, University College London, Maple House, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospitals NHS Foundation Trust, London, UK
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK
- Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, Burlington Danes Building, Du Cane Road, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
27
|
Brassard SL, Balodis IM. A review of effort-based decision-making in eating and weight disorders. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110333. [PMID: 33905755 DOI: 10.1016/j.pnpbp.2021.110333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/19/2021] [Accepted: 04/21/2021] [Indexed: 12/26/2022]
Abstract
Effort-based decision-making provides a framework to understand the mental computations estimating the amount of work ("effort") required to obtain a reward. The aim of the current review is to systematically synthesize the available literature on effort-based decision-making across the spectrum of eating and weight disorders. More specifically, the current review summarises the literature examining whether 1) individuals with eating disorders and overweight/obesity are willing to expend more effort for rewards compared to healthy controls, 2) if particular components of effort-based decision-making (i.e. risk, discounting) relate to specific binge eating conditions, and 3) how individual differences in effort and reward -processing measures relate to eating pathology and treatment measures. A total of 96 studies were included in our review, following PRISMA guidelines. The review suggests that individuals with binge eating behaviours 1) are more likely to expend greater effort for food rewards, but not monetary rewards, 2) demonstrate greater decision-making impairments under risk and uncertainty, 3) prefer sooner rather than delayed rewards for both food and money, and 4) demonstrate increased implicit 'wanting' for high fat sweet foods. Finally, individual differences in effort and reward -processing measures relating to eating pathology and treatment measures are also discussed.
Collapse
Affiliation(s)
- Sarah L Brassard
- Department of Neuroscience, McMaster University, Canada; Peter Boris Center for Addictions Research, St. Joseph's Healthcare Hamilton, Canada
| | - Iris M Balodis
- Department of Neuroscience, McMaster University, Canada; Peter Boris Center for Addictions Research, St. Joseph's Healthcare Hamilton, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, Canada.
| |
Collapse
|
28
|
Abstract
OBJECTIVE Acute Δ9-tetrahydrocannabinol (THC) administration in humans (Lawn etal., 2016) and rats (Silveira, Adams, Morena, Hill, & Winstanley, 2016) has been associated with decreased effort allocation that may explain amotivation during acute cannabis intoxication. To date, however, whether residual effects of cannabis use on effort-based decision-making are present and observable in humans have not yet been determined. The goal of this study was to test whether prolonged cannabis use has residual effects on effort-based decision-making in 24-hr abstinent cannabis using adults. METHOD We evaluated performance on the Effort Expenditure for Reward Task (EEfRT) in 41 adult cannabis users (mean age = 24.63 years, 21 males) and 45 nonusers (mean age = 23.90 years, 19 males). A mixed 2x3x3 ANOVA with age as a covariate was performed to examine the effect of group, probability of winning, and reward amount on EEfRT performance. EEfRT performance was operationalized as % of trials for which the hard (vs. easy) condition was chosen. Pearson's correlations were conducted to test the relationship between EEfRT performance and measures of cannabis use, anhedonia and motivation. RESULTS We found that cannabis users selected hard trials significantly more than nonusers regardless of win probability or reward level. Frequency of cannabis use was positively correlated with amount of % hard trials chosen. There were no significant correlations between % hard trials chosen, self-reported anhedonia, or motivation. CONCLUSIONS These results suggest that unlike acute effects, residual effects of cannabis following 24 hrs of abstinence are associated with greater effort allocation during effort-based decision-making.
Collapse
|
29
|
Freeman AM, Mokrysz C, Hindocha C, Lawn W, Morgan CJ, Freeman TP, Saunders R, Curran HV. Does variation in trait schizotypy and frequency of cannabis use influence the acute subjective, cognitive and psychotomimetic effects of delta-9-tetrahydrocannabinol? A mega-analysis. J Psychopharmacol 2021; 35:804-813. [PMID: 33427016 DOI: 10.1177/0269881120959601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While the acute effects of cannabis are relatively benign for most users, some individuals experience significant adverse effects. This study aimed to identify whether variation in schizotypal personality traits and frequency of cannabis use influence the acute effects of delta-9-tetrahydrocannabinol (THC). METHODS Individual participant data from four double-blind, randomised, placebo-controlled, acute crossover studies involving 128 cannabis users were combined for a mega-analysis. Using multilevel linear models and moderation analyses, frequency of cannabis use and schizotypal personality traits were investigated as potential moderators of the subjective, cognitive and psychotomimetic effects of acute THC. RESULTS There was evidence of a moderating effect where increased frequency of cannabis use was associated with reduced intensity of subjective (changes in alertness and feeling stoned) and psychosis-like effects following THC when compared with placebo. Moderating effects of cannabis use frequency on acute memory impairment were weak. Trait schizotypy did not moderate the acute psychosis-like effects of THC compared with placebo. CONCLUSIONS Our results suggest that a pattern of domain-specific tolerance develops to the acute effects of THC. Tolerance to the alertness-reducing effects occurred more readily than tolerance to psychotomimetic effects. Only partial tolerance to feeling stoned was found, and there was weak evidence for tolerance to memory impairment. Trait schizotypy did not moderate THC's effects on psychotomimetic symptoms.
Collapse
Affiliation(s)
- Abigail M Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - Celia Ja Morgan
- Psychopharmacology and Addiction Research Centre (PARC), Department of Psychology, University of Exeter, Exeter, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| |
Collapse
|
30
|
Langlois C, Potvin S, Khullar A, Tourjman SV. Down and High: Reflections Regarding Depression and Cannabis. Front Psychiatry 2021; 12:625158. [PMID: 34054594 PMCID: PMC8160288 DOI: 10.3389/fpsyt.2021.625158] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/15/2021] [Indexed: 12/20/2022] Open
Abstract
In light of the recent changes in the legal status of cannabis in Canada, the understanding of the potential impact of the use of cannabis by individuals suffering from depression is increasingly considered as being important. It is fundamental that we look into the existing literature to examine the influence of cannabis on psychiatric conditions, including mood disorders. In this article, we will explore the relationship that exists between depression and cannabis. We will examine the impact of cannabis on the onset and course of depression, and its treatment. We have undertaken a wide-ranging review of the literature in order to address these questions. The evidence from longitudinal studies suggest that there is a bidirectional relationship between cannabis use and depression, such that cannabis use increases the risk for depression and vice-versa. This risk is possibly higher in heavy users having initiated their consumption in early adolescence. Clinical evidence also suggests that cannabis use is associated with a worse prognosis in individuals with major depressive disorder. The link with suicide remains controversial. Moreover, there is insufficient data to determine the impact of cannabis use on cognition in individuals with major depression disorder. Preliminary evidence suggesting that the endogenous cannabinoid system is involved in the pathophysiology of depression. This will need to be confirmed in future positron emission tomography studies. Randomized controlled trials are needed to investigate the potential efficacy of motivational interviewing and/or cognitive behavioral therapy for the treatment of cannabis use disorder in individuals with major depressive major disorder. Finally, although there is preclinical evidence suggesting that cannabidiol has antidepressant properties, randomized controlled trials will need to properly investigate this possibility in humans.
Collapse
Affiliation(s)
| | - Stéphane Potvin
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Atul Khullar
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Smadar Valérie Tourjman
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| |
Collapse
|
31
|
Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies. Curr Opin Psychol 2021; 38:19-24. [DOI: 10.1016/j.copsyc.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/31/2023]
|
32
|
Laksmidewi AAAP, Soejitno A. Endocannabinoid and dopaminergic system: the pas de deux underlying human motivation and behaviors. J Neural Transm (Vienna) 2021; 128:615-630. [PMID: 33712975 PMCID: PMC8105194 DOI: 10.1007/s00702-021-02326-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/04/2021] [Indexed: 01/11/2023]
Abstract
Endocannabinoid system (ECS) has been identified ever since cannabinoid, an active substance of Cannabis, was known to interact with endogenous cannabinoid (endocannabinoid/eCB) receptors. It later turned out that eCB was more intricate than previously thought. It has a pervasive role and exerts a multitude of cellular signaling mechanisms, regulating various physiological neurotransmission pathways in the human brain, including the dopaminergic (DA) system. eCB roles toward DA system were robust, clearly delineated, and reproducible with respect to physiological as well as pathological neurochemical and neurobehavioral manifestations of DA system, particularly those involving the nigrostriatal and mesocorticolimbic pathways. The eCB–DA system regulates the basics in the Maslow’s pyramid of hierarchy of needs required for individual survival such as food and sexual activity for reproductive purpose to those of higher needs in the pyramid, including self-actualization behaviors leading to achievement and reward (e.g., academic- and/or work-related performance and achievements). It is, thus, interesting to specifically discuss the eCB–DA system, not only on the molecular level, but also its tremendous potential to be developed as a future therapeutic strategy for various neuropsychiatric problems, including obesity, drug addiction and withdrawal, pathological hypersexuality, or low motivation behaviors.
Collapse
Affiliation(s)
- A A A Putri Laksmidewi
- Neurobehavioral and Cognitive Division, Neurology Department, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia.
| | - Andreas Soejitno
- Neurobehavioral and Cognitive Division, Neurology Department, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia
| |
Collapse
|
33
|
Bourque J, Potvin S. Cannabis and Cognitive Functioning: From Acute to Residual Effects, From Randomized Controlled Trials to Prospective Designs. Front Psychiatry 2021; 12:596601. [PMID: 34177633 PMCID: PMC8222623 DOI: 10.3389/fpsyt.2021.596601] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/17/2021] [Indexed: 12/30/2022] Open
Abstract
In recent years, several jurisdictions have revised their regulation policy toward both medical and recreational use of cannabis. These changes have elicited concerns regarding how legalization impacts academic achievement and work performance. This review evaluates the acute and long-term (residual) association between cannabis use and cognitive functioning that underlies poor academic and work performance. Relative to other reviews, this article focuses on cross-over randomized controlled trials and prospective designs given that they allow to test the impairing effects of cannabis exposure at the within-subject level. Acute cannabis cognitive effects are discussed separately for known confounding factors such as levels of delta-9-tetrahydrocannabinol (Δ9-THC), Δ9-THC:cannabidiol ratio, previous cannabis use and, comorbidity with psychosis-spectrum disorders. The cognitive residual effects of cannabis are detailed in relation to duration of abstinence, frequency of use, comorbidity with psychosis-spectrum disorders, types of cognitive domains assessed, and age of cannabis use initiation. Moreover, considering the fact that adequate longitudinal studies can make inferences about causality between cannabis use and impaired cognitive functioning when disentangling between-subject from within-subject variation, proofs for the three main non-mutually exclusive hypotheses about this relationship will be presented: i) the cognitive vulnerability hypothesis as part of the more general common antecedent hypothesis, ii) the concurrent cannabis impairing hypothesis, and iii) the neurotoxic hypothesis of cannabis. Current research provides evidence for mild to moderate acute cannabis effects on episodic and working memory, processing speed, and executive functions. Mild residual impairing effects were also observed in these exact same cognitive domains, suggesting that adverse effects following cannabis intoxication persist at least days or weeks following cannabis abstinence. Relative to adult-onset, adolescent-onset cannabis use seems to explain the dose-response relationship and is associated with longer lasting residual effects even in mild users (<weekly). The association between cannabis and cognition is likely explained by common antecedents, such that genetic and shared environment factors predispose individuals to both cannabis use and cognitive deficits, and to a lesser degree, neurotoxic effects.
Collapse
Affiliation(s)
- Josiane Bourque
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| |
Collapse
|
34
|
Dawes C, Bickerdike A, O'Neill C, Carneiro Pereira S, Waddington JL, Moran PM, O'Tuathaigh CMP. Cannabis Use, Schizotypy and Kamin Blocking Performance. Front Psychiatry 2021; 12:633476. [PMID: 34887781 PMCID: PMC8649723 DOI: 10.3389/fpsyt.2021.633476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Cannabis use has been associated with increased risk for a first episode of psychosis and inappropriate assignment of salience to extraneous stimuli has been proposed as a mechanism underlying this association. Psychosis-prone (especially schizotypal) personality traits are associated with deficits in associative learning tasks that measure salience allocation. The aim of this study was to examine the relationship between history of cannabis use and Kamin blocking (KB), a form of selective associative learning, in a non-clinical sample. Additionally, KB was examined in relation to self-reported schizotypy and aberrant salience scale profiles. A cross-sectional study was conducted in 307 healthy participants with no previous psychiatric or neurological history. Participants were recruited and tested using the Testable Minds behavioural testing platform. KB was calculated using Oades' "mouse in the house task", performance of which is disrupted in schizophrenia patients. Schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), and the Aberrant Salience Inventory (ASI) was used to assess self-reported unusual or inappropriate salience. The modified Cannabis Experience Questionnaire (CEQm) was used to collect detailed history of use of cannabis and other recreational drugs. Regression models and Bayesian t-tests or ANOVA (or non-parametric equivalents) examined differences in KB based on lifetime or current cannabis use (frequent use during previous year), as well as frequency of use among those who had previously used cannabis. Neither lifetime nor current cannabis use was associated with any significant change in total or trial-specific KB scores. Current cannabis use was associated with higher Disorganised SPQ dimension scores and higher total and sub-scale values for the ASI. A modest positive association was observed between total KB score and Disorganised SPQ dimension scores, but no relationships were found between KB and other SPQ measures. Higher scores on "Senses Sharpening" ASI sub-scale predicted decreased KB score only in participants who have not engaged in recent cannabis use. These results are discussed in the context of our understanding of the effects of long-term cannabis exposure on salience attribution, as well as inconsistencies in the literature with respect to both the relationship between KB and schizotypy and the measurement of KB associative learning phenomena.
Collapse
Affiliation(s)
- Christopher Dawes
- School of Psychology, University Park, University of Nottingham, Nottingham, United Kingdom
| | - Andrea Bickerdike
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Cork, Ireland
| | - Cian O'Neill
- Department of Sport, Leisure, and Childhood Studies, Munster Technological University, Cork, Ireland
| | - Sarah Carneiro Pereira
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paula M Moran
- School of Psychology, University Park, University of Nottingham, Nottingham, United Kingdom
| | - Colm M P O'Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| |
Collapse
|
35
|
Morel A, Lebard P, Dereux A, Azuar J, Questel F, Bellivier F, Marie-Claire C, Fatséas M, Vorspan F, Bloch V. Clinical Trials of Cannabidiol for Substance Use Disorders: Outcome Measures, Surrogate Endpoints, and Biomarkers. Front Psychiatry 2021; 12:565617. [PMID: 33692705 PMCID: PMC7937926 DOI: 10.3389/fpsyt.2021.565617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 01/21/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Cannabidiol (CBD) is a cannabinoid of potential interest for the treatment of substance use disorders. Our aim was to review the outcome measures, surrogate endpoints, and biomarkers in published and ongoing randomized clinical trials. Methods: We conducted a search in PubMed, Web of Science, PMC, PsycINFO, EMBASE, CENTRAL Cochrane Library, "clinicalTrials.gov," "clinicaltrialsregister.eu," and "anzctr.org.au" for published and ongoing studies. Inclusion criteria were randomized clinical trials (RCTs) examining the use of CBD alone or in association with other cannabinoids, in all substance use disorders. The included studies were analyzed in detail and their qualities assessed by a standardized tool (CONSORT 2010). A short description of excluded studies, consisting in controlled short-term or single administration in non-treatment-seeking drug users, is provided. Findings: The screening retrieved 207 published studies, including only 3 RCTs in cannabis use disorder. Furthermore, 12 excluded studies in cannabis, tobacco, and opioid use disorders are described. Interpretation: Primary outcomes were validated withdrawal symptoms scales and drug use reduction in the three RCTs. In the short-term or crossover studies, the outcome measures were visual analog scales for subjective states; self-rated scales for withdrawal, craving, anxiety, or psychotomimetic symptoms; and laboratory tasks of drug-induced craving, effort expenditure, attentional bias for substance, impulsivity, or anxiety to serve as surrogate endpoints for treatment efficacy. Of note, ongoing studies are now adding peripheral biomarkers of the endocannabinoid system status to predict treatment response. Conclusion: The outcome measures and biomarkers assessed in the ongoing CBD trials for substance use disorders are improving.
Collapse
Affiliation(s)
- Alix Morel
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France
| | - Pierre Lebard
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France
| | - Alexandra Dereux
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France.,INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Julien Azuar
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France.,INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Frank Questel
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France.,INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France.,INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France.,UFR Médecine, Université de Paris, 3 rue Thomas Mann, Paris, France
| | - Cynthia Marie-Claire
- INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Mélina Fatséas
- University of Bordeaux, Bordeaux, France.,CNRS-UMR 5287- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France.,Pôle d'addictologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Avenue de Magellan, Pessac, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France.,INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France.,UFR Médecine, Université de Paris, 3 rue Thomas Mann, Paris, France
| | - Vanessa Bloch
- INSERM UMRS1144, 4 avenue de l'Observatoire, Paris, France.,FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France.,Service de Pharmacie, Hôpital Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, 200 rue du Fg St Denis, Paris, France
| |
Collapse
|
36
|
Abstract
Cannabinoid receptors, located throughout the body, are part of the endocannabinoid system. Cannabinoid CB1 and CB2 receptors are G protein-coupled receptors present from the early stages of gestation, which is involved in various physiological processes, including appetite, pain-sensation, mood, and memory. Due to the lipophilic nature of cannabinoids, it was initially thought that these compounds exert several biological effects by disrupting the cell membrane nonspecifically. Recent biochemical and behavioral findings have demonstrated that blockade of CB1 receptors engenders antidepressant-like neurochemical changes (increases in extracellular levels of monoamines in cortical but not subcortical brain regions) and behavioral effects consistent with antidepressant/antistress activity. We aim to define various roles of cannabinoid receptors in modulating signaling pathways and association with several pathophysiological conditions.
Collapse
|
37
|
Cannabis, nicotine and the negative symptoms of schizophrenia: Systematic review and meta-analysis of observational studies. Neurosci Biobehav Rev 2020; 116:415-425. [DOI: 10.1016/j.neubiorev.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
|
38
|
Lawn W, Hill J, Hindocha C, Yim J, Yamamori Y, Jones G, Walker H, Green SF, Wall MB, Howes OD, Curran HV, Freeman TP, Bloomfield MAP. The acute effects of cannabidiol on the neural correlates of reward anticipation and feedback in healthy volunteers. J Psychopharmacol 2020; 34:969-980. [PMID: 32755273 PMCID: PMC7745615 DOI: 10.1177/0269881120944148] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cannabidiol has potential therapeutic benefits for people with psychiatric disorders characterised by reward function impairment. There is existing evidence that cannabidiol may influence some aspects of reward processing. However, it is unknown whether cannabidiol acutely affects brain function underpinning reward anticipation and feedback. HYPOTHESES We predicted that cannabidiol would augment brain activity associated with reward anticipation and feedback. METHODS We administered a single 600 mg oral dose of cannabidiol and matched placebo to 23 healthy participants in a double-blind, placebo-controlled, repeated-measures design. We employed the monetary incentive delay task during functional magnetic resonance imaging to assay the neural correlates of reward anticipation and feedback. We conducted whole brain analyses and region-of-interest analyses in pre-specified reward-related brain regions. RESULTS The monetary incentive delay task elicited expected brain activity during reward anticipation and feedback, including in the insula, caudate, nucleus accumbens, anterior cingulate and orbitofrontal cortex. However, across the whole brain, we did not find any evidence that cannabidiol altered reward-related brain activity. Moreover, our Bayesian analyses showed that activity in our regions-of-interest was similar following cannabidiol and placebo. Additionally, our behavioural measures of motivation for reward did not show a significant difference between cannabidiol and placebo. DISCUSSION Cannabidiol did not acutely affect the neural correlates of reward anticipation and feedback in healthy participants. Future research should explore the effects of cannabidiol on different components of reward processing, employ different doses and administration regimens, and test its reward-related effects in people with psychiatric disorders.
Collapse
Affiliation(s)
- Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - James Hill
- Translational Psychiatry Research Group, University College London, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
- Translational Psychiatry Research Group, University College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Jocelyn Yim
- Translational Psychiatry Research Group, University College London, London, UK
| | - Yumeya Yamamori
- Translational Psychiatry Research Group, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Gus Jones
- Translational Psychiatry Research Group, University College London, London, UK
| | - Hannah Walker
- Translational Psychiatry Research Group, University College London, London, UK
| | - Sebastian F Green
- Translational Psychiatry Research Group, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK
- Invicro London, Hammersmith Hospital, London, UK
| | - Oliver D Howes
- Psychiatric Imaging Group, Imperial College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Translational Psychiatry Research Group, University College London, London, UK
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Michael AP Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, UK
- Translational Psychiatry Research Group, University College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
- Psychiatric Imaging Group, Imperial College London, London, UK
- The Traumatic Stress Clinic, St Pancras Hospital, London, UK
- National Hospital for Neurology and Neurosurgery, London, UK
| |
Collapse
|
39
|
Freeman TP, Lorenzetti V. 'Standard THC units': a proposal to standardize dose across all cannabis products and methods of administration. Addiction 2020; 115:1207-1216. [PMID: 31606008 DOI: 10.1111/add.14842] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/18/2019] [Accepted: 09/27/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Cannabis products are becoming increasingly diverse, and vary considerably in concentrations of ∆9 -tetrahydrocannabinol (THC) and cannabidiol (CBD). Higher doses of THC can increase the risk of harm from cannabis, while CBD may partially offset some of these effects. Lower Risk Cannabis Use Guidelines currently lack recommendations based on quantity of use, and could be improved by implementing standard units. However, there is currently no consensus on how units should be measured or standardized among different cannabis products or methods of administration. ARGUMENT Existing proposals for standard cannabis units have been based on specific methods of administration (e.g. joints) and these may not capture other methods, including pipes, bongs, blunts, dabbing, vaporizers, vape pens, edibles and liquids. Other proposals (e.g. grams of cannabis) cannot account for heterogeneity in THC concentrations among different cannabis products. Similar to alcohol units, we argue that standard cannabis units should reflect the quantity of primary active pharmacological constituents (dose of THC). On the basis of experimental and ecological data, public health considerations and existing policy, we propose that a 'standard THC unit' should be fixed at 5 mg THC for all cannabis products and methods of administration. If supported by sufficient evidence in future, consumption of standard CBD units might offer an additional strategy for harm reduction. CONCLUSIONS Standard ∆9 -tetrahydrocannabinol (THC) units can potentially be applied among all cannabis products and methods of administration to guide consumers and promote safer patterns of use.
Collapse
Affiliation(s)
- Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.,National Addiction Centre, King's College London, London,, UK.,Clinical Psychopharmacology Unit, University College London, London, UK
| | - Valentina Lorenzetti
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| |
Collapse
|
40
|
Giustiniani J, Nicolier M, Teti Mayer J, Chabin T, Masse C, Galmès N, Pazart L, Trojak B, Bennabi D, Vandel P, Haffen E, Gabriel D. Behavioral and Neural Arguments of Motivational Influence on Decision Making During Uncertainty. Front Neurosci 2020; 14:583. [PMID: 32581698 PMCID: PMC7290000 DOI: 10.3389/fnins.2020.00583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/12/2020] [Indexed: 11/24/2022] Open
Abstract
The scientific world is increasingly interested in motivation, primarily due to the suspected impact on decision-making abilities, particularly in uncertain conditions. To explore this plausible relationship, 28 healthy participants were included in the study and performed decision-making and motivational tasks while their neural activity was recorded. All participants performed the Iowa Gambling Task (IGT) and were split into two groups based on their score, one favorable group with 14 participants who performed advantageously and one undecided group with 14 participants who failed to develop the correct strategy on the IGT. In addition, all participants performed the Effort Expenditure for Reward Task (EEfRT), which defines the motivational level of each participant by the effort that participants agree to do in function of reward magnitudes and probabilities to receive these reward (10, 50, and 90%). The completion of both tasks allowed for the exploration of the relationship between the motivational level and decision-making abilities. The EEfRT was adapted to electroencephalography (EEG) recordings to explore how motivation could influence reward experience. Behavioral results showed no difference in EEfRT performances on the whole task between the two groups’ performances on the IGT. However, there was a negative correlation between the difficulty to develop an optimal strategy on the IGT and the percentage of difficult choices at the 90% condition on the EEfRT. Each probability condition has been previously associated to different motivational and emotional states, with the 90% condition associated to the reward sensitivity. This behavioral result leads to the hypothesis that reward sensitivity may induce an inability to develop an optimal strategy on the IGT. Group analysis demonstrated that only the undecided group showed a P300 during the processing of the outcome, whereas the favorable group showed a blunted P300. Similarly, there was a negative correlation between the P300 amplitude and the ability to develop an optimal strategy on the IGT. In conclusion, behavioral and neuronal data provides evidence that the propensity to focus only on the immediate outcomes is related to the development of an inefficient strategy on the IGT, without influence of motivation.
Collapse
Affiliation(s)
- Julie Giustiniani
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Magali Nicolier
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, Besançon, France
| | - Juliana Teti Mayer
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Thibault Chabin
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Caroline Masse
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Nathan Galmès
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Lionel Pazart
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Benoit Trojak
- Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France.,Department of Psychiatry and Addictology, University Hospital of Dijon, Dijon, France.,EA 4452, LPPM, University of Burgundy Franche-Comté, Dijon, France
| | - Djamila Bennabi
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France
| | - Pierre Vandel
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France
| | - Damien Gabriel
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, Besançon, France
| |
Collapse
|
41
|
Brancato A, Castelli V, Lavanco G, Marino RAM, Cannizzaro C. In utero Δ9-tetrahydrocannabinol exposure confers vulnerability towards cognitive impairments and alcohol drinking in the adolescent offspring: Is there a role for neuropeptide Y? J Psychopharmacol 2020; 34:663-679. [PMID: 32338122 DOI: 10.1177/0269881120916135] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cannabinoid consumption during pregnancy has been increasing on the wave of the broad-based legalisation of cannabis in Western countries, raising concern about the putative detrimental outcomes on foetal neurodevelopment. Indeed, since the endocannabinoid system regulates synaptic plasticity, emotional and cognitive processes from early stages of life interfering with it and other excitability endogenous modulators, such as neuropeptide Y (NPY), might contribute to the occurrence of a vulnerable phenotype later in life. AIMS This research investigated whether in utero exposure to Δ9-tetrahydrocannabinol (THC) may induce deficits in emotional/cognitive processes and alcohol vulnerability in adolescent offspring. NPY and excitatory postsynaptic density (PSD) machinery were measured as markers of neurobiological vulnerability. METHODS Following in utero THC exposure (2 mg/kg delivered subcutaneously), preadolescent male rat offspring were assessed for: behavioural reactivity in the open field test, neutral declarative memory and aversive limbic memory in the Novel Object and Emotional Object Recognition tests, immunofluorescence for NPY neurons and the PSD proteins Homer-1, 1b/c and 2 in the prefrontal cortex, amygdala and nucleus accumbens at adolescence (cohort 1); and instrumental learning, alcohol taking, relapse and conflict behaviour in the operant chamber throughout adolescence until early adulthood (cohort 2). RESULTS In utero THC-exposed adolescent rats showed: (a) increased locomotor activity; (b) no alteration in neutral declarative memory; (c) impaired aversive limbic memory; (d) decreased NPY-positive neurons in limbic regions; (e) region-specific variations in Homer-1, 1b/c and 2 immunoreactivity; (f) decreased instrumental learning and increased alcohol drinking, relapse and conflict behaviour in the operant chamber. CONCLUSION Gestational THC impaired the formation of memory traces when integration between environmental encoding and emotional/motivational processing was required and promoted the development of alcohol-addictive behaviours. The abnormalities in NPY signalling and PSD make-up may represent the common neurobiological background, suggesting new targets for future research.
Collapse
Affiliation(s)
- Anna Brancato
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties of Excellence 'G. D'Alessandro', University of Palermo, Palermo, Italy
| | - Valentina Castelli
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties of Excellence 'G. D'Alessandro', University of Palermo, Palermo, Italy.,Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Gianluca Lavanco
- INSERM U1215, NeuroCentre Magendie, Bordeaux, France.,University of Bordeaux, Bordeaux, France.,Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Rosa Anna Maria Marino
- Department of Anatomy and Neurobiology, School of Medicine, University of Maryland, Baltimore, USA
| | - Carla Cannizzaro
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties of Excellence 'G. D'Alessandro', University of Palermo, Palermo, Italy
| |
Collapse
|
42
|
Giustiniani J, Nicolier M, Teti Mayer J, Chabin T, Masse C, Galmès N, Pazart L, Trojak B, Bennabi D, Vandel P, Haffen E, Gabriel D. Event-Related Potentials (ERP) Indices of Motivation during the Effort Expenditure for Reward Task. Brain Sci 2020; 10:E283. [PMID: 32397250 PMCID: PMC7287692 DOI: 10.3390/brainsci10050283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/23/2022] Open
Abstract
Dynamic and temporal facets of the various constructs that comprise motivation remain to be explored. Here, we adapted the Effort Expenditure for Reward Task, a well-known laboratory task used to evaluate motivation, to study the event-related potentials associated with reward processing. The Stimulus Preceding Negativity (SPN) and the P300 were utilized as motivation indicators with high density electroencephalography. The SPN was found to be more negative for difficult choices compared to easy choices, suggesting a greater level of motivation, at a neurophysiological level. The insula, a structure previously associated with both effort discounting and prediction error, was concomitantly activated during the generation of the SPN. Processing a gain significantly altered the amplitude of the P300 compared to an absence of gain, particularly on centroparietal electrodes. One of the generators of the P300 was located on the vmPFC, a cerebral structure involved in the choice between two positive results and their predictions, during loss processing. Both the SPN and the P300 appear to be reliable neural markers of motivation. We postulate that the SPN represents the strength of the motivational level, while the P300 represents the impact of motivation on updating memories of the feedback.
Collapse
Affiliation(s)
- Julie Giustiniani
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
| | - Magali Nicolier
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
- Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, 25000 Besançon, France
| | - Juliana Teti Mayer
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
| | - Thibault Chabin
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
| | - Caroline Masse
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
| | - Nathan Galmès
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
| | - Lionel Pazart
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
| | - Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon, France;
- EA 4452, LPPM, University of Burgundy Franche-Comté, 21000 Dijon, France
| | - Djamila Bennabi
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- FondaMental Foundation, 94000 Créteil, France
| | - Pierre Vandel
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, University Hospital of Besançon, 25000 Besançon, France; (M.N.); (J.T.M.); (C.M.); (D.B.); (P.V.); (E.H.)
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
- FondaMental Foundation, 94000 Créteil, France
| | - Damien Gabriel
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, 25000 Besançon, France; (T.C.); (N.G.); (L.P.); (D.G.)
- Clinical Investigation Centre, University Hospital of Besançon, Inserm CIC 1431, 25000 Besançon, France
- Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, 25000 Besançon, France
| |
Collapse
|
43
|
Hindocha C, Freeman TP, Schafer G, Gardner C, Bloomfield MA, Bramon E, Morgan CJ, Curran HV. Acute effects of cannabinoids on addiction endophenotypes are moderated by genes encoding the CB1 receptor and FAAH enzyme. Addict Biol 2020; 25:e12762. [PMID: 31013550 DOI: 10.1111/adb.12762] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/15/2019] [Accepted: 03/23/2019] [Indexed: 11/29/2022]
Abstract
Understanding genetic factors that contribute to cannabis use disorder (CUD) is important, but to date, findings have been equivocal. Single-nucleotide polymorphisms (SNPs) in the cannabinoid receptor 1 gene (CNR1; rs1049353 and rs806378) and fatty acid amide hydrolase (FAAH) gene (rs324420) have been implicated in CUD. Their relationship to addiction endophenotypes such as cannabis-related state satiety, the salience of appetitive cues, and craving after acute cannabinoid administration has not been investigated. Forty-eight cannabis users participated in a double-blind, placebo-controlled, four-way crossover experiment where they were administered treatments in a randomized order via vaporization: placebo, Δ9 -tetrahydrocannabinol (THC) (8 mg), THC + cannabidiol (THC + CBD) (8 + 16 mg), and CBD (16 mg). Cannabis-related state satiety, appetitive cue salience (cannabis and food), and cannabis craving were assessed each day. Participants were genotyped for rs1049353, rs806378, and rs324420. Results indicated that CNR1 rs1049353 GG carriers showed increased state satiety after THC/THC + CBD administration in comparison with placebo and reduced the salience of appetitive cues after THC in comparison with CBD administration; A carriers did not vary on either of these measures indicative of a vulnerability to CUD. CNR1 rs806378 CC carriers showed greater salience to appetitive cues in comparison with T carriers, but there was no evidence for changes in state satiety. FAAH rs324420 A carriers showed greater bias to appetitive cues after THC, in comparison with CC carriers. FAAH CC carriers showed reduced bias after THC in comparison with CBD. No SNPs modulated craving. These findings identify candidate neurocognitive mechanisms through which endocannabinoid system genetics may influence vulnerability to CUD.
Collapse
Affiliation(s)
- Chandni Hindocha
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain SciencesUniversity College London London UK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College Hospital London UK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain SciencesUniversity College London London UK
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of Bath Bath UK
- National Addiction Centre, Institute of Psychiatry, Psychology & NeuroscienceKing's College London London UK
| | - Grainne Schafer
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
| | - Chelsea Gardner
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
| | - Michael A.P. Bloomfield
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain SciencesUniversity College London London UK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College Hospital London UK
- Division of PsychiatryUniversity College London London UK
| | - Elvira Bramon
- Division of PsychiatryUniversity College London London UK
- Institute of Psychiatry, Psychology & NeuroscienceKing's College London London UK
- Institute of Cognitive NeuroscienceUniversity College London London UK
| | - Celia J.A. Morgan
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
- Psychopharmacology and Addiction Research CentreUniversity of Exeter Exeter UK
| | - H. Valerie Curran
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College London London UK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College Hospital London UK
| |
Collapse
|
44
|
Petrucci AS, LaFrance EM, Cuttler C. A Comprehensive Examination of the Links between Cannabis Use and Motivation. Subst Use Misuse 2020; 55:1155-1164. [PMID: 32100610 DOI: 10.1080/10826084.2020.1729203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Cannabis use is widely perceived to produce an "amotivational syndrome" characterized by reduced desire to work or compete, passivity, and lower achievement orientation. The notion that cannabis diminishes motivation has been perpetuated in popular culture, despite the equivocal results of past research. Moreover, previous literature has largely failed to consider the potentially confounding influences of depression, other substance use, and personality, despite known relationships between these variables and cannabis use.Purpose: The purpose of this study was to elucidate the nature of the relationships between specific aspects of motivation and cannabis use/misuse. Moreover, we sought to determine whether depression, alcohol and other substance use, and/or personality could account for these relationships.Method: A total of 1,168 participants completed a survey comprising self-report measures of motivation (self-efficacy, apathy, goal orientation, reward-sensitivity, and behavioral inhibition/approach systems) and cannabis use/misuse (cannabis use status, cannabis use frequency, quantity, age of onset of cannabis use, symptoms of cannabis use disorder, problematic cannabis use).Results: The results revealed small (r < .30) but significant correlations between various aspects of cannabis use and motivation, which were largely accounted for by cannabis-related differences in depression, alcohol and other substance use, and personality. However, relationships between cannabis misuse and apathy remained statistically significant after controlling for confounds, indicating that individuals who misuse cannabis may demonstrate higher levels of apathy specifically.Conclusion: Collectively, these results suggest that differences in depression, substance use, and personality between cannabis users and non-users largely explain differences in motivation between these groups.
Collapse
Affiliation(s)
- Aria S Petrucci
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Emily M LaFrance
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, Washington, USA.,Translational Addiction Research Center, Washington State University, Pullman, Washington, USA
| |
Collapse
|
45
|
Abstract
Objective: This review discusses the relationship between cannabis use and psychotic, bipolar, depressive, and anxiety disorders, as well as suicide. It summarizes epidemiological evidence from cross-sectional and long-term prospective studies and considers possible etiological mechanisms. Methods: Systematic reviews and methodologically robust studies in the field (from inception to February 2019) were identified using a comprehensive search of Medline, PsychINFO, and Embase and summarized using a narrative synthesis. Results: Consistent evidence, both from observational and experimental studies, has confirmed the important role of cannabis use in the initiation and persistence of psychotic disorders. The size of the effect is related to the extent of cannabis use, with greater risk for early cannabis use and use of high-potency varieties and synthetic cannabinoids. Accumulating evidence suggests that frequent cannabis use also increases the risk for mania as well as for suicide. However, the effect on depression is less clear and findings on anxiety are contradictory with only a few methodologically robust studies. Furthermore, the relationship with common mental disorders may involve reverse causality, as depression and anxiety are reported to lead to greater cannabis consumption in some studies. Pathogenetic mechanisms focus on the effect of tetrahydrocannabinol (THC, the main psychoactive ingredient of cannabis) interacting with genetic predisposition and perhaps other environmental risk factors. Cannabidiol (CBD), the other important ingredient of traditional cannabis, ameliorates the psychotogenic effects of THC but is absent from the high-potency varieties that are increasingly available. Conclusions: The evidence that heavy use of high-THC/low-CBD types of cannabis increases the risk of psychosis is sufficiently strong to merit public health education. Evidence of similar but smaller effects in mania and suicide is growing, but is not convincing for depression and anxiety. There is much current interest in the possibility that CBD may be therapeutically useful.
Collapse
Affiliation(s)
- Lucia Sideli
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.,Department of Biomedicine, Neurosciences, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Harriet Quigley
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.,South London and Maudsley NHS Trust Biomedical Research Centre, London, UK
| | - Caterina La Cascia
- Department of Biomedicine, Neurosciences, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Robin M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.,Department of Biomedicine, Neurosciences, and Advanced Diagnostic, University of Palermo, Palermo, Italy.,South London and Maudsley NHS Trust Biomedical Research Centre, London, UK
| |
Collapse
|
46
|
Cannabis and Psychosis Through the Lens of DSM-5. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214149. [PMID: 31661851 PMCID: PMC6861931 DOI: 10.3390/ijerph16214149] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 12/27/2022]
Abstract
Evidence for an association between cannabis and psychosis has been documented in literature in many forms including experimental studies, epidemiological data, and case series. The association has implications for psychotic outcomes ranging from mild to severe and occurring over minutes to years. Due to the huge variety of exposures and outcome measures reported, creating a coherent account of all the available information is difficult. A useful way to conceptualize these wide-ranging results is to consider the association between cannabis and psychosis as it occurs within the context of widely used DSM-5 diagnoses. In the present review we examine cannabis/psychosis associations as they pertain to Cannabis Intoxication, Cannabis-Induced Psychotic Disorder, and Schizophrenia. This allows for an understanding of the cannabis and psychosis association along something approaching a continuum. Cannabis intoxication becomes Cannabis-Induced Psychotic Disorder once certain severity and duration criteria are met and Cannabis-Induced Psychotic Disorder is heavily associated with future schizophrenia diagnoses.
Collapse
|
47
|
Freeman AM, Petrilli K, Lees R, Hindocha C, Mokrysz C, Curran HV, Saunders R, Freeman TP. How does cannabidiol (CBD) influence the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review. Neurosci Biobehav Rev 2019; 107:696-712. [PMID: 31580839 DOI: 10.1016/j.neubiorev.2019.09.036] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 01/08/2023]
Abstract
The recent liberalisation of cannabis regulation has increased public and scientific debate about its potential benefits and risks. A key focus has been the extent to which cannabidiol (CBD) might influence the acute effects of delta-9-tetrahydrocannabinol (THC), but this has never been reviewed systematically. In this systematic review of how CBD influences the acute effects of THC we identified 16 studies involving 466 participants. Ten studies were judged at low risk of bias. The findings were mixed, although CBD was found to reduce the effects of THC in several studies. Some studies found that CBD reduced intense experiences of anxiety or psychosis-like effects of THC and blunted some of the impairments on emotion and reward processing. However, CBD did not consistently influence the effects of THC across all studies and outcomes. There was considerable heterogeneity in dose, route of administration and THC:CBD ratio across studies and no clear dose-response profile emerged. Although findings were mixed, this review suggests that CBD may interact with some acute effects of THC.
Collapse
Affiliation(s)
- Abigail M Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Katherine Petrilli
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Rachel Lees
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, Gower Street, London, WC1E 6BT, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Rob Saunders
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK; National Addiction Centre, King's College London, London, SE5 8BB, UK
| |
Collapse
|
48
|
Pacheco-Colón I, Ramirez AR, Gonzalez R. Effects of Adolescent Cannabis Use on Motivation and Depression: A Systematic Review. CURRENT ADDICTION REPORTS 2019; 6:532-546. [PMID: 34079688 DOI: 10.1007/s40429-019-00274-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of review This article reviews recent behavioral and neuroimaging studies to elucidate whether adolescent cannabis use is related to reduced motivation and increased risk of depression. Recent findings Recent work suggests that heavy adolescent cannabis use predicts poorer educational outcomes, often presumed to reflect reduced academic motivation, as well as increased levels of depressive symptoms. However, evidence of a link between cannabis use and general motivation was lacking. Factors such as concurrent alcohol and tobacco use, trajectories of cannabis use during adolescence, and cannabis-related changes in underlying neurocircuitry may impact associations among cannabis use, motivation, and depression. Summary Heavy adolescent cannabis use is associated with poorer educational outcomes and increased levels of depressive symptoms. The role of depression in how cannabis may affect motivation, broadly, is not yet clear, as most studies have not examined associations among all three constructs. Future work should explore possible overlap between cannabis effects on motivation and depression, and clarify the temporality of these associations.
Collapse
Affiliation(s)
- Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University
| | - Ana Regina Ramirez
- Center for Children and Families, Department of Psychology, Florida International University
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University
| |
Collapse
|
49
|
Wall MB, Pope R, Freeman TP, Kowalczyk OS, Demetriou L, Mokrysz C, Hindocha C, Lawn W, Bloomfield MA, Freeman AM, Feilding A, Nutt D, Curran HV. Dissociable effects of cannabis with and without cannabidiol on the human brain's resting-state functional connectivity. J Psychopharmacol 2019; 33:822-830. [PMID: 31013455 DOI: 10.1177/0269881119841568] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Two major constituents of cannabis are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the main psychoactive component; CBD may buffer the user against the harmful effects of THC. AIMS We examined the effects of two strains of cannabis and placebo on the human brain's resting-state networks using fMRI. METHODS Seventeen healthy volunteers (experienced with cannabis, but not regular users) underwent three drug treatments and scanning sessions. Treatments were cannabis containing THC (Cann-CBD; 8 mg THC), cannabis containing THC with CBD (Cann+CBD; 8 mg THC + 10 mg CBD), and matched placebo cannabis. Seed-based resting-state functional connectivity analyses were performed on three brain networks: the default mode (DMN; defined by positive connectivity with the posterior cingulate cortex: PCC+), executive control (ECN; defined by negative connectivity with the posterior cingulate cortex: PCC-) and salience (SAL; defined by positive connectivity with the anterior insula: AI+) network. RESULTS Reductions in functional connectivity (relative to placebo) were seen in the DMN (PCC+) and SAL (AI+) networks for both strains of cannabis, with spatially dissociable effects. Across the entire salience network (AI+), Cann-CBD reduced connectivity relative to Cann+CBD. The PCC in the DMN was specifically disrupted by Cann-CBD, and this effect correlated with subjective drug effects, including feeling 'stoned' and 'high'. CONCLUSIONS THC disrupts the DMN, and the PCC is a key brain region involved in the subjective experience of THC intoxication. CBD restores disruption of the salience network by THC, which may explain its potential to treat disorders of salience such as psychosis and addiction.
Collapse
Affiliation(s)
- Matthew B Wall
- 1 Invicro London, Hammersmith Hospital, London, UK.,2 Clinical Psychopharmacology Unit, University College London, London, UK.,3 Division of Brain Sciences, Imperial College London, London, UK
| | - Rebecca Pope
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- 2 Clinical Psychopharmacology Unit, University College London, London, UK.,4 Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.,5 National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Oliwia S Kowalczyk
- 6 Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Lysia Demetriou
- 1 Invicro London, Hammersmith Hospital, London, UK.,3 Division of Brain Sciences, Imperial College London, London, UK
| | - Claire Mokrysz
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| | - Chandni Hindocha
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| | - Will Lawn
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| | - Michael Ap Bloomfield
- 2 Clinical Psychopharmacology Unit, University College London, London, UK.,7 Division of Psychiatry, University College London, London, UK.,8 Psychiatric Imaging, MRC London Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Abigail M Freeman
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - David Nutt
- 3 Division of Brain Sciences, Imperial College London, London, UK
| | - H Valerie Curran
- 2 Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
50
|
Eikemo M, Lobmaier PP, Pedersen ML, Kunøe N, Matziorinis AM, Leknes S, Sarfi M. Intact responses to non-drug rewards in long-term opioid maintenance treatment. Neuropsychopharmacology 2019; 44:1456-1463. [PMID: 30928994 PMCID: PMC6785711 DOI: 10.1038/s41386-019-0377-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/12/2019] [Accepted: 03/24/2019] [Indexed: 12/13/2022]
Abstract
Disruption of non-drug reward processing in addiction could stem from long-term drug use, addiction-related psychosocial stress, or a combination of these. It remains unclear whether long-term opioid maintenance treatment (OMT) disrupts reward processing. Here, we measured subjective and objective reward responsiveness in 26 previously heroin-addicted mothers in >7 years stable OMT with minimal psychosocial stress and illicit drug use. The comparison group was 30 healthy age-matched mothers (COMP). Objective reward responsiveness was assessed in a two-alternative forced-choice task with skewed rewards. Results were also compared to performance from an additional 968 healthy volunteers (meta-analytic approach). We further compared subprocesses of reward-based decisions across groups using computational modelling with a Bayesian drift diffusion model of decision making. Self-reported responsiveness to non-drug rewards was high for both groups (means: OMT = 6.59, COMP = 6.67, p = 0.84, BF10 = 0.29), yielding moderate evidence against subjective anhedonia in this OMT group. Importantly, the mothers in OMT also displayed robust reward responsiveness in the behavioral task (t19 = 2.72, p = 0.013, BF10 = 3.98; d = 0.61). Monetary reward changed their task behavior to the same extent as the local comparison group (reward bias OMT = 0.12, COMP = 0.12, p = 0.96, BF10 = 0.18) and in line with data from 968 healthy controls previously tested. Computational modelling revealed that long-term OMT did not even change decision subprocesses underpinning reward behavior. We conclude that reduced sensitivity to rewards and anhedonia are not necessary consequences of prolonged opioid use.
Collapse
Affiliation(s)
- Marie Eikemo
- Norwegian Centre for Addiction Research (SERAF), Faculty of Medicine, University of Oslo, Oslo, Norway. .,Division for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. .,Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway.
| | - Philipp P. Lobmaier
- 0000 0004 1936 8921grid.5510.1Norwegian Centre for Addiction Research (SERAF), Faculty of Medicine, University of Oslo, Oslo, Norway ,0000 0004 0389 8485grid.55325.34Division for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Mads L. Pedersen
- 0000 0004 1936 8921grid.5510.1Department of Psychology, University of Oslo, Oslo, Norway ,0000 0004 0389 8485grid.55325.34The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Nikolaj Kunøe
- 0000 0004 1936 8921grid.5510.1Norwegian Centre for Addiction Research (SERAF), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anna Maria Matziorinis
- 0000 0004 1936 8921grid.5510.1Department of Psychology, University of Oslo, Oslo, Norway
| | - Siri Leknes
- 0000 0004 1936 8921grid.5510.1Department of Psychology, University of Oslo, Oslo, Norway ,0000 0004 0389 8485grid.55325.34The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Monica Sarfi
- 0000 0004 1936 8921grid.5510.1Norwegian Centre for Addiction Research (SERAF), Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|