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Ohmann HA, Kuper N, Wacker J. Examining the reliability and validity of two versions of the Effort-Expenditure for Rewards Task (EEfRT). PLoS One 2022; 17:e0262902. [PMID: 35089948 PMCID: PMC8797221 DOI: 10.1371/journal.pone.0262902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 01/08/2022] [Indexed: 01/09/2023] Open
Abstract
The Effort-Expenditure for Rewards Task (EEfRT) has gained validity evidence from several studies. However, various modifications have been applied to the original version, which have never been compared systematically. In Study 1, we tested 120 healthy participants to directly compare two versions of the EEfRT. In Study 2, we tested a larger sample of 394 healthy participants to further examine the original EEfRT. We replicated the split-half reliability of both task versions. However, self-reported personality traits (e.g., trait BAS) correlated with only some task performance parameters in Study 1, which did not replicate for the original EEfRT in Study 2. Our results indicate complex and sometimes inconsistent relations between different personality traits, task properties, and reward attributes.
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Affiliation(s)
- Hanno Andreas Ohmann
- Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Niclas Kuper
- Faculty of Psychology and Sports Science, Universität Bielefeld, Bielefeld, Germany
| | - Jan Wacker
- Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany
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2
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Examining Relations Between Obsessive-Compulsive Features, Substance-Use Disorders, and Antisocial Personality Disorder in the Vietnam Era Twin Cohort. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00299-9] [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: 11/26/2022] Open
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3
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Juszczak GR, Bobrowska A. Assessment of Problem-Solving Skills and Inhibitory Control in Mice Using Water Escape Detour Test. ACTA ACUST UNITED AC 2021; 10:e82. [PMID: 32870595 DOI: 10.1002/cpmo.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite the importance of emotional intelligence, its biological mechanism is still not well understood. For this reason, we have developed a rodent detour task which requires an animal to reach a highly desired object placed directly behind a transparent barrier that blocks the direct route to the target. This apparently simple task is highly dependent on the emotional control that is necessary to inhibit prepotent and counterproductive responses driven by the sight of a desired object. The water escape detour task designed for mice enables testing the ability to solve emotionally challenging problems, as well as identification of an impairment termed perseveration. Such a maladaptive reaction to a challenging situation is characterized by difficulty in terminating an unsuccessful response, leading to persistent repetition of inappropriate behavior. This issue is important because perseveration is associated with schizophrenia, drug abuse, and aging. © 2020 Wiley Periodicals LLC. Basic Protocol: Water escape detour task Support Protocol 1: Preparation of escape platform Support Protocol 2: Preparation of the transparent barrier Alternate Protocol: Water escape detour task for testing acute effects.
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Affiliation(s)
- Grzegorz R Juszczak
- Department of Animal Behavior and Welfare, Institute of Genetics and Animal Biotechnology, Magdalenka, Poland
| | - Anna Bobrowska
- Department of Animal Behavior and Welfare, Institute of Genetics and Animal Biotechnology, Magdalenka, Poland
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4
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Initiation of Moderately Frequent Cannabis use in Adolescence and Young Adulthood is Associated with Declines in Verbal Learning and Memory: A Longitudinal Comparison of Pre- versus Post-Initiation Cognitive Performance. J Int Neuropsychol Soc 2021; 27:621-636. [PMID: 34261549 PMCID: PMC8486043 DOI: 10.1017/s1355617721000631] [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: 11/07/2022]
Abstract
OBJECTIVE Cannabis use is associated with relative cognitive weaknesses as observed by cross-sectional as well as longitudinal research. Longitudinal studies, controlling for relevant confounds, are necessary to differentiate premorbid from post-initiation contributions to these effects. METHODS We followed a sample of adolescents and young adults across ten years. Participants provided neurocognitive data and substance use information at two-year intervals. Participants who initiated cannabis and/or alcohol use were identified (n = 86) and split into alcohol-only initiators (n = 39) and infrequent (n = 29) and moderately frequent (n = 18) cannabis initiators. Participants completed the Rey Auditory Verbal Learning Task (RAVLT) and the Iowa Gambling Task (IGT). Group differences before and after substance use initiation and the extent to which alcohol, nicotine, and cannabis use frequencies contributed to cognitive functions over time were examined. RESULTS After controlling for parental education, RAVLT new learning was worse in moderately frequent cannabis users prior to use initiation. RAVLT total learning and delayed recall showed significant declines from pre- to post-initiation in moderately frequent cannabis users. Regression analyses confirmed that frequencies of cannabis, but not alcohol, use contributed to post-initiation variations. Nicotine use showed an independent negative association with delayed memory. Findings for the IGT were not significant. CONCLUSIONS Verbal learning and memory may be disrupted following the initiation of moderately frequent cannabis use while decreased new learning may represent a premorbid liability. Our use of a control group of alcohol-only users adds interpretive clarity to the findings and suggests that future studies should carefully control for comorbid substance use.
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Sideli L, Trotta G, Spinazzola E, La Cascia C, Di Forti M. Adverse effects of heavy cannabis use: even plants can harm the brain. Pain 2021; 162:S97-S104. [PMID: 32804835 PMCID: PMC8216111 DOI: 10.1097/j.pain.0000000000001963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/08/2020] [Accepted: 06/12/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, Palermo University, Palermo, Italy
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
- South London and Maudsley NHS Mental Health Foundation Trust, London, United Kingdom
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6
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Block RI, Jager G, Luijten M, Ramsey NF. Associations of Regular Marijuana Use by Adolescent Boys With Verbal Memory and Perseveration. Psychol Rep 2021; 125:839-861. [PMID: 33517837 DOI: 10.1177/0033294121988992] [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: 11/17/2022]
Abstract
Many American and Dutch adolescents use marijuana regularly. There is concern that such use may impair cognitive function more in adolescents than adults. We examined effects of regular marijuana use on long-term memory and perseveration among American and Dutch adolescents. We administered Buschke's Selective Reminding Test (BSRT) to assess long-term memory and the Wisconsin Card Sorting Test (WCST) to assess perseveration in male teenagers. Usable test data were obtained for 12 American marijuana users, 13 American controls, 9 Dutch marijuana users, and 12 Dutch controls. In BSRT, users showed lower overall long-term storage than controls (adjusted means ± SE's for numbers of words per trial of 9.4 ± 0.2, 13.4 ± 0.3, 11.7 ± 0.2, and 12.4 ± 0.2 for American users, Dutch users, American controls, and Dutch controls, respectively). Marijuana was associated with memory effects only in American, not Dutch, users. Bivariate Pearson correlations for American and Dutch users combined showed associations of lower total recall with more uses in the previous year and lifetime (r = -0.61 and r = -0.53, respectively); and more perseverative errors with more uses in the previous year (r = 0.55). Some findings were consistent with the possibility that regular adolescent marijuana use causes deficits in cognition, especially memory. However, a causal interpretation cannot be inferred from our findings and is challenging to reconcile with the observation of memory deficits only in American users. Our study was novel in examining the influence of nationality on marijuana's cognitive effects. More studies of this topic should compare effects across nationalities or cultures.
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Affiliation(s)
- Robert I Block
- Department of Anesthesia, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Gerry Jager
- Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, the Netherlands
| | - Maartje Luijten
- Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands; Behavioural Science Institute and Orthopedagogics: Family and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Nick F Ramsey
- Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
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7
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Everett TJ, Gomez DM, Hamilton LR, Oleson EB. Endocannabinoid modulation of dopamine release during reward seeking, interval timing, and avoidance. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110031. [PMID: 32663486 DOI: 10.1016/j.pnpbp.2020.110031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/15/2020] [Accepted: 06/28/2020] [Indexed: 01/02/2023]
Abstract
Endocannabinoids (eCBs) are neuromodulators that influence a wide range of neural systems and behaviors. In the current review, we describe our recent research showing how eCBs, particularly 2-arachidonoylglycerol (2-AG), concurrently shape mesolimbic dopamine (DA) release and associated behavior. We will restrict our discussion by emphasizing three distinct behaviors: reward seeking, interval timing, and active avoidance. During reward seeking we find that 2-AG is necessary to observe cue-evoked DA release events that are thought to represent the value of a rewarding outcome. We then describe data showing that 2-AG modulates unique patterns of DA release and behavior observed under conditions of periodic reinforcement. These data are discussed within the context of interval timing and adjunctive behavior. eCB modulation of DA release is also implicated in defensive behavior, including the avoidance of harm. As in reward seeking, our data suggest that the concentration of DA that is evoked by a warning signal can represent the value of an avoidance outcome. And, disrupting eCB signaling concomitantly reduces the concentration of the avoidance value signal and active avoidance. Disruptions in reward seeking, interval timing, and defensive behavior are commonly observed in a variety of movement disorders (e.g., Parkinson's and Huntington's disease) and disorders of motivation (e.g., addiction). We believe our data on eCB-DA interactions have implications for the development of novel pharmacotherapies to treat these disorders. Thus, we conclude by discussing how eCB pharmacology might be harnessed to treat disorders of movement and motivation.
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Affiliation(s)
| | - Devan M Gomez
- Psychology Department, University of Colorado Denver, USA; Department of Biomedical Sciences, Marquette University, USA
| | | | - Erik B Oleson
- Psychology Department, University of Colorado Denver, USA; Integrative Biology Department, University of Colorado Denver, USA.
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8
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Hamidullah S, Thorpe HHA, Frie JA, Mccurdy RD, Khokhar JY. Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates. Front Hum Neurosci 2020; 14:298. [PMID: 32848673 PMCID: PMC7418456 DOI: 10.3389/fnhum.2020.00298] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/03/2020] [Indexed: 12/11/2022] Open
Abstract
Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.
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Affiliation(s)
| | - Hayley H A Thorpe
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Richard D Mccurdy
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
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9
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Sofis MJ, Lemley SM, Budney AJ, Stanger C, Jarmolowicz DP. Persisting on the past: Cross-sectional and prospective associations between sunk cost propensity and cannabis use. Exp Clin Psychopharmacol 2020; 28:225-234. [PMID: 31070426 PMCID: PMC6842029 DOI: 10.1037/pha0000299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Prevalence of cannabis use in the United States continues to rise, and 30% of cannabis users eventually meet criteria for Cannabis Use Disorder (CUD). One response to this problem is to develop decision-making constructs that indicate vulnerability to CUD that might not be gleaned from diagnostic criteria. Unfortunately, there is limited evidence that decision-making constructs consistently relate to cannabis use. Interestingly, those who exhibit the sunk cost bias, an overgeneralized tendency to persist based on past investment, and those who use cannabis, both tend to focus on the past and perseverate more than their counterparts. Despite this overlap, no studies have assessed whether the sunk cost bias is positively associated with cannabis use. In 2 experiments with undergraduates, relations between cannabis use and the propensity to engage in the sunk cost bias were examined using negative binomial models. Experiment 1 (n = 46) evaluated the association between sunk cost bias propensity (using hypothetical costs and rewards) and frequency of cannabis use over the past 30 days. Greater sunk cost propensity was associated with more frequent cannabis use after controlling for demographics and alcohol use. In Experiment 2 (n = 103), more frequent cannabis use during a 6-week follow-up period was predicted by greater sunk cost propensity at baseline (using a real cost and reward-based task), independently and after controlling for mental health symptoms, alcohol use, and demographics. These findings provide preliminary evidence that a propensity to exhibit the sunk cost bias may be an important feature associated with cannabis use. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Abstract
Background: Chronic consumption of alcohol and marijuana, especially when initiated at an early age, has been implicated in cognitive alterations in the domain of executive functioning. Despite the robustness of this finding in Western populations, its generalizability to other cultural contexts is largely unknown. In this study, we examined whether the regular use of alcohol or marijuana use relates to impaired executive functioning in male students of a Nigerian university. Methods: Chronic alcohol users (n = 39), chronic marijuana users (n = 35) and drug-abstinent control participants (n = 40) recruited through snow-ball sampling technique completed a computerized version of the Wisconsin Card Sorting Test (cWCST). As an established measure of executive functioning, the cWCST allows for the simultaneous assessment of three distinct executive processes: set shifting, rule inference, and set maintenance. Results revealed a selective set-shifting deficit in both alcohol and marijuana users. Results: Both groups committed significantly more perseverative errors than the control group, and group differences were significantly stronger on this indicator of set shifting than on indicators of rule inference or set maintenance. Conclusions: Our findings support the generalizability of drug-related deficits in executive functioning and contribute to the characterization of executive dysfunction in non-Western populations. Future longitudinal studies are required to clarify whether executive dysfunction is an antecedent or consequence of alcohol and marijuana use in young Nigerians.
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Affiliation(s)
- Tochukwu Nweze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Cyprian C. Eze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Florian Lange
- Behavioral Engineering Group, KU Leuven, Leuven, Belgium
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11
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Scott JC, Slomiak ST, Jones JD, Rosen AFG, Moore TM, Gur RC. Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis. JAMA Psychiatry 2018; 75:585-595. [PMID: 29710074 PMCID: PMC6137521 DOI: 10.1001/jamapsychiatry.2018.0335] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Substantial shifts in perception and policy regarding cannabis have recently occurred, with use of cannabis increasing while its perceived harm decreases. One possible risk of increased cannabis use is poorer cognitive functioning, especially in youth. OBJECTIVE To provide the first quantitative synthesis of the literature examining cannabis and cognitive functioning in adolescents and young adults (with a mean age of 26 years and younger). DATA SOURCES PubMed, PsycInfo, Academic Search Premier, Scopus, and bibliographies of relevant reviews were searched for peer-reviewed, English-language studies from the date the databases began through May 2017. STUDY SELECTION Consensus criteria were used to determine study inclusion through abstract and manuscript review. DATA EXTRACTION AND SYNTHESIS This study followed Meta-analysis of Observational Studies in Epidemiology guidelines. Effect size estimates were calculated using multivariate mixed-effects models for cognitive functioning outcomes classified into 10 domains. MAIN OUTCOMES AND MEASURES Results from neurocognitive tests administered in cross-sectional studies were primary outcomes, and we examined the influence of a priori explanatory variables on variability in effect size. RESULTS Sixty-nine studies of 2152 cannabis users (mean [SD] age, 20.6 [2.8] years; 1472 [68.4%] male) and 6575 comparison participants with minimal cannabis exposure were included (mean [SD] age, 20.8 [3.4]; 3669 [55.8%] male). Results indicated a small overall effect size (presented as mean d) for reduced cognitive functioning associated with frequent or heavy cannabis use (d, -0.25; 95% CI, -0.32 to -0.17; P < .001). The magnitude of effect sizes did not vary by sample age or age at cannabis use onset. However, studies requiring an abstinence period longer than 72 hours (15 studies; n = 928) had an overall effect size (d, -0.08; 95% CI, -0.22 to 0.07) that was not significantly different from 0 and smaller than studies with less stringent abstinence criteria (54 studies; n = 7799; d, -0.30; 95% CI, -0.37 to -0.22; P = .01). CONCLUSIONS AND RELEVANCE Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with cannabis use. Although other outcomes (eg, psychosis) were not examined in the included studies, results indicate that previous studies of cannabis in youth may have overstated the magnitude and persistence of cognitive deficits associated with use. Reported deficits may reflect residual effects from acute use or withdrawal. Future studies should examine individual differences in susceptibility to cannabis-associated cognitive dysfunction.
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Affiliation(s)
- J. Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania
| | - Samantha T. Slomiak
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jason D. Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Adon F. G. Rosen
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania
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12
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Nusbaum AT, Whitney P, Cuttler C, Spradlin A, Hinson JM, McLaughlin RJ. Altered attentional control strategies but spared executive functioning in chronic cannabis users. Drug Alcohol Depend 2017; 181:116-123. [PMID: 29045919 DOI: 10.1016/j.drugalcdep.2017.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cannabis use has increased rapidly in recent decades. The increase in cannabis use makes it important to understand the potential influence of chronic use on attentional control and other executive functions (EFs). Because cannabis is often used to reduce stress, and because stress can constrain attentional control and EFs, the primary goal of this study was to determine the joint effect of acute stress and chronic cannabis use on specific EFs. METHODS Thirty-nine cannabis users and 40 non-users were assigned to either a stress or no stress version of the Maastricht Acute Stress Test. Participants then completed two cognitive tasks that involve EFs: (1) task switching, and (2) a novel Flexible Attentional Control Task. These two tasks provided assessments of vigilant attention, inhibitory control, top-down attentional control, and cognitive flexibility. Salivary cortisol was assessed throughout the study. RESULTS Reaction time indices showed an interaction between stress and cannabis use on top-down attentional control (p=0.036, np2=0.059). Follow-up tests showed that cannabis users relied less on top-down attentional control than did non-users in the no stress version. Despite not relying on top-down control, the cannabis users showed no overall performance deficits on the tasks. CONCLUSIONS Chronic cannabis users performed cognitive tasks involving EFs as well as non-users while not employing cognitive control processes that are typical for such tasks. These results indicate alterations in cognitive processing in cannabis users, but such alterations do not necessarily lead to global performance deficits.
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Affiliation(s)
- Amy T Nusbaum
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Paul Whitney
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Carrie Cuttler
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA; Translational Addiction Research Center, Washington State University, USA.
| | - Alexander Spradlin
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - John M Hinson
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Ryan J McLaughlin
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA; Translational Addiction Research Center, Washington State University, USA; Washington State University, Department of Integrative Physiology and Neuroscience, Pullman, WA, 99164-7620, USA.
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13
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Becker MP, Collins PF, Schultz A, Urošević S, Schmaling B, Luciana M. Longitudinal changes in cognition in young adult cannabis users. J Clin Exp Neuropsychol 2017; 40:529-543. [PMID: 29058519 DOI: 10.1080/13803395.2017.1385729] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Adolescent cannabis use (CU) is associated with impaired attention, executive function, and verbal learning/memory. These associations are generally observed in cross-sectional studies. Longitudinal studies of cannabis users are lacking. METHOD The present study examines associations between CU and cognition over time in chronic daily adolescent-onset CUs, as compared to nonusing controls. Both groups completed a neuropsychological battery at study intake and again 2 years later. RESULTS Baseline group differences have been published and indicated deficits in verbal learning and memory, motivated decision-making, planning, and working memory in CUs. In this follow-up report, the longitudinal performance of users is compared to that of sustained nonusers using the same battery. At follow-up, the majority of CUs continued to report regular and heavy cannabis use. Relative impairments in the domains of working memory, planning and verbal memory remained stable, suggesting that these are enduring vulnerabilities associated with continued CU during young adulthood. Improvements in motivated decision-making were evident in both groups. In addition, CUs demonstrated relatively better performance on short-duration speeded tasks. An earlier age of CU onset was associated with poorer verbal learning and memory and planning performance over time. CONCLUSIONS Verbal learning and memory and planning processes, as well as their neural correlates, merit further scrutiny within etiological models of cannabis-induced cognitive impairments.
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Affiliation(s)
- Mary P Becker
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
| | - Paul F Collins
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
| | - Ashley Schultz
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
| | - Snežana Urošević
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
| | - Brittany Schmaling
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
| | - Monica Luciana
- a Department of Psychology , University of Minnesota , Minneapolis , MN , USA
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Thijssen S, Rashid B, Gopal S, Nyalakanti P, Calhoun VD, Kiehl KA. Regular cannabis and alcohol use is associated with resting-state time course power spectra in incarcerated adolescents. Drug Alcohol Depend 2017; 178:492-500. [PMID: 28715777 PMCID: PMC5561725 DOI: 10.1016/j.drugalcdep.2017.05.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 12/24/2022]
Abstract
Cannabis and alcohol are believed to have widespread effects on the brain. Although adolescents are at increased risk for substance use, the adolescent brain may also be particularly vulnerable to the effects of drug exposure due to its rapid maturation. Here, we examined the association between cannabis and alcohol use duration and resting-state functional connectivity in a large sample of male juvenile delinquents. The present sample was drawn from the Southwest Advanced Neuroimaging Cohort, Youth sample, and from a youth detention facility in Wisconsin. All participants were scanned at the maximum-security facilities using The Mind Research Network's 1.5T Avanto SQ Mobile MRI scanner. Information on cannabis and alcohol regular use duration was collected using self-report. Resting-state networks were computed using group independent component analysis in 201 participants. Associations with cannabis and alcohol use were assessed using Mancova analyses controlling for age, IQ, smoking and psychopathy scores in the complete case sample of 180 male juvenile delinquents. No associations between alcohol or cannabis use and network spatial maps were found. Longer cannabis use was associated with decreased low frequency power of the default mode network, the executive control networks (ECNs), and several sensory networks, and with decreased functional network connectivity. Duration of alcohol use was associated with decreased low frequency power of the right frontoparietal network, salience network, dorsal attention network, and several sensory networks. Our findings suggest that adolescent cannabis and alcohol use are associated with widespread differences in resting-state time course power spectra, which may persist even after abstinence.
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Affiliation(s)
- Sandra Thijssen
- School of Pedagogical and Educational Sciences, Erasmus University of Rotterdam, The Netherlands; Center for Child and Family Studies, Leiden University, The Netherlands
| | - Barnaly Rashid
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Shruti Gopal
- The Mind Research Network, Albuquerque, NM, USA; Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, NY, USA
| | | | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA; Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, NY, USA
| | - Kent A Kiehl
- The Mind Research Network, Albuquerque, NM, USA; Department of Neurosciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA; Departments of Psychology, Neuroscience, and Law, University Of New Mexico, Albuquerque, NM, United States.
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Camchong J, Lim KO, Kumra S. Adverse Effects of Cannabis on Adolescent Brain Development: A Longitudinal Study. Cereb Cortex 2017; 27:1922-1930. [PMID: 26912785 DOI: 10.1093/cercor/bhw015] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Cannabis is widely perceived as a safe recreational drug and its use is increasing in youth. It is important to understand the implications of cannabis use during childhood and adolescence on brain development. This is the first longitudinal study that compared resting functional connectivity of frontally mediated networks between 43 healthy controls (HCs; 20 females; age M = 16.5 ± 2.7) and 22 treatment-seeking adolescents with cannabis use disorder (CUD; 8 females; age M = 17.6 ± 2.4). Increases in resting functional connectivity between caudal anterior cingulate cortex (ACC) and superior frontal gyrus across time were found in HC, but not in CUD. CUD showed a decrease in functional connectivity between caudal ACC and dorsolateral and orbitofrontal cortices across time. Lower functional connectivity between caudal ACC cortex and orbitofrontal cortex at baseline predicted higher amounts of cannabis use during the following 18 months. Finally, high amounts of cannabis use during the 18-month interval predicted lower intelligence quotient and slower cognitive function measured at follow-up. These data provide compelling longitudinal evidence suggesting that repeated exposure to cannabis during adolescence may have detrimental effects on brain resting functional connectivity, intelligence, and cognitive function.
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Affiliation(s)
- Jazmin Camchong
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Kelvin O Lim
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, USA.,Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Sanjiv Kumra
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, USA
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16
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Dahlgren MK, Sagar KA, Racine MT, Dreman MW, Gruber SA. Marijuana Use Predicts Cognitive Performance on Tasks of Executive Function. J Stud Alcohol Drugs 2016; 77:298-308. [PMID: 26997188 DOI: 10.15288/jsad.2016.77.298] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Despite growing evidence that chronic marijuana use is associated with cognitive impairment, particularly when use is initiated at an early age, national trends demonstrate significant decreases in the perceived risk of marijuana corresponding with increased use, especially among youth. The current study assessed the impact of marijuana use on executive function and whether patterns of marijuana use, including earlier age at onset, higher frequency, and increased magnitude of use, predict impairment. METHOD Forty-four chronic, heavy marijuana smokers (37 male, 7 female) and 32 healthy, nonsmoking control participants (20 male, 12 female) recruited from the Greater Boston area completed two assessments of executive function: the Stroop Color Word Test and Wisconsin Card Sorting Test (WCST). RESULTS Marijuana smokers had poorer executive function relative to control participants, a between-group difference that was primarily driven by individuals with early onset of marijuana use (before age 16; n = 21); significance remained even when controlling for frequency and magnitude of use. Further, earlier age at marijuana onset and increased marijuana use predicted poorer neurocognitive performance, and perseverative errors on the WCST significantly predicted marijuana group membership. CONCLUSIONS These findings underscore the impact of early onset of marijuana use on executive function impairment independent of increased frequency and magnitude of use. In addition, poorer performance on the WCST may serve as a neuropsychological marker for heavy marijuana users. These results highlight the need for additional research to identify predictors associated with early marijuana use, as exposure to marijuana during a period of developmental vulnerability may result in negative cognitive consequences.
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Affiliation(s)
- Mary Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychology, Tufts University, Medford, Massachusetts
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Megan T Racine
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Meredith W Dreman
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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17
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Nguyen-Louie TT, Castro N, Matt GE, Squeglia LM, Brumback T, Tapert SF. Effects of Emerging Alcohol and Marijuana Use Behaviors on Adolescents' Neuropsychological Functioning Over Four Years. J Stud Alcohol Drugs 2016; 76:738-48. [PMID: 26402354 DOI: 10.15288/jsad.2015.76.738] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Adolescence is a period of neuromaturation concomitant with increased substance involvement. Most substance use studies of adolescents have focused on categorical classifications (e.g., dependent vs. nondependent), but little is known about the influence of specific substance use behaviors on cognitive functioning in youth. METHOD This study prospectively evaluated the quantitative effects of different substance use behaviors on neuropsychological functioning. A cognitive test battery was administered at baseline (ages 12-14 years), before substance use initiation, and at follow-up (M = 4.0 years, SD = 2.0) to evaluate changes in verbal memory, visuospatial ability, psychomotor speed, processing speed, and working memory. Robust regressions examined substance use behaviors as predictors of neuropsychological functioning (N = 234). RESULTS Several substance use behaviors predicted follow-up neuropsychological functioning above and beyond effects of baseline performance on the same measure (ps < .05). Specifically, more alcohol use days predicted worse verbal memory (β = -.15) and visuospatial ability (β = -.19). More postdrinking effects (β = -.15) and greater drug use (β = -.11) predicted worse psychomotor speed. Processing speed was not predicted by substance involvement (ps > .05). Unexpectedly, more alcohol use predicted better working memory performance (β = .12). CONCLUSIONS The frequency and intensity of adolescent alcohol use may be more intricately linked to neuropsychological outcomes than previously considered. The low prevalence of substance use disorder in the sample suggests that subdiagnostic users may still experience adverse effects to verbal memory, visuospatial functioning, and psychomotor speed after initiating intense or frequent alcohol use.
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Affiliation(s)
- Tam T Nguyen-Louie
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Norma Castro
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California
| | | | - Ty Brumback
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Susan F Tapert
- Veterans Affairs San Diego Healthcare System, La Jolla, California.,Department of Psychiatry, University of California San Diego, La Jolla, California
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18
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Broyd SJ, van Hell HH, Beale C, Yücel M, Solowij N. Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic Review. Biol Psychiatry 2016; 79:557-67. [PMID: 26858214 DOI: 10.1016/j.biopsych.2015.12.002] [Citation(s) in RCA: 400] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 01/05/2023]
Abstract
Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistence or recovery across all cognitive domains remains underresearched. Associations between poorer performance and a range of cannabis use parameters, including a younger age of onset, are frequently reported. Little further evidence has emerged for the development of tolerance to the acutely impairing effects of cannabis. Evidence for potential protection from harmful effects by cannabidiol continues to increase but is not definitive. In light of increasing trends toward legalization of cannabis, the knowledge gained from this body of research needs to be incorporated into strategies to minimize harm.
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Affiliation(s)
- Samantha J Broyd
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Hendrika H van Hell
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Camilla Beale
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong.
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Winsauer PJ, Filipeanu CM, Weed PF, Sutton JL. Hormonal status and age differentially affect tolerance to the disruptive effects of delta-9-tetrahydrocannabinol (Δ(9)-THC) on learning in female rats. Front Pharmacol 2015; 6:133. [PMID: 26191005 PMCID: PMC4488627 DOI: 10.3389/fphar.2015.00133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 06/15/2015] [Indexed: 12/28/2022] Open
Abstract
The effects of hormone status and age on the development of tolerance to Δ(9)-THC were assessed in sham-operated (intact) or ovariectomized (OVX) female rats that received either intraperitoneal saline or 5.6 mg/kg of Δ(9)-THC daily from postnatal day (PD) 75-180 (early adulthood onward) or PD 35-140 (adolescence onward). During this time, the four groups for each age (i.e., intact/saline, intact/THC, OVX/saline, and OVX/THC) were trained in a learning and performance procedure and dose-effect curves were established for Δ(9)-THC (0.56-56 mg/kg) and the cannabinoid type-1 receptor (CB1R) antagonist rimonabant (0.32-10 mg/kg). Despite the persistence of small rate-decreasing and error-increasing effects in intact and OVX females from both ages during chronic Δ(9)-THC, all of the Δ(9)-THC groups developed tolerance. However, the magnitude of tolerance, as well as the effect of hormone status, varied with the age at which chronic Δ(9)-THC was initiated. There was no evidence of dependence in any of the groups. Hippocampal protein expression of CB1R, AHA1 (a co-chaperone of CB1R) and HSP90β (a molecular chaperone modulated by AHA-1) was affected more by OVX than chronic Δ(9)-THC; striatal protein expression was not consistently affected by either manipulation. Hippocampal brain-derived neurotrophic factor expression varied with age, hormone status, and chronic treatment. Thus, hormonal status differentially affects the development of tolerance to the disruptive effects of delta-9-tetrahydrocannabinol (Δ(9)-THC) on learning and performance behavior in adolescent, but not adult, female rats. These factors and their interactions also differentially affect cannabinoid signaling proteins in the hippocampus and striatum, and ultimately, neural plasticity.
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Affiliation(s)
- Peter J. Winsauer
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center New OrleansNew Orleans, LA, USA
- Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center New OrleansNew Orleans, LA, USA
| | - Catalin M. Filipeanu
- Department of Pharmacology, Howard University College of MedicineWashington, DC, USA
| | - Peter F. Weed
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center New OrleansNew Orleans, LA, USA
| | - Jessie L. Sutton
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center New OrleansNew Orleans, LA, USA
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20
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Padula CB, McQueeny T, Lisdahl KM, Price JS, Tapert SF. Craving is associated with amygdala volumes in adolescent marijuana users during abstinence. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:127-32. [PMID: 25668330 DOI: 10.3109/00952990.2014.966198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Amygdala volume abnormalities have been reported in relation to craving in substance-dependent adults, but it remains unclear if these effects are seen in adolescent marijuana (MJ) users, particularly following abstinence. OBJECTIVES The aim of this study was to examine the relationship between amygdala volume and craving during 28 days of abstinence in adolescent MJ users. METHODS MJ-using adolescents (n = 22) aged 16-19 were recruited as part of a larger study on brain function in teen drug users. Craving measures were collected twice per week throughout a 28-day abstinence period. High-resolution anatomical magnetic resonance imaging data were collected at the end of the 28 days of confirmed abstinence. Left and right amygdala volumes were traced by hand (ICC > 0.86). Composite scores for self-reported craving and withdrawal symptoms throughout the 28-day abstinence period were calculated to provide four composite measures of total craving, mood, sleep, and somatic complaints. RESULTS Results revealed that greater craving during abstinence was significantly associated with smaller left and right amygdala volumes, after controlling for age and gender. Other measures of withdrawal, including mood, somatic complaints and sleep problems, were not related to amygdala morphometry. CONCLUSION These results are consistent with previous findings in adult alcohol- and cocaine-dependent individuals, who demonstrated a relationship between reduced amygdala volumes and increased craving. Future studies are needed to determine if these brain-behavior relationships are attributable to MJ use or predate the onset of substance use.
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Affiliation(s)
- Claudia B Padula
- Veterans Affairs Palo Alto Health Care System, Sierra Pacific Mental Illness Research Education and Clinical Center and Stanford University, Department of Psychiatry and Behavioral Sciences , Palo Alto, CA
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21
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Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther 2014; 148:1-16. [PMID: 25460036 DOI: 10.1016/j.pharmthera.2014.11.009] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/14/2022]
Abstract
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Monash Clinical & Imaging Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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22
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Bjork JM, Pardini DA. Who are those "risk-taking adolescents"? Individual differences in developmental neuroimaging research. Dev Cogn Neurosci 2014; 11:56-64. [PMID: 25176616 PMCID: PMC4324055 DOI: 10.1016/j.dcn.2014.07.008] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 12/01/2022] Open
Abstract
Rates of development differ across brain regions linked to reward and inhibition. Adolescent risk-taking has been attributed in part to normative neurodevelopment. Significant risky behavior in mid-adolescence is not characteristic of typical youth. Youth with behavior disorders show increased behavioral and brain responses to reward. Maturational theories of adolescent risk-taking can consider individual differences.
Functional magnetic resonance imaging (fMRI) has illuminated the development of human brain function. Some of this work in typically-developing youth has ostensibly captured neural underpinnings of adolescent behavior which is characterized by risk-seeking propensity, according to psychometric questionnaires and a wealth of anecdote. Notably, cross-sectional comparisons have revealed age-dependent differences between adolescents and other age groups in regional brain responsiveness to prospective or experienced rewards (usually greater in adolescents) or penalties (usually diminished in adolescents). These differences have been interpreted as reflecting an imbalance between motivational drive and behavioral control mechanisms, especially in mid-adolescence, thus promoting greater risk-taking. While intriguing, we caution here that researchers should be more circumspect in attributing clinically significant adolescent risky behavior to age-group differences in task-elicited fMRI responses from neurotypical subjects. This is because actual mortality and morbidity from behavioral causes (e.g. substance abuse, violence) by mid-adolescence is heavily concentrated in individuals who are not neurotypical, who rather have shown a lifelong history of behavioral disinhibition that frequently meets criteria for a disruptive behavior disorder, such as conduct disorder, oppositional-defiant disorder, or attention-deficit hyperactivity disorder. These young people are at extreme risk of poor psychosocial outcomes, and should be a focus of future neurodevelopmental research.
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Affiliation(s)
- James M Bjork
- Department of Psychiatry, Virginia Commonwealth University, 203 East Cary Street, Suite 202, Richmond, VA 23219, USA.
| | - Dustin A Pardini
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
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23
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Intellectual, neurocognitive, and academic achievement in abstinent adolescents with cannabis use disorder. Psychopharmacology (Berl) 2014; 231:1467-77. [PMID: 24619597 PMCID: PMC3969383 DOI: 10.1007/s00213-014-3463-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 01/21/2014] [Indexed: 11/27/2022]
Abstract
RATIONALE The active component of cannabis, delta-9 tetrahydrocannabinol (THC), has a long half-life and widespread neurocognitive effects. There are inconsistent reports of neurocognitive deficits in adults and adolescents with cannabis use disorders (CUD), particularly after a period of abstinence. OBJECTIVES This study aims to examine neurocognitive measures (IQ, academic achievement, attention, memory, executive functions) in abstinent adolescents with CUD, while controlling for demographic, psychopathology, and poly-substance confounders. METHODS We investigated neurocognitive performance in three groups: adolescents with CUD after successful first treatment and in full remission (n = 33); controls with psychiatric disorders without substance use disorder history (n = 37); and healthy adolescents (n = 43). RESULTS Adolescents with psychiatric disorders, regardless of CUD status, performed significantly worse than the healthy adolescents in academic achievement. No group differences were seen in IQ, attention, memory, or executive functions. Lower academic achievement was positively associated with younger age of CUD onset, regular cannabis use, and maximum daily use. In the CUD group, lifetime nicotine use episodes were negatively associated with IQ. Lower overall neurocognitive function was associated with younger age of onset of regular cannabis use and relapse within the 1 year follow-up. CONCLUSIONS Verifiably, abstinent adolescents with CUD history did not differ from the two comparison groups, suggesting that previously reported neurocognitive deficits may be related to other factors, including residual drug effects, preexisting cognitive deficits, concurrent use of other substances (e.g., nicotine), or psychopathology. Adolescents with CUD may not be vulnerable to THC neuropsychological deficits once they achieve remission from all drugs for at least 30 days.
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24
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Jager G, Block RI, Luijten M, Ramsey NF. Tentative evidence for striatal hyperactivity in adolescent cannabis-using boys: a cross-sectional multicenter fMRI study. J Psychoactive Drugs 2013; 45:156-67. [PMID: 23909003 DOI: 10.1080/02791072.2013.785837] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Adolescents' risk-taking behavior has been linked to a maturational imbalance between reward ("go") and inhibitory-control ("stop")-related brain circuitry. This may drive adolescent drug-taking, such as cannabis use. In this study, we assessed the non-acute effects of adolescent cannabis use on reward-related brain function. We performed a two-site (United States and Netherlands; pooled data) functional magnetic resonance imaging (fMRI) study with a cross-sectional design. Twenty-one abstinent but frequent cannabis-using boys were compared with 24 non-using peers on reward-related brain function, using a monetary incentive delay task with fMRI. Focus was on anticipatory and response stages of reward and brain areas critically involved in reward processing like the striatum. Performance in users was normal. Region-of-interest analysis indicated striatal hyperactivity during anticipatory stages of reward in users. Intriguingly, this effect was most pronounced during non-rewarding events. Striatal hyperactivity in adolescent cannabis users may signify an overly sensitive motivational brain circuitry. Frequent cannabis use during adolescence may induce diminished ability to disengage the motivational circuit when no reward can be obtained. This could strengthen the search for reinforcements like drugs of abuse, even when facing the negative (non-rewarding) consequences.
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Affiliation(s)
- Gerry Jager
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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25
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Crane NA, Schuster RM, Fusar-Poli P, Gonzalez R. Effects of cannabis on neurocognitive functioning: recent advances, neurodevelopmental influences, and sex differences. Neuropsychol Rev 2013; 23:117-37. [PMID: 23129391 PMCID: PMC3593817 DOI: 10.1007/s11065-012-9222-1] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/22/2012] [Indexed: 12/19/2022]
Abstract
Decades of research have examined the effects of cannabis on neurocognition. Recent advances in this field provide us with a better understanding of how cannabis use influences neurocognition both acutely (during intoxication) and non-acutely (after acute effects subside). Evidence of problems with episodic memory is one of the most consistent findings reported; however, several other neurocognitive domains appear to be adversely affected by cannabis use under various conditions. There is significant variability in findings across studies, thus a discussion of potential moderators is increasingly relevant. The purpose of this review was to 1) provide an update on research of cannabis' acute and non-acute effects on neurocognition, with a focus on findings since 2007 and 2) suggest and discuss how neurodevelopmental issues and sex differences may influence cannabis effects on neurocognition. Finally we discuss how future investigations may lead to better understanding of the complex interplay among cannabis, stages of neurodevelopment, and sex on neurocognitive functioning.
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Affiliation(s)
| | | | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London
| | - Raul Gonzalez
- Department of Psychology, Florida International University
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26
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Impulsivity, attention, memory, and decision-making among adolescent marijuana users. Psychopharmacology (Berl) 2013; 226:307-19. [PMID: 23138434 PMCID: PMC3581724 DOI: 10.1007/s00213-012-2908-5] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 10/17/2012] [Indexed: 12/11/2022]
Abstract
RATIONALE Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. OBJECTIVES The purpose of this research was to determine unique associations between adolescent marijuana use and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from nonusers. METHODS Marijuana-using adolescents (n = 45) and controls (n = 48) were tested. Logistic regression analyses were conducted to test for: (1) differences between marijuana users and nonusers on each measure, (2) associations between marijuana use and each measure after controlling for the other measures, and (3) the degree to which (1) and (2) together elucidated differences among marijuana users and nonusers. RESULTS Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. CONCLUSIONS This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population.
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Addicott MA, Pearson JM, Wilson J, Platt ML, McClernon FJ. Smoking and the bandit: a preliminary study of smoker and nonsmoker differences in exploratory behavior measured with a multiarmed bandit task. Exp Clin Psychopharmacol 2013; 21:66-73. [PMID: 23245198 PMCID: PMC4028629 DOI: 10.1037/a0030843] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Advantageous decision-making is an adaptive trade-off between exploring alternatives and exploiting the most rewarding option. This trade-off may be related to maladaptive decision-making associated with nicotine dependence; however, explore/exploit behavior has not been previously investigated in the context of addiction. The explore/exploit trade-off is captured by the multiarmed bandit task, in which different arms of a slot machine are chosen to discover the relative payoffs. The goal of this study was to preliminarily investigate whether smokers differ from nonsmokers in their degree of exploratory behavior. Smokers (n = 18) and nonsmokers (n = 17) completed a 6-armed bandit task as well as self-report measures of behavior and personality traits. Smokers were found to exhibit less exploratory behavior (i.e., made fewer switches between slot machine arms) than nonsmokers within the first 300 trials of the bandit task. The overall proportion of exploratory choices negatively correlated with self-reported measures of delay aversion and nonplanning impulsivity. These preliminary results suggest that smokers make fewer initial exploratory choices on the bandit task. The bandit task is a promising measure that could provide valuable insights into how nicotine use and dependence is associated with explore/exploit decision-making.
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Affiliation(s)
- Merideth A. Addicott
- Department of Psychiatry and Behavioral Research, Duke University and Duke University School of Medicine, Durham NC USA 27710,Duke-UNC Brain Imaging and Analysis Center, Duke University and Duke University School of Medicine, Durham NC USA 27710
| | - John M. Pearson
- Department of Neurobiology, Duke University and Duke University School of Medicine, Durham NC USA 27710,Center for Cognitive Neuroscience, Duke University and Duke University School of Medicine, Durham NC USA 27710
| | - Jessica Wilson
- Center for Cognitive Neuroscience, Duke University and Duke University School of Medicine, Durham NC USA 27710,Department of Psychology and Neuroscience, Duke University and Duke University School of Medicine, Durham NC USA 27710
| | - Michael L. Platt
- Department of Neurobiology, Duke University and Duke University School of Medicine, Durham NC USA 27710,Center for Cognitive Neuroscience, Duke University and Duke University School of Medicine, Durham NC USA 27710,Department of Evolutionary Anthropology, Duke University and Duke University School of Medicine, Durham NC USA 27710
| | - F. Joseph McClernon
- Department of Psychiatry and Behavioral Research, Duke University and Duke University School of Medicine, Durham NC USA 27710,Duke-UNC Brain Imaging and Analysis Center, Duke University and Duke University School of Medicine, Durham NC USA 27710,Durham Veterans Affairs Medical Center, Duke University and Duke University School of Medicine, Durham NC USA 27710
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Griffith-Lendering MFH, Huijbregts SCJ, Vollebergh WAM, Swaab H. Motivational and cognitive inhibitory control in recreational cannabis users. J Clin Exp Neuropsychol 2012; 34:688-97. [DOI: 10.1080/13803395.2012.668874] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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29
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Bickel WK, Jarmolowicz DP, Mueller ET, Gatchalian KM, McClure SM. Are executive function and impulsivity antipodes? A conceptual reconstruction with special reference to addiction. Psychopharmacology (Berl) 2012; 221:361-87. [PMID: 22441659 PMCID: PMC4035182 DOI: 10.1007/s00213-012-2689-x] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Accepted: 03/05/2012] [Indexed: 12/31/2022]
Abstract
RATIONALE Although there is considerable interest in how either executive function (EF) or impulsivity relate to addiction, there is little apparent overlap between these research areas. OBJECTIVES The present paper aims to determine if components of these two constructs are conceptual antipodes--widely separated on a shared continuum. METHODS EFs and impulsivities were compared and contrasted. Specifically, the definitions of the components of EF and impulsivity, the methods used to measure the various components, the populations of drug users that show deficits in these components, and the neural substrates of these components were compared and contrasted. RESULTS Each component of impulsivity had an antipode in EF. EF, however, covered a wider range of phenomena, including compulsivity. CONCLUSIONS Impulsivity functions as an antipode of certain components of EF. Recognition of the relationship between EF and impulsivity may inform the scientific inquiry of behavioral problems such as addiction. Other theoretical implications are discussed.
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Affiliation(s)
- Warren K Bickel
- Addiction Recovery Research Center and Virginia Tech Department of Psychology, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA.
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Simons JS, Dvorak RD, Merrill JE, Read JP. Dimensions and severity of marijuana consequences: development and validation of the Marijuana Consequences Questionnaire (MACQ). Addict Behav 2012; 37:613-21. [PMID: 22305645 DOI: 10.1016/j.addbeh.2012.01.008] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 11/06/2011] [Accepted: 01/09/2012] [Indexed: 10/14/2022]
Abstract
The Marijuana Consequences Questionnaire (MACQ) is a 50-item self-report measure modeled after the Young Adult Alcohol Consequences Questionnaire (YAACQ). College students (n=315) completed questionnaires online. A confirmatory factor analysis supported the hypothesized 8-factor structure. The results indicate good convergent and discriminant validity of the MACQ. A brief, unidimensional, 21-item version (B-MACQ) was developed by a Rasch model. Comparison of item severity estimates of the B-MACQ items and the corresponding items from the YAACQ indicates that the severity of alcohol- and marijuana-problems is defined by a relatively unique pattern of consequences. The MACQ and B-MACQ provide promising new alternatives to assessing marijuana-related problems.
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Abstract
This case describes the clinical course of a cannabis-dependent individual entering a 12-week abstinence-based research program. The case illustrates the effects of chronic, heavy cannabis use on executive functions at three time points: 1) 24 hours of abstinence; 2) 4 weeks of abstinence; and 3) 12 weeks of abstinence. It is followed by discussions by two clinical psychologists and a psychiatrist. The findings described here have important clinical implications, as executive functions have a vital role in treatment participation and in sustaining recovery. It should be of particular interest to clinicians who work with people with cannabis use disorders.
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Mahmood OM, Jacobus J, Bava S, Scarlett A, Tapert SF. Learning and memory performances in adolescent users of alcohol and marijuana: interactive effects. J Stud Alcohol Drugs 2011; 71:885-94. [PMID: 20946746 DOI: 10.15288/jsad.2010.71.885] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Lifetime alcohol hangover and withdrawal symptoms in youth have been shown to predict poorer recall of verbal and nonverbal information, as well as reduced visuospatial skills. Some evidence has suggested that negative effects of alcohol on the brain may be buffered in part by potential neuroprotective properties of cannabinoids. We hypothesized that a history of more alcohol hangover symptoms would predict worse performances on measures of verbal and visual memory, and that this relationship would be moderated by marijuana involvement. METHOD Participants were 130 adolescents (65 with histories of heavy marijuana use, and 65 non-marijuana-using controls), ranging in age from 15.7 to 19.1 years. Neuropsychological tests for visual and verbal memory and interviews assessing lifetime and recent substance use, hangover/withdrawal symptoms, and abuse and dependence criteria were administered. RESULTS Regression models revealed that greater alcohol hangover symptoms predicted worse verbal learning (p < .05) and memory (p < .05) (California Verbal Learning Test, Second Edition) scores for non-marijuana users, but alcohol hangover symptoms were not linked to performance among marijuana users. Alcohol hangover symptoms did not predict visual memory in either group. CONCLUSIONS Results confirm previous studies linking adolescent heavy drinking to reduced verbal learning and memory performance. However, this relationship is not seen in adolescents with similar levels of alcohol involvement who also are heavy users of marijuana.
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Affiliation(s)
- Omar M Mahmood
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
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Klugmann M, Goepfrich A, Friemel CM, Schneider M. AAV-Mediated Overexpression of the CB1 Receptor in the mPFC of Adult Rats Alters Cognitive Flexibility, Social Behavior, and Emotional Reactivity. Front Behav Neurosci 2011; 5:37. [PMID: 21808613 PMCID: PMC3139222 DOI: 10.3389/fnbeh.2011.00037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 06/29/2011] [Indexed: 12/20/2022] Open
Abstract
The endocannabinoid (ECB) system is strongly involved in the regulation of cognitive processing and emotional behavior and evidence indicates that ECB signaling might affect these behavioral abilities by modulations of prefrontal cortical functions. The aim of the present study was to examine the role of the CB1 receptor in the medial prefrontal cortex (mPFC) on cognitive flexibility and emotional behavior. Therefore, the CB1 receptor was overexpressed by adeno-associated virus vector-mediated gene transfer specifically in the mPFC of adult Wistar rats. Animals were then tested in different anxiety-related paradigms for emotional reactivity [e.g., elevated plus maze (EPM), light/dark emergence test (EMT), social interaction] and the attentional set shift task (ASST) – an adaptation of the human Wisconsin card sorting test – for cognitive abilities and behavioral flexibility. A subtle increase in exploratory behavior was found in CB1 receptor overexpressing animals (CB1-R) compared to Empty vector injected controls (Empty) in the EMT and EPM, although general locomotor activity did not differ between the groups. During social interaction testing, social contact behavior toward the unknown conspecific was found to be decreased, whereas social withdrawal was increased in CB1-R animals and they showed an inadequate increase in exploratory behavior compared to control animals. In the ASST, impaired reversal learning abilities were detected in CB1-R animals compared to controls, indicating reduced behavioral flexibility. In conclusion, upregulation of the CB1 receptor specifically in the rat mPFC induces alterations in emotional reactivity, leads to inadequate social behavior, and impairs cognitive flexibility. These findings might be relevant for neuropsychiatric disorders, since higher cortical CB1 receptor expression levels as well as similar behavioral impairments as observed in the present study have been described in schizophrenic patients.
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Affiliation(s)
- Matthias Klugmann
- Translational Neuroscience Facility, Department of Physiology, School of Medical Sciences, University of New South Wales Sydney, NSW, Australia
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Allen CP, Leri F. Excitotoxic lesions to the prefrontal cortex of Sprague-Dawley rats do not impair response matching. Neurosci Lett 2011; 495:30-4. [PMID: 21414386 DOI: 10.1016/j.neulet.2011.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 02/02/2011] [Accepted: 03/08/2011] [Indexed: 11/30/2022]
Abstract
Perseveration refers to maladaptive persistence of behavior outside appropriate contexts and despite negative outcomes. In humans, perseveration is a symptom of a variety of psychiatric disorders. In rats, perseveration has been observed in reversal learning tasks following lesions of the prefrontal cortex (PFC). However, the exact nature of the impairment underlying this effect remains unclear. Male Sprague-Dawley rats were trained on a novel reversal task that requires switching between two rewarded options varying in effort (concurrent fixed and progressive ratios) necessary to obtain the reward. Following initial training, bilateral lesions of the dorsal PFC, medial PFC, or orbitofrontal cortex were produced by NMDA infusions. When animals were re-tested post-surgery, no significant impairments were found. These results indicate that, in trained rats, the PFC is not necessary for selecting responses on the basis of favorable effort-to-reward contingencies.
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Affiliation(s)
- Craig P Allen
- Department of Psychology, University of Guelph, Guelph, ON, Canada
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Rose-Jacobs R, Soenksen S, Appugliese DP, Cabral HJ, Richardson MA, Beeghly M, Heeren TC, Frank DA. Early adolescent executive functioning, intrauterine exposures and own drug use. Neurotoxicol Teratol 2011; 33:379-92. [PMID: 21371553 PMCID: PMC3145371 DOI: 10.1016/j.ntt.2011.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 02/22/2011] [Accepted: 02/24/2011] [Indexed: 12/21/2022]
Abstract
Individual differences in adolescents' executive functioning are often attributed either to intrauterine substance exposure or to adolescents' own substance use, but both predictors typically have not been evaluated simultaneously in the same study. This prospective study evaluated whether intrauterine drug exposures, the adolescents' own substance use, and/or their potential interactions are related to poorer executive functioning after controlling for important contextual variables. Analyses were based on data collected on a sample of 137 predominantly African-American/African Caribbean adolescents from low-income urban backgrounds who were followed since their term birth. Intrauterine substance exposures (cocaine, marijuana, alcohol, and cigarettes) and adolescents' substance use were documented using a combination of biological assays and maternal and adolescent self-report. At 12-14 years of age, examiners masked to intrauterine exposures and current substance use assessed the adolescents using the Delis-Kaplan Executive Function System (D-KEFS), an age-referenced instrument evaluating multiple dimensions of executive functioning (EF). Results of covariate-controlled analyses in this study suggest that when intrauterine substance exposures and young adolescents' substance use variables were in the same analysis models, subtle differences in specific EF outcomes were identifiable in this non-referred sample. While further study with larger samples is indicated, these findings suggest that 1) research on adolescent substance use and intrauterine exposure research should evaluate both predictors simultaneously, 2) subtle neurocognitive effects associated with specific intrauterine drug exposures can be identified during early adolescence, and 3) intrauterine substance exposure effects may differ from those associated with adolescents' own drug use.
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Affiliation(s)
- Ruth Rose-Jacobs
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, 88 East Newton Street, Boston, MA 02118, United States.
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Wesley MJ, Hanlon CA, Porrino LJ. Poor decision-making by chronic marijuana users is associated with decreased functional responsiveness to negative consequences. Psychiatry Res 2011; 191:51-9. [PMID: 21145211 PMCID: PMC3125637 DOI: 10.1016/j.pscychresns.2010.10.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 10/07/2010] [Accepted: 10/08/2010] [Indexed: 11/30/2022]
Abstract
Chronic marijuana users (MJ Users) perform poorly on the Iowa Gambling Task (IGT), a complex decision-making task in which monetary wins and losses guide strategy development. This functional magnetic resonance imaging (MRI) study sought to determine if the poor performance of MJ Users was related to differences in brain activity while evaluating wins and losses during the strategy development phase of the IGT. MJ Users (16) and Controls (16) performed a modified IGT in an MRI scanner. Performance was tracked and functional activity in response to early wins and losses was examined. While the MJ Users continued to perform poorly at the end of the task, there was no difference in group performance during the initial strategy development phase. During this phase, before the emergence of behavioral differences, Controls exhibited significantly greater activity in response to losses in the anterior cingulate cortex, medial frontal cortex, precuneus, superior parietal lobe, occipital lobe and cerebellum as compared to MJ Users. Furthermore, in Controls, but not MJ Users, the functional response to losses in the anterior cingulate cortex, ventral medial prefrontal cortex and rostral prefrontal cortex positively correlated with performance over time. These data suggest MJ Users are less sensitive to negative feedback during strategy development.
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Affiliation(s)
- Michael J. Wesley
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Colleen A. Hanlon
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Linda J. Porrino
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
- Center for the Neurobiological Investigation of Drug Abuse, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
- Address correspondence to: Linda J. Porrino, Ph.D., Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1083, Tel: 336 716 8575, FAX: 336 716 8501,
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Cognitive Impairments in Adolescent Cannabis Users are Related to THC Levels. ADDICTIVE DISORDERS & THEIR TREATMENT 2010. [DOI: 10.1097/adt.0b013e3181c8c667] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bava S, Tapert SF. Adolescent brain development and the risk for alcohol and other drug problems. Neuropsychol Rev 2010; 20:398-413. [PMID: 20953990 PMCID: PMC2988999 DOI: 10.1007/s11065-010-9146-6] [Citation(s) in RCA: 271] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 10/05/2010] [Indexed: 01/31/2023]
Abstract
Dynamic changes in neurochemistry, fiber architecture, and tissue composition occur in the adolescent brain. The course of these maturational processes is being charted with greater specificity, owing to advances in neuroimaging and indicate grey matter volume reductions and protracted development of white matter in regions known to support complex cognition and behavior. Though fronto-subcortical circuitry development is notable during adolescence, asynchronous maturation of prefrontal and limbic systems may render youth more vulnerable to risky behaviors such as substance use. Indeed, binge-pattern alcohol consumption and comorbid marijuana use are common among adolescents, and are associated with neural consequences. This review summarizes the unique characteristics of adolescent brain development, particularly aspects that predispose individuals to reward seeking and risky choices during this phase of life, and discusses the influence of substance use on neuromaturation. Together, findings in this arena underscore the importance of refined research and programming efforts in adolescent health and interventional needs.
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Affiliation(s)
- Sunita Bava
- VA San Diego Healthcare System, 3350 La Jolla Village Drive (151B), San Diego, CA 92126, USA
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Oberlin BG, Bristow RE, Heighton ME, Grahame NJ. Pharmacologic dissociation between impulsivity and alcohol drinking in high alcohol preferring mice. Alcohol Clin Exp Res 2010; 34:1363-75. [PMID: 20491739 PMCID: PMC3967789 DOI: 10.1111/j.1530-0277.2010.01220.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Impulsivity is genetically correlated with, and precedes, addictive behaviors and alcoholism. If impulsivity or attention is causally related to addiction, certain pharmacological manipulations of impulsivity and/or attention may affect alcohol drinking, and vice versa. The current studies were designed to explore the relationship among impulsivity, drinking, and vigilance in selectively bred High Alcohol Preferring (HAP) mice, a line that has previously demonstrated both high impulsivity and high alcohol consumption. Amphetamine, naltrexone, and memantine were tested in a delay discounting (DD) task for their effects on impulsivity and vigilance. The same drugs and doses were also assessed for effects on alcohol drinking in a 2-bottle choice test. METHODS HAP mice were subjected to a modified version of adjusting amount DD using 0.5-second and 10-second delays to detect decreases and increases, respectively, in impulsive responding. In 2 experiments, mice were given amphetamine (0.4, 0.8, or 1.2 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) before DD testing. Another pair of studies used scheduled access, 2-bottle choice drinking to assess effects of amphetamine (0.4, 1.2, or 3.0 mg/kg), naltrexone (3 and 10 mg/kg), and memantine (1 and 5 mg/kg) on alcohol consumption. RESULTS Amphetamine dose-dependently reduced impulsivity and vigilance decrement in DD, but similar doses left alcohol drinking unaffected. Naltrexone and memantine decreased alcohol intake at doses that did not affect water drinking but had no effects on impulsivity or vigilance decrement in the DD task. CONCLUSIONS Contrary to our hypothesis, none of the drugs tested here, while effective on either alcohol drinking or impulsivity, decreased both behaviors. These findings suggest that the genetic association between drinking and impulsivity observed in this population is mediated by mechanisms other than those targeted by the drugs tested in these studies.
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Affiliation(s)
- Brandon G. Oberlin
- Stark Neuroscience Institute, Program in Medical Neuroscience, Indiana University School of Medicine, 402 N Blackford St., Indianapolis, IN 46202, USA, Voice: (317) 278-8456, FAX: (317) 274-6756
| | - R. Evan Bristow
- Dept. of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH 45056, USA, Voice: (513) 529-2400, FAX: (513) 529-2420
| | - Meredith E. Heighton
- Dept. of Psychology, Indiana University Purdue University at Indianapolis (IUPUI), 402 N Blackford St., Indianapolis, IN 46202, USA, Voice: (317) 278-8456, FAX: (317) 274-6756
| | - Nicholas J. Grahame
- Associate Professor, Dept. Psychology, Indiana University Purdue University at Indianapolis (IUPUI), 402 N Blackford St., Indianapolis, IN 46202, USA, Voice: (317) 274-0194, FAX: (317) 274-6756
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Allen CP, Leri F. Effect of acute and repeated cocaine exposure on response matching capabilities of Sprague–Dawley rats responding for sucrose on concurrent schedules of reinforcement. Pharmacol Biochem Behav 2010; 96:96-103. [DOI: 10.1016/j.pbb.2010.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 04/10/2010] [Accepted: 04/16/2010] [Indexed: 11/28/2022]
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Anokhin AP, Golosheykin S, Grant JD, Heath AC. Developmental and genetic influences on prefrontal function in adolescents: a longitudinal twin study of WCST performance. Neurosci Lett 2010; 472:119-22. [PMID: 20132870 DOI: 10.1016/j.neulet.2010.01.067] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 12/09/2009] [Accepted: 01/26/2010] [Indexed: 01/13/2023]
Abstract
Adolescence is characterized by a relative immaturity of the prefrontal cortex and associated cognitive control functions, which is hypothesized to be a major contributing factor to high-risk behaviors. However, little is known about the role of genetic and environmental factors in frontal brain development during adolescence. Here we examined heritability of performance on the Wisconsin Card Sorting Test (WCST), an established neuropsychological measure of prefrontally mediated executive functioning, in a longitudinal sample of adolescent twins (n=747) tested at ages 12 and 14. WSCT performance significant improved with age as indicated by a decrease in the number of perseverative errors (p<0.001), which was paralleled by an increase in heritability in females (19% at age 12 and 49% at age 14) and shared environmental influences in males (non-significant at age 12 and 34% at age 14). The results suggest increasing influence of familial factors on frontal executive functioning during adolescence, as well as gender differences in the relative role of genetic and environmental factors.
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Affiliation(s)
- Andrey P Anokhin
- Washington University School of Medicine, St. Louis, MO 63110, USA.
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Piechatzek M, Indlekofer F, Daamen M, Glasmacher C, Lieb R, Pfister H, Tucha O, Lange KW, Wittchen HU, Schütz CG. Is moderate substance use associated with altered executive functioning in a population-based sample of young adults? Hum Psychopharmacol 2009; 24:650-65. [PMID: 19946940 DOI: 10.1002/hup.1069] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Substance use (SU) has been linked with impaired cognitive functioning. Evidence comes mainly from clinical studies or studies examining heavy users. Though, the majority of users are not involved in heavy use. This study investigates the association between moderate use and cognition in a population-based sample. METHODS A total of 284 young adults with ecstasy, cannabis or alcohol use and a control group were sampled from the EDSP database for participation in the Munich Assessment of Young Adults (MAYA) study. Subjects completed a comprehensive battery of neuropsychological tests (executive functions, working memory and impulsivity). Multiple linear regression models were conducted to examine the relationship between use and cognitive performance. RESULTS Increased ecstasy consumption was associated with increased error-proneness (Stroop task, CANTAB ID/ED-shift, spatial working memory). More frequent cannabis use and more extensive alcohol consumption were associated with a higher degree of impulsiveness. CONCLUSIONS Based on mild to moderate SU, little indication of differences in executive functioning was found. For ecstasy use, an increased error-proneness was revealed. The subtle differences in relatively young individuals warrant further investigation in prospective long-term studies to identify subjects at risk, and to examine effects of prolonged patterns of use on executive functioning.
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Jacobus J, McQueeny T, Bava S, Schweinsburg BC, Frank L, Yang TT, Tapert SF. White matter integrity in adolescents with histories of marijuana use and binge drinking. Neurotoxicol Teratol 2009; 31:349-55. [PMID: 19631736 PMCID: PMC2762024 DOI: 10.1016/j.ntt.2009.07.006] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 06/04/2009] [Accepted: 07/15/2009] [Indexed: 11/30/2022]
Abstract
Structural brain abnormalities have been observed in adolescents with alcohol use disorders but less is known about neuropathological brain characteristics of teens with sub-diagnostic binge drinking or the common pattern of binge drinking combined with marijuana use. The goal of this study was to examine white matter integrity in adolescents with histories of binge drinking and marijuana use. Diffusion tensor imaging (DTI) was conducted with 42 adolescents (ages 16-19) classified as controls, binge drinkers, or binge drinkers who are also heavy marijuana users. Tract based spatial analysis identified shared fiber structure across individuals and facilitated voxelwise comparisons of fractional anisotropy (FA) and mean diffusivity (MD) between groups. Significant between group differences were found in FA in eight white matter regions (ps < or = .016) between the binge drink-only group and controls, including superior corona radiata, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and superior longitudinal fasciculus. Interestingly, in 4 of these same regions, binge drinkers who are also heavy marijuana users had higher FA than binge drinkers who did not use marijuana (ps<.05). MD did not differ between groups. Findings are largely consistent with research suggesting less neuropathology in adolescents without histories of substance use. However, binge drinkers who also use marijuana did not show as consistent a divergence from non-users as did the binge drink-only group. Detection of white matter alterations may have implications in identifying early cognitive dysfunction in substance using adolescents.
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Affiliation(s)
- J. Jacobus
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System
| | - T. McQueeny
- University of Cincinnati, Department of Psychology
| | - S. Bava
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
| | - B. C. Schweinsburg
- Yale University School of Medicine, Department of Psychiatry
- VA Connecticut Healthcare System
| | - L.R. Frank
- University of California San Diego, Department of Radiology
| | - T. T. Yang
- University of California San Diego, Department of Psychiatry
| | - S. F. Tapert
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
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Oberlin BG, Grahame NJ. High-alcohol preferring mice are more impulsive than low-alcohol preferring mice as measured in the delay discounting task. Alcohol Clin Exp Res 2009; 33:1294-303. [PMID: 19389183 DOI: 10.1111/j.1530-0277.2009.00955.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Repeated studies have shown that high impulsivity, when defined as the tendency to choose small immediate rewards over larger delayed rewards, is more prevalent in drug addicts and alcoholics when compared with nonaddicts. Assessing whether impulsivity precedes and potentially causes addiction disorders is difficult in humans because they all share a history of drug use. In this study, we address this question by testing alcohol-naïve mice from lines showing heritable differences in alcohol intake. METHODS Replicated selected lines of outbred high-alcohol preferring (HAP) mice were compared to a low-alcohol preferring (LAP) line as well as the low-drinking progenitor line (HS/Ibg) on an adjusting amount delay discounting (DD) task. The DD task employs 2 levers to present subjects with a choice between a small, immediate and a large, delayed saccharin reward. By adjusting the quantity of the immediate reward up and down based on choice behavior, the task allows an estimate of how the subjective value of the delayed reinforcer decreases as delays increase. Latency to respond was also measured for each trial. RESULTS Both HAP2 and HAP1 lines of mice were more impulsive than the LAP2 and HS/Ibg lines, respectively. Hyperbolic curve-fitting confirmed steeper discounting in the high-alcohol drinking lines. In addition, the high-alcohol drinking lines demonstrated greater within-session increases in reaction times relative to the low-alcohol drinking lines. No other differences (consumption of saccharin, total trials completed) consistently mapped onto genetic differences in alcohol drinking. CONCLUSIONS Alcohol-naïve outbred mice selected for high-alcohol drinking were more impulsive with saccharin reinforcers than low-alcohol drinkers. These data are consistent with results seen using inbred strain descendents of high-alcohol drinking and low-alcohol drinking rat lines, and suggest that impulsivity is a heritable difference that precedes alcoholism.
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Affiliation(s)
- B G Oberlin
- Department of Psychology, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana, USA
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Functional consequences of marijuana use in adolescents. Pharmacol Biochem Behav 2009; 92:559-65. [PMID: 19348837 DOI: 10.1016/j.pbb.2009.04.001] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2008] [Revised: 03/30/2009] [Accepted: 04/01/2009] [Indexed: 11/23/2022]
Abstract
Nearly half of 12th graders have tried marijuana, and 6% use daily. This paper reviews studies on neuropsychological functioning, brain structure, brain function, and subjective and objective measures of sleep in relation to adolescent marijuana use. Adolescents who use marijuana heavily tend to show disadvantaged attention, learning, and processing speed; subtle abnormalities in brain structure; increased activation during cognitive tasks despite intact performance; and compromised objective indicators of sleep quality. Some abnormalities appear to persist beyond a month of abstinence, but may resolve within three months if cessation is maintained. Recommendations for future studies include characterizing these indices in youth prior to the onset of marijuana use then examining change after chronic use has started, and using large samples of youth with varying degrees of involvement with marijuana as well as alcohol, nicotine, and other drugs to characterize the interactive influences on neurocognition and neural health.
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Giroud C, Bollmann M, Thomas A, Mangin P, Favrat B. Consommation de cannabis: quels sont les risques ? ACTA ACUST UNITED AC 2009. [DOI: 10.1051/ata/2009021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Using the MATRICS to guide development of a preclinical cognitive test battery for research in schizophrenia. Pharmacol Ther 2009; 122:150-202. [PMID: 19269307 DOI: 10.1016/j.pharmthera.2009.02.004] [Citation(s) in RCA: 257] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 02/17/2009] [Indexed: 12/29/2022]
Abstract
Cognitive deficits in schizophrenia are among the core symptoms of the disease, correlate with functional outcome, and are not well treated with current antipsychotic therapies. In order to bring together academic, industrial, and governmental bodies to address this great 'unmet therapeutic need', the NIMH sponsored the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. Through careful factor analysis and consensus of expert opinion, MATRICS identified seven domains of cognition that are deficient in schizophrenia (attention/vigilance, working memory, reasoning and problem solving, processing speed, visual learning and memory, verbal learning and memory, and social cognition) and recommended a specific neuropsychological test battery to probe these domains. In order to move the field forward and outline an approach for translational research, there is a need for a "preclinical MATRICS" to develop a rodent test battery that is appropriate for drug development. In this review, we outline such an approach and review current rodent tasks that target these seven domains of cognition. The rodent tasks are discussed in terms of their validity for probing each cognitive domain as well as a brief overview of the pharmacology and manipulations relevant to schizophrenia for each task.
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Aharonovich E, Brooks AC, Nunes EV, Hasin DS. Cognitive deficits in marijuana users: Effects on motivational enhancement therapy plus cognitive behavioral therapy treatment outcome. Drug Alcohol Depend 2008; 95:279-83. [PMID: 18329188 PMCID: PMC2429981 DOI: 10.1016/j.drugalcdep.2008.01.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 01/07/2008] [Accepted: 01/08/2008] [Indexed: 11/17/2022]
Abstract
Clinical variables that affect treatment outcome for marijuana-dependent individuals are not yet well understood, including the effects of cognitive functioning. To address this, level of cognitive functioning and treatment outcome were investigated. Twenty marijuana-dependent outpatients were administered a neuropsychological battery at treatment entry. All patients received 12 weekly individual sessions of combined motivational enhancement therapy and cognitive behavioral therapy. The Wilcoxon Exact Test was used to compare cognitive functioning test scores between completers and dropouts, and the Fisher Exact Test was used to compare proportion of negative urines between those with higher and lower scores on the cognitive tests. Marijuana abstinence was unrelated to cognitive functioning. However, dropouts scored significantly lower than completers on measures of abstract reasoning and processing accuracy, providing initial evidence that cognitive functioning plays a role in treatment retention of adult marijuana-dependent patients. If supported by further studies, the findings may help inform the development of interventions tailored for cognitively impaired marijuana-dependent patients.
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Affiliation(s)
- Efrat Aharonovich
- Columbia University, Department of Psychiatry, College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
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Pattij T, Wiskerke J, Schoffelmeer ANM. Cannabinoid modulation of executive functions. Eur J Pharmacol 2008; 585:458-63. [PMID: 18423599 DOI: 10.1016/j.ejphar.2008.02.099] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 01/25/2008] [Accepted: 02/07/2008] [Indexed: 11/25/2022]
Abstract
Executive functions are higher-order cognitive processes such as attention, behavioural flexibility, decision-making, inhibitory control, planning, time estimation and working memory that exert top-down control over behaviour. In addition to the role of cannabinoid signaling in other cognitive functions such as mnemonic processes, interest in its involvement in executive functions has arisen more recently. Here, we will briefly review some of the recent findings indicating a modulatory role of cannabinoid action on executive functioning. In addition, a growing body of evidence suggests that in particular adolescents are more vulnerable for the deleterious effects of drugs of abuse such as cannabis on cognitive functioning. Therefore, in this paper we will also briefly discuss some recent developments in this research field.
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Affiliation(s)
- Tommy Pattij
- Department of Anatomy and Neurosciences, Center for Neurogenomics and Cognitive Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Medina KL, Hanson KL, Schweinsburg AD, Cohen-Zion M, Nagel BJ, Tapert SF. Neuropsychological functioning in adolescent marijuana users: subtle deficits detectable after a month of abstinence. J Int Neuropsychol Soc 2007; 13:807-20. [PMID: 17697412 PMCID: PMC2269704 DOI: 10.1017/s1355617707071032] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Revised: 03/13/2007] [Accepted: 03/14/2007] [Indexed: 11/06/2022]
Abstract
In adults, studies examining the long-lasting cognitive effects of marijuana use demonstrate subtle deficits in attention, executive function, and memory. Because neuromaturation continues through adolescence, these results cannot necessarily generalize to adolescent marijuana users. The goal of this study was to examine neuropsychological functioning in abstinent marijuana using and demographically similar control adolescents. Data were collected from 65 adolescent marijuana users (n=31, 26% females) and controls (n=34, 26% females) 16-18 years of age. Extensive exclusionary criteria included independent psychiatric, medical, and neurologic disorders. Neuropsychological assessments were conducted after>23 days of monitored abstinence. After controlling for lifetime alcohol use and depressive symptoms, adolescent marijuana users demonstrated slower psychomotor speed (p<.05), and poorer complex attention (p<.04), story memory (p<.04), and planning and sequencing ability (p<.001) compared with controls. Post hoc analysis revealed that the number of lifetime marijuana use episodes was associated with poorer cognitive function, even after controlling for lifetime alcohol use. The general pattern of results suggested that, even after a month of monitored abstinence, adolescent marijuana users demonstrate subtle neuropsychological deficits compared with nonusers. It is possible that frequent marijuana use during adolescence may negatively influence neuromaturation and cognitive development.
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Affiliation(s)
- Krista Lisdahl Medina
- Department of Psychiatry, University of California, San Diego, and Psychology Department, VA San Diego Healthcare System, San Diego, California 92161, USA
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