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Happer JP, Courtney KE, Baca RE, Andrade G, Thompson C, Shen Q, Liu TT, Jacobus J. Nicotine use during late adolescence and young adulthood is associated with changes in hippocampal volume and memory performance. Front Neurosci 2024; 18:1436951. [PMID: 39221006 PMCID: PMC11361958 DOI: 10.3389/fnins.2024.1436951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Background With the advent of electronic nicotine delivery systems, the use of nicotine and tobacco products (NTPs) among adolescents and young adults remains high in the US. Use of e-cigarettes additionally elevates the risk of problematic use of other substances like cannabis, which is often co-used with NTPs. However, their effects on brain health, particularly the hippocampus, and cognition during this neurodevelopmental period are poorly understood. Methods Healthy late adolescents/young adults (N = 223) ages 16-22 completed a structural MRI to examine right and left hippocampal volumes. Memory was assessed with the NIH Toolbox Picture Sequence Memory Test (PSMT) and Rey Auditory Verbal Learning Test (RAVLT). Cumulative 6-month NTP and cannabis episodes were assessed and modeled continuously on hippocampal volumes. Participants were then grouped based on 6-month NTP use to examine relationships with the hippocampus and memory: current users (CU) endorsed weekly or greater use; light/abstinent users (LU) endorsed less than weekly; and never users (NU). Results NTP use predicted larger hippocampal volumes bilaterally while cannabis use had no impact nor interacted with NTP use. For memory, larger left hippocampal volumes were positively associated with PSMT performance, RAVLT total learning, short delay and long delay recall for the NU group. In contrast, there was a negative relationship between hippocampal volumes and performances for LU and CU groups. No differences were detected between NTP-using groups. Conclusion These results suggest that the hippocampus is sensitive to NTP exposure during late adolescence/young adulthood and may alter typical hippocampal morphometry in addition to brain-behavior relationships underlying learning and memory processes.
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Affiliation(s)
- Joseph P. Happer
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Kelly E. Courtney
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Rachel E. Baca
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Gianna Andrade
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Courtney Thompson
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Qian Shen
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Thomas T. Liu
- Center for Functional MRI, University of California, San Diego, San Diego, CA, United States
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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Hernandez Mejia M, Courtney KE, Wade NE, Wallace A, Baca RE, Shen Q, Happer JP, Jacobus J. The Combined Effects of Nicotine and Cannabis on Cortical Thickness Estimates in Adolescents and Emerging Adults. Brain Sci 2024; 14:195. [PMID: 38539584 PMCID: PMC10967898 DOI: 10.3390/brainsci14030195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 08/03/2024] Open
Abstract
Early life substance use, including cannabis and nicotine, may result in deleterious effects on the maturation of brain tissue and gray matter cortical development. The current study employed linear regression models to investigate the main and interactive effects of past-year nicotine and cannabis use on gray matter cortical thickness estimates in 11 bilateral independent frontal cortical regions in 223 16-22-year-olds. As the frontal cortex develops throughout late adolescence and young adulthood, this period becomes crucial for studying the impact of substance use on brain structure. The distinct effects of nicotine and cannabis use status on cortical thickness were found bilaterally, as cannabis and nicotine users both had thinner cortices than non-users. Interactions between nicotine and cannabis were also observed, in which cannabis use was associated with thicker cortices for those with a history of nicotine and tobacco product (NTP) use in three left frontal regions. This study sheds light on the intricate relationship between substance use and brain structure, suggesting a potential modulation of cannabis' impact on cortical thickness by nicotine exposure, and emphasizing the need for further longitudinal research to characterize these interactions and their implications for brain health and development.
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Affiliation(s)
- Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92182, USA
| | - Kelly E. Courtney
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Natasha E. Wade
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Alexander Wallace
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Rachel E. Baca
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Qian Shen
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | | | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
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Woodcock EA, Greenwald MK, Chen I, Feng D, Cohn JA, Lundahl LH. HIV chronicity as a predictor of hippocampal memory deficits in daily cannabis users living with HIV. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100189. [PMID: 37736522 PMCID: PMC10509297 DOI: 10.1016/j.dadr.2023.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
Background Antiretroviral medications have increased the lifespan of persons living with HIV (PLWH) thereby unmasking memory decline that may be attributed to chronological age, HIV symptomatology, HIV disease chronicity, and/or substance use (especially cannabis use which is common among PLWH). To date, few studies have attempted to disentangle these effects. In a sample of daily cannabis-using PLWH, we investigated whether hippocampal memory function, assessed via an object-location associative learning task, was associated with age, HIV chronicity and symptom severity, or substance use. Methods 48 PLWH (12.9 ± 9.6 years since HIV diagnosis), who were 44 years old on average (range: 24-64 years; 58 % male) and reported daily cannabis use (recent use confirmed by urinalysis) completed the study. We assessed each participant's demographics, substance use, medical history, current HIV symptoms, and hippocampal memory function via a well-validated object-location associative learning task. Results Multiple regression analyses found that living more years since HIV+ diagnosis predicted significantly worse associative learning total score (r=-0.40) and learning rate (r=-0.34) whereas chronological age, cannabis-use characteristics, and recent HIV symptom severity were not significantly related to hippocampal memory function. Conclusions In daily cannabis-using PLWH, HIV chronicity was related to worse hippocampal memory function independent from cannabis use, age, and HIV symptomatology. Object-location associative learning performance could serve as an 'early-warning' metric of cognitive decline among PLWH. Future research should examine longitudinal changes in associative learning proficiency and evaluate interventions to prevent hippocampal memory decline among PLWH. ClinicalTrials.gov: NCT01536899.
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Affiliation(s)
- Eric A. Woodcock
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI USA
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI USA
| | - Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI USA
| | - Irene Chen
- Wayne State University School of Medicine, Detroit, MI USA
| | - Danni Feng
- Wayne State University School of Medicine, Detroit, MI USA
| | - Jonathan A. Cohn
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI USA
| | - Leslie H. Lundahl
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI USA
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Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Psychiatr Clin North Am 2023; 46:655-676. [PMID: 37879830 DOI: 10.1016/j.psc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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5
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Soleimani N, Kazemi K, Helfroush MS, Aarabi A. Altered brain structural and functional connectivity in cannabis users. Sci Rep 2023; 13:5847. [PMID: 37037859 PMCID: PMC10086048 DOI: 10.1038/s41598-023-32521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023] Open
Abstract
Cannabis is one of the most used and commodified illicit substances worldwide, especially among young adults. The neurobiology mechanism of cannabis is yet to be identified particularly in youth. The purpose of this study was to concurrently measure alterations in brain structural and functional connectivity in cannabis users using resting-state functional magnetic resonance images (rs-fMRI) and diffusion-weighted images (DWI) from a group of 73 cannabis users (age 22-36, 19 female) in comparison with 73 healthy controls (age 22-36, 14 female) from Human Connectome Project (HCP). Several significant differences were observed in local structural/functional network measures (e.g. degree and clustering coefficient), being prominent in the insular and frontal opercular cortex and lateral/medial temporal cortex. The rich-club organization of structural networks revealed a normal trend, distributed within bilateral frontal, temporal and occipital regions. However, minor differences were found between the two groups in the superior and inferior temporal gyri. Functional rich-club nodes were mostly located within parietal and posterior areas, with minor differences between the groups found mainly in the centro-temporal and parietal regions. Regional network measures of structural/functional networks were associated with times used cannabis (TUC) in several regions. Although the structural/functional network in both groups showed small-world property, no differences between cannabis users and healthy controls were found regarding the global network measures, showing no association with cannabis use. After FDR correction, all of the significant associations between network measures and TUC were found to be insignificant, except for the association between degree and TUC within the presubiculum region. To recap, our findings revealed alterations in local topological properties of structural and functional networks in cannabis users, although their global brain network organization remained intact.
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Affiliation(s)
- Najme Soleimani
- Department of Electrical Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Kamran Kazemi
- Department of Electrical Engineering, Shiraz University of Technology, Shiraz, Iran.
| | | | - Ardalan Aarabi
- Faculty of Medicine, University of Picardie Jules Verne, Amiens, France
- Laboratory of Functional Neuroscience and Pathologies, University Research Center, University Hospital, Amiens, France
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Harper J, Wilson S, Bair JL, Hunt RH, Thomas KM, Malone SM, Iacono WG. Testing the consequences of alcohol, cannabis, and nicotine use on hippocampal volume: a quasi-experimental cotwin control analysis of young adult twins. Psychol Med 2023; 53:2671-2681. [PMID: 37310301 PMCID: PMC10123841 DOI: 10.1017/s0033291721004682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Alcohol, cannabis, and nicotine use are highly comorbid and alarmingly prevalent in young adults. The hippocampus may be particularly sensitive to substance exposure. This remains largely untested in humans and familial risk may confound exposure effects. We extend prior work on alcohol and hippocampal volume in women by testing common and unique substance use effects and the potential moderating role of sex on hippocampal volume during emerging adulthood. A quasi-experimental cotwin control (CTC) design was used to separate familial risk from exposure consequences. METHODS In a population-based sample of 435 24-year-old same-sex twins (58% women), dimensional measures (e.g. frequency, amount) of alcohol, cannabis, and nicotine use across emerging adulthood were assessed. Hippocampal volume was assessed using MRI. RESULTS Greater substance use was significantly associated with lower hippocampal volume for women but not men. The same pattern was observed for alcohol, cannabis, and nicotine. CTC analyses provided evidence that hippocampal effects likely reflected familial risk and the consequence of substance use in general and alcohol and nicotine in particular; cannabis effects were in the expected direction but not significant. Within-pair mediation analyses suggested that the effect of alcohol use on the hippocampus may reflect, in part, comorbid nicotine use. CONCLUSIONS The observed hippocampal volume deviations in women likely reflected substance-related premorbid familial risk and the consequences of smoking and, to a lesser degree, drinking. Findings contribute to a growing body of work suggesting heightened risk among women toward experiencing deleterious effects of substance exposure on the still-developing young adult hippocampus.
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Affiliation(s)
- Jeremy Harper
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Twin Cities, USA
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Twin Cities, USA
| | - Jessica L. Bair
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, USA
| | - Ruskin H. Hunt
- Institute of Child Development, University of Minnesota, Twin Cities, USA
| | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota, Twin Cities, USA
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Jones DM, Guy MC, Fairman BJ, Soule E, Eissenberg T, Fagan P. Nicotine Dependence among Current Cigarette Smokers Who Use E-Cigarettes and Cannabis. Subst Use Misuse 2023; 58:618-628. [PMID: 36852436 PMCID: PMC10249428 DOI: 10.1080/10826084.2023.2177961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Co-use of tobacco and cannabis and dual use of cigarettes and e-cigarettes are very common among young adults. However, it is unclear whether co-use of cigarettes, e-cigarettes, and/or cannabis is associated with higher levels of nicotine dependence than cigarette-only use. We investigated the relationship between cigarette/nicotine dependence and co-use of tobacco and cannabis among 4 groups of cigarette smokers aged 18-35: cigarette-only smokers, cigarette-e-cigarette (CIG-ECIG) co-users, cigarette-cannabis (CIG-CAN) co-users, and cigarette-e-cigarette-cannabis (CIG-ECIG-CAN) co-users. METHODS Data were from a 2018 cross-sectional survey based on a national convenience sample of smokers aged 18-35 (n = 315). Cigarette/nicotine dependence was measured by the Fagerstrom Test of Nicotine Dependence (FTND) and e-cigarette dependence was measured by the Penn State E-cigarette Dependence Index. Bivariate analyses examined sociodemographic and tobacco/other substance use characteristics by co-use status and multivariable linear regression assessed the relationship between co-use and nicotine dependence. RESULTS In the sample, 27.6% were cigarette-only smokers, 24.8% were CIG-ECIG, 27.6% were CIG-CAN, and 20.0% were CIG-ECIG-CAN co-users. Significant differences were observed in sociodemographic and tobacco/other substance use characteristics by co-use status. E-cigarette co-users had low e-cigarette dependence, but moderate FTND scores. In adjusted analyses, only CIG-ECIG co-use was associated with higher FTND scores compared to cigarette-only smoking. However, CIG-ECIG and CIG-ECIG-CAN co-use were associated with higher FTND scores compared to CIG-CAN co-use. CONCLUSIONS Co-use of cigarettes and e-cigarettes was associated with greater nicotine dependence among smokers aged 18-35. Additional research is needed to understand the underlying mechanisms of these relationships and inform prevention efforts.
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Affiliation(s)
- Dina M. Jones
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Slot #820, Little Rock, AR 72205 USA
| | - Mignonne C. Guy
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, 100 West Franklin Street, Suite 200, Richmond, VA 23220 USA
- Department of African American Studies, Virginia Commonwealth University, 816 W. Franklin Street, Room 201, Richmond, VA 23284-3509 USA
| | - Brian J. Fairman
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Slot #820, Little Rock, AR 72205 USA
| | - Eric Soule
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, 100 West Franklin Street, Suite 200, Richmond, VA 23220 USA
- Eastern Carolina University, Department of Health Education and Promotion, 300 Curry Ct., Carol Belk Building, Greenville, NC 27858 USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, 100 West Franklin Street, Suite 200, Richmond, VA 23220 USA
| | - Pebbles Fagan
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Slot #820, Little Rock, AR 72205 USA
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Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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10
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Daniju Y, Faulkner P, Brandt K, Allen P. Prefrontal cortex and putamen grey matter alterations in cannabis and tobacco users. J Psychopharmacol 2022; 36:1315-1323. [PMID: 36112825 PMCID: PMC9716493 DOI: 10.1177/02698811221117523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Previous magnetic resonance imaging studies in regular cannabis users report altered grey matter volume (GMV) in brain regions, including the prefrontal cortex (PFC), putamen and hippocampus. However, most studies have tended to recruit recreational users with high levels of cannabis use, and have not controlled for the possible confounding effects of tobacco use. We attempt to address these limitations in the present study. METHODS We acquired volumetric images in sex, age and IQ-matched groups of (1) regular Cannabis users who also smoke Tobacco cigarettes ('CT'; n = 33), (2) non-cannabis-using Tobacco cigarette smokers ('T'; n = 19) and (3) non-cannabis/tobacco-using Controls ('C'; n = 35). GMV in bilateral PFC, putamen and hippocampal regions was compared across groups. We also examined the associations between GMV differences and levels of cannabis and tobacco use, measures of intellectual function, and of depression, anxiety and stress. RESULTS Relative to controls, both CT and T groups showed lower GMV in the left inferior frontal gyrus, and greater GMV in the putamen. In addition, lower GMV in the right frontal pole in the CT group (but not the T group) was associated with lifetime cannabis use, but not with cigarette use. CONCLUSIONS Regular cannabis users who also smoked tobacco cigarettes showed altered GMV patterns relative to controls. However, a similar pattern of GMV differences was also seen between regular tobacco users that did not use cannabis. Further research is needed to disentangle the effects of cannabis and tobacco use on brain structure.
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Affiliation(s)
- Yusuf Daniju
- School of Psychology, Whitelands College, University of Roehampton, London, UK
| | - Paul Faulkner
- School of Psychology, Whitelands College, University of Roehampton, London, UK,Combined Universities Brain Imaging Centre, Royal Holloway University of London, UK
| | - Kaz Brandt
- School of Psychology, Whitelands College, University of Roehampton, London, UK
| | - Paul Allen
- School of Psychology, Whitelands College, University of Roehampton, London, UK,Combined Universities Brain Imaging Centre, Royal Holloway University of London, UK,Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Paul Allen, School of Psychology, University of Roehampton, Whitelands College, Holybourne Avenue, London SW15 4JD, UK.
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Gravely S, Driezen P, McClure EA, Hammond D, Michael Cummings K, Chan G, Hyland A, Borland R, East KA, Fong GT, Schauer GL, Quah ACK, Ouimet J, Smith DM. Differences between adults who smoke cigarettes daily and do and do not co-use cannabis: Findings from the 2020 ITC four country smoking and vaping survey. Addict Behav 2022; 135:107434. [PMID: 35908323 DOI: 10.1016/j.addbeh.2022.107434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/28/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about population-level differences between adults who exclusively smoke cigarettes and those who smoke cigarettes and also use cannabis (co-consumers). Thus, this study describes differences on sociodemographic, cigarette-dependence, health and behavioral variables, and risk perceptions associated with smoking cannabis. METHODS This cross-sectional study included 6941 respondents from the 2020 ITC Four Country Smoking and Vaping Survey (US, Canada, Australia, England). Adult daily cigarette smokers were included and categorized as: cigarette-only smokers (never used cannabis/previously used cannabis, but not in the past 12 months, n = 4857); occasional co-consumers (cannabis use in the past 12 months, but < weekly use, n = 739); or regular co-consumers (use cannabis ≥ weekly, n = 1345). All outcomes were self-reported. Regression models were conducted on weighted data. RESULTS Overall, 19.9 % of respondents reported regular cannabis co-use and 10.1 % reported occasional co-use. Regular co-use was highest in Canada (27.2 %), followed by the US (24.4 %), England (12.7 %) and Australia (12.3 %). Compared to cigarette-only smokers, regular co-consumers were more likely to be male and report chest/breathing problems (p < 0.001). All co-consumers were more likely to be younger, have lower income, be experiencing financial stress, reside in Canada, have depressive symptoms, use alcohol more frequently and binge drink, use other tobacco/nicotine products, and perceive smoking cannabis as low health risk and less harmful than smoking cigarettes (all p < 0.001). Cigarette dependence measures were similar between co-consumers and cigarette-only smokers (all p ≥ 0.05). CONCLUSIONS Although there were no differences on cigarette dependence measures between daily cigarette smokers who do and do not use cannabis, there are several other risk factors that may affect tobacco use and abstinence among co-consumers (e.g., greater depression, high-risk alcohol consumption). Thus, tobacco cessation treatment may require multi-pronged strategies to address other health behaviors. Continued surveillance is needed to determine the nature and health implications of co-use considering changing policies, markets, and products.
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Affiliation(s)
| | | | - Erin A McClure
- Medical University of South Carolina (MUSC), Hollings Cancer Center, USA
| | | | - K Michael Cummings
- Medical University of South Carolina (MUSC), Hollings Cancer Center, USA
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Australia
| | | | | | | | - Geoffrey T Fong
- University of Waterloo, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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12
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Wade NE, Courtney KE, Doran N, Baca R, Aguinaldo LD, Thompson C, Finegan J, Jacobus J. Young Adult E-Cigarette and Combustible Tobacco Users Attitudes, Substance Use Behaviors, Mental Health, and Neurocognitive Performance. Brain Sci 2022; 12:brainsci12070889. [PMID: 35884696 PMCID: PMC9312928 DOI: 10.3390/brainsci12070889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 02/05/2023] Open
Abstract
Nicotine and tobacco product (NTP) use has escalated, largely due to the advent of e-cigarettes. The NTP administration method (i.e., combustible cigarette, e-cigarette) may be an important differentiator. We assessed young adult substance use history, nicotine attitudes, mental health, and neurocognition by the NTP use method. Emerging adults (16–22 year olds) were divided into combustible NTP users (Combustible+ = 79, had used any combustible NTP in the last 6 months), non-combustible users (E-Cig = 43, had used non-combustible NTP, in the past 6 months), and NTP Naïve (n = 79; had not used NTP in the past 6 months) based on past 6-month NTP use patterns. Participants completed self-report and objective neurocognition measures. Analysis of covariance assessed mental health and neurocognition by group, controlling for confounds and correcting for multiple comparisons. Nicotine groups reported more favorable attitudes toward combustible cigarette and e-cigarette use, with taste as the primary reason for e-cigarette use. Combustible+ reported more nicotine dependence and craving. Substance use differed by group, with Combustible+ using the most NTP, alcohol, and cannabis. Nicotine groups reported higher depression and stress symptoms; male Combustible+ reported higher depression symptoms than other same-gender groups. Groups did not differ on neurocognition, though cannabis use was associated with inaccurate emotional Stroop responses. Overall, research suggests that young adult combustible users are likely qualitatively different from non-combustible users. Understanding the unique characteristics related to NTP product use will help guide intervention and prevention development.
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Abstract
UNLABELLED Attention allows us to select relevant information from the background. Although several studies have described that cannabis use induces deleterious effects on attention, it remains unclear if cannabis dependence affects the attention network systems differently. OBJECTIVES To evaluate whether customary consumption of cannabis or cannabis dependence impacts the alerting, orienting, and executive control systems in young adults; to find out whether it is related to tobacco or alcohol dependence and if cannabis use characteristics are associated with the attention network systems. METHOD One-hundred and fifty-four healthy adults and 102 cannabis users performed the Attention Network Test (ANT) to evaluate the alerting, orienting, and executive control systems. RESULTS Cannabis use enhanced the alerting system but decreased the orienting system. Moreover, those effects seem to be associated with cannabis dependence. Out of all the cannabis-using variables, only the age of onset of cannabis use significantly predicted the efficiency of the orienting and executive control systems. CONCLUSION Cannabis dependence favors tonic alertness but reduces selective attention ability; earlier use of cannabis worsens the efficiency of selective attention and resolution of conflicts.
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14
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Kuhns L, Kroon E, Filbey F, Cousijn J. Unraveling the role of cigarette use in neural cannabis cue reactivity in heavy cannabis users. Addict Biol 2021; 26:e12941. [PMID: 32761688 PMCID: PMC7862430 DOI: 10.1111/adb.12941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/15/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022]
Abstract
Cue reactivity is an important biomarker of cannabis use disorder (CUD). Despite high rates of cigarette and cannabis co‐use, its role in cannabis cue reactivity remains unclear. Using a visual functional magnetic resonance imaging cue reactivity paradigm, we investigated interactive effects of cannabis and cigarette use on cannabis cue relative to cigarette and neutral cue reactivity in a priori regions of interest—the amygdala, striatum, anterior cingulate cortex (ACC), ventral tegmental area (VTA), and orbitofrontal cortex—and a whole‐brain analysis. In our sample of cannabis users and controls closely matched on cigarette use, significant interactions between cannabis and cigarette use status emerged in the amygdala, striatum, ACC, frontal pole, and inferior frontal gyrus. Cannabis‐only users showed heightened cue reactivity in the amygdala compared with nonusing controls. Co‐users did not show heightened cue reactivity compared with cigarette smoking controls, although cue‐induced VTA activity was positively correlated with grams per week of cannabis. Cigarette smoking controls showed unexpectedly heightened cue reactivity compared to co‐users and nonsmoking controls. These findings and the high prevalence of cannabis and cigarette co‐use underscore the importance of considering cigarette smoking status when investigating the role of cue reactivity in heavy cannabis use.
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Affiliation(s)
- Lauren Kuhns
- Neuroscience of Addiction (NofA) Lab, Department of Psychology University of Amsterdam Amsterdam The Netherlands
- The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam Amsterdam The Netherlands
| | - Emese Kroon
- Neuroscience of Addiction (NofA) Lab, Department of Psychology University of Amsterdam Amsterdam The Netherlands
- The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam Amsterdam The Netherlands
| | - Francesca Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences University of Texas at Dallas Dallas TX USA
| | - Janna Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology University of Amsterdam Amsterdam The Netherlands
- The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam Amsterdam The Netherlands
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15
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Jacobs W, Idoko E, Montgomery L, Smith ML, Merianos AL. Concurrent E-cigarette and marijuana use and health-risk behaviors among U.S. high school students. Prev Med 2021; 145:106429. [PMID: 33476680 PMCID: PMC8194044 DOI: 10.1016/j.ypmed.2021.106429] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/28/2022]
Abstract
The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.
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Affiliation(s)
- Wura Jacobs
- Department of Kinesiology, California State University, Stanislaus, One University Circle, Turlock, CA 95382, USA.
| | - Ehikowoicho Idoko
- Department of Health and Kinesiology, Texas A&M University, 2929 Research Parkway, College Station, TX 77843, USA.
| | - LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, P.O. Box 670559, Cincinnati, OH 45267, USA.
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab, College Station, TX 77843, USA; School of Public Health, Texas A&M University, 212 Adriance Lab, College Station, TX 77843, USA.
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati, OH 45221, USA.
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16
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Hammond CJ, Wu J, Krishnan-Sarin S, Mayes LC, Potenza MN, Crowley MJ. Co-occurring tobacco and cannabis use in adolescents: Dissociable relationships with mediofrontal electrocortical activity during reward feedback processing. Neuroimage Clin 2021; 30:102592. [PMID: 33667977 PMCID: PMC7932890 DOI: 10.1016/j.nicl.2021.102592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/11/2020] [Accepted: 02/05/2021] [Indexed: 12/01/2022]
Abstract
Differences in corticostriatal neural activity during feedback processing of rewards and losses have been separately related to cannabis and tobacco use but remain understudied relative to co-use in adolescents. Using high-density EEG (128 electrode system, 1000 Hz sampling), we examined event-related potentials (ERPs) elicited by monetary reward, neutral, and loss feedback during performance on a non-learning four-choice guessing task in a sample of non-deprived daily-cigarette-smoking adolescents (n = 36) who used tobacco and cannabis regularly (TC adolescents), and non-smoking healthy control adolescents (HCs) (n = 29). Peak amplitudes and latencies of mediofrontal ERPs indexing feedback-related negativities (FRNs) were used as outcomes in repeated-measures ANOVAs. No differences in FRNs were observed between TC and HC adolescents. Within TC adolescents, cannabis-use and tobacco-use variables had distinct relationships with the FRN, with cannabis-related problem severity being positively correlated with FRN amplitude during reward feedback and tobacco-related problem severity being negatively correlated with FRN latency during non-loss feedback (i.e., reward and neutral). These findings suggest that co-occurring cannabis and tobacco use may have dissociable relationships with feedback processing relating to each drug and support an incentive salience model of addiction severity related to cannabis use in adolescents.
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Affiliation(s)
- Christopher J Hammond
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
| | - Jia Wu
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | | | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neuroscience, Yale University, New Haven, CT, United States; Connecticut Council on Problem Gambling, Wethersfield, CT, United States; Connecticut Mental Health Center, New Haven, CT, United States
| | - Michael J Crowley
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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17
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Hernandez Mejia M, Wade NE, Baca R, Diaz VG, Jacobus J. The Influence of Cannabis and Nicotine Co-use on Neuromaturation: A Systematic Review of Adolescent and Young Adult Studies. Biol Psychiatry 2021; 89:162-171. [PMID: 33334432 PMCID: PMC7749265 DOI: 10.1016/j.biopsych.2020.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that the use of cannabis and nicotine and tobacco-related products (NTPs) during the adolescent years has harmful effects on the developing brain. Yet, few studies have focused on the developing brain as it relates to the co-administration of cannabis and NTPs, despite the high prevalence rates of co-use in adolescence. This review aims to synthesize the existing literature on neurocognitive, structural neuroimaging, and functional neuroimaging outcomes associated with cannabis and NTP co-use. A systematic search of peer-reviewed articles resulted in a pool of 1107 articles. Inclusion criteria were 1) data-based study; 2) age range of 13 to 35 years or, for preclinical studies, nonadult subjects; 3) cannabis and NTP group jointly considered; and 4) neurocognitive, structural neuroimaging, or functional neuroimaging as an outcome measure. Twelve studies met inclusion criteria. Consistent with the literature, cannabis and nicotine were found to have independent effects on cognition. The available research on the co-use of cannabis and NTPs demonstrates a potential nicotine-related masking effect on cognitive deficits associated with cannabis use, yet there is little research on co-use and associations with neuroimaging indices. In neuroimaging studies, there is preliminary evidence for hippocampal volume differences in co-users and a lack of evidence for co-use differences related to nucleus accumbens activity during reward processing. Notably, no structural neuroimaging studies were found to examine the combined effects of nicotine and cannabis in adolescent-only populations. Further research, including longitudinal studies, is warranted to investigate the influence of cannabis and NTP co-use on maturation.
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Affiliation(s)
- Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California
| | - Natasha E Wade
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Vanessa G Diaz
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, San Diego, California.
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18
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Chang L, Liang H, Kandel SR, He JJ. Independent and Combined Effects of Nicotine or Chronic Tobacco Smoking and HIV on the Brain: A Review of Preclinical and Clinical Studies. J Neuroimmune Pharmacol 2020; 15:658-693. [PMID: 33108618 DOI: 10.1007/s11481-020-09963-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
Tobacco smoking is highly prevalent among HIV-infected individuals. Chronic smokers with HIV showed greater cognitive deficits and impulsivity, and had more psychopathological symptoms and greater neuroinflammation than HIV non-smokers or smokers without HIV infection. However, preclinical studies that evaluated the combined effects of HIV-infection and tobacco smoking are scare. The preclinical models typically used cell cultures or animal models that involved specific HIV viral proteins or the administration of nicotine to rodents. These preclinical models consistently demonstrated that nicotine had neuroprotective and anti-inflammatory effects, leading to cognitive enhancement. Although the major addictive ingredient in tobacco smoking is nicotine, chronic smoking does not lead to improved cognitive function in humans. Therefore, preclinical studies designed to unravel the interactive effects of chronic tobacco smoking and HIV infection are needed. In this review, we summarized the preclinical studies that demonstrated the neuroprotective effects of nicotine, the neurotoxic effects of the HIV viral proteins, and the scant literature on nicotine or tobacco smoke in HIV transgenic rat models. We also reviewed the clinical studies that evaluated the neurotoxic effects of tobacco smoking, HIV infection and their combined effects on the brain, including studies that evaluated the cognitive and behavioral assessments, as well as neuroimaging measures. Lastly, we compared the different approaches between preclinical and clinical studies, identified some gaps and proposed some future directions. Graphical abstract Independent and combined effects of HIV and tobacco/nicotine. Left top and bottom panels: Both clinical studies of HIV infected persons and preclinical studies using viral proteins in vitro or in vivo in animal models showed that HIV infection could lead to neurotoxicity and neuroinflammation. Right top and bottom panels: While clinical studies of tobacco smoking consistently showed deleterious effects of smoking, clinical and preclinical studies that used nicotine show mild cognitive enhancement, neuroprotective and possibly anti-inflammatory effects. In the developing brain, however, nicotine is neurotoxic. Middle overlapping panels: Clinical studies of persons with HIV who were smokers typically showed additive deleterious effects of HIV and tobacco smoking. However, in the preclinical studies, when nicotine was administered to the HIV-1 Tg rats, the neurotoxic effects of HIV were attenuated, but tobacco smoke worsened the inflammatory cascade.
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Affiliation(s)
- Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA.
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | - Huajun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA
| | - Suresh R Kandel
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA
| | - Johnny J He
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA.
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19
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Nguyen TD, Riordan-Short S, Dang TTT, O’Brien R, Noestheden M. Quantitation of Select Terpenes/Terpenoids and Nicotine Using Gas Chromatography-Mass Spectrometry with High-Temperature Headspace Sampling. ACS OMEGA 2020; 5:5565-5573. [PMID: 32201850 PMCID: PMC7081649 DOI: 10.1021/acsomega.0c00384] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/18/2020] [Indexed: 05/22/2023]
Abstract
Plants are the main sources of many high-value bioactive terpenoids used in the medical, fragrance, and food industries. Increasing demand for these bioactive plants and their derivative products (e.g., cannabis and extracts thereof) requires robust approaches to verify feedstock, identify product adulteration, and ensure product safety. Reported here are single-laboratory validation details for a robust testing method to quantitate select terpenes and terpenoids in dry plant materials and terpenoid-containing vaping liquids (e.g., a derivative product) using high-temperature headspace gas chromatography-mass spectrometry, with glycerol used as a headspace solvent. Validated method recoveries were 75-103%, with excellent repeatability (relative standard deviation (RSD) < 5%) and intermediate precision (RSD < 12%). The use of high-temperature headspace (180 °C) permitted terpene and terpenoid profiles to be monitored at temperatures consistent with vaping conditions.
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Affiliation(s)
- Trinh-Don Nguyen
- Department
of Chemistry, Irving K. Barber School of Arts and Sciences, University of British Columbia, Kelowna, British Columbia V1V 1V7, Canada
- Supra
Research and Development, Kelowna, British Columbia V1W 4C2, Canada
| | | | - Thu-Thuy T. Dang
- Department
of Chemistry, Irving K. Barber School of Arts and Sciences, University of British Columbia, Kelowna, British Columbia V1V 1V7, Canada
| | - Rob O’Brien
- Supra
Research and Development, Kelowna, British Columbia V1W 4C2, Canada
- Department
of Biology, Irving K. Barber School of Arts and Sciences, University of British Columbia, Kelowna, British Columbia V1V 1V7, Canada
| | - Matthew Noestheden
- Department
of Chemistry, Irving K. Barber School of Arts and Sciences, University of British Columbia, Kelowna, British Columbia V1V 1V7, Canada
- Supra
Research and Development, Kelowna, British Columbia V1W 4C2, Canada
- E-mail: . Phone: +1 778 760 8982 (M.N.)
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20
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Abstract
Given the aging Baby Boomer generation, changes in cannabis legislation, and the growing acknowledgment of cannabis for its therapeutic potential, it is predicted that cannabis use in the older population will escalate. It is, therefore, important to determine the interaction between the effects of cannabis and aging. The aim of this report is to describe the link between cannabis use and the aging brain. Our review of the literature found few and inconsistent empirical studies that directly address the impact of cannabis use on the aging brain. However, research focused on long-term cannabis use points toward cumulative effects on multimodal systems in the brain that are similarly affected during aging. Specifically, the effects of cannabis and aging converge on overlapping networks in the endocannabinoid, opioid, and dopamine systems that may affect functional decline particularly in the hippocampus and prefrontal cortex, which are critical areas for memory and executive functioning. To conclude, despite the limited current knowledge on the potential interactive effects between cannabis and aging, evidence from the literature suggests that cannabis and aging effects are concurrently present across several neurotransmitter systems. There is a great need for future research to directly test the interactions between cannabis and aging.
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Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Jennifer DiMuzio
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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21
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Cannabis use in youth is associated with limited alterations in brain structure. Neuropsychopharmacology 2019; 44:1362-1369. [PMID: 30780151 PMCID: PMC6784999 DOI: 10.1038/s41386-019-0347-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/17/2018] [Accepted: 02/13/2019] [Indexed: 01/03/2023]
Abstract
Frequent cannabis use during adolescence has been associated with alterations in brain structure. However, studies have featured relatively inconsistent results, predominantly from small samples, and few studies have examined less frequent users to shed light on potential brain structure differences across levels of cannabis use. In this study, high-resolution T1-weighted MRIs were obtained from 781 youth aged 14-22 years who were studied as part of the Philadelphia Neurodevelopmental Cohort. This sample included 147 cannabis users (109 occasional [≤1-2 times per week] and 38 frequent [≥3 times per week] users) and 634 cannabis non-users. Several structural neuroimaging measures were examined in whole brain analyses, including gray and white matter volumes, cortical thickness, and gray matter density. Established procedures for stringent quality control were conducted, and two automated neuroimaging software processing packages were used to ensure robustness of results. There were no significant differences by cannabis group in global or regional brain volumes, cortical thickness, or gray matter density, and no significant group by age interactions were found. Follow-up analyses indicated that values of structural neuroimaging measures by cannabis group were similar across regions, and any differences among groups were likely of a small magnitude. In sum, structural brain metrics were largely similar among adolescent and young adult cannabis users and non-users. Our data converge with prior large-scale studies suggesting small or limited associations between cannabis use and structural brain measures in youth. Detailed studies of vulnerability to structural brain alterations and longitudinal studies examining long-term risk are clearly indicated.
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22
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Lorenzetti V, Chye Y, Silva P, Solowij N, Roberts CA. Does regular cannabis use affect neuroanatomy? An updated systematic review and meta-analysis of structural neuroimaging studies. Eur Arch Psychiatry Clin Neurosci 2019; 269:59-71. [PMID: 30706169 DOI: 10.1007/s00406-019-00979-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/03/2019] [Indexed: 12/22/2022]
Abstract
Regular cannabis use is associated with adverse cognitive and mental health outcomes that have been ascribed to aberrant neuroanatomy in brain regions densely innervated with cannabinoid receptors. Neuroanatomical differences between cannabis users and controls have been assessed in multiple structural magnetic resonance imaging (sMRI) studies. However, there is heterogeneity in the results leading to cautious interpretation of the data so far. We examined the sMRI evidence to date in human cannabis users, to establish more definitely whether neuroanatomical alterations are associated with regular cannabis use. The regional specificity and association with cannabis use indices (i.e. cumulative dosage, duration) were also explored. We systematically reviewed and meta-analysed published sMRI studies investigating regional brain volumes (cortical, subcortical and global) in cannabis users and non-user controls. Three electronic databases were searched (PubMed, Scopus, and PsycINFO). A total of 17 meta-analyses were conducted (one for each cortical, subcortical and global volume) using the generic inverse variance method, whereby standardised mean difference in volume was calculated between users and non-users. Exploratory meta-regressions were conducted to investigate the association between cannabis use indices and regional brain volumes. A total of 30 articles were eligible for inclusion, contributing 106 effect sizes across 17 meta-analyses. Regular cannabis users had significantly smaller volumes of the hippocampus (SMD = 0.14, 95% CIs [0.02, 0.27]; Z = 2.29, p = 0.02, I2 = 74%) and orbitofrontal cortex {medial (SMD = 0.30, 95% CIs [0.15, 0.45]; Z = 3.89, p = 0.0001, I2 = 51%), lateral (SMD = 0.19, 95% CIs [0.07, 0.32]; Z = 3.10, p = 0.002, I2 = 26%)} relative to controls. The volumes of the hippocampus and orbitofrontal cortex were not significantly associated with cannabis duration and dosage. Our findings are consistent with evidence of aberrance in brain regions involved in reward, learning and memory, and motivation circuits in the regular use of substances other than cannabis, pointing to commonality in neurobiological abnormalities between regular users of cannabis and of other substances.
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Affiliation(s)
- Valentina Lorenzetti
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Daniel Mannix building, Fitzroy, VIC, 3065, Australia.
| | - Yann Chye
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Pedro Silva
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Carl A Roberts
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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23
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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24
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Filbey FM, Gohel S, Prashad S, Biswal BB. Differential associations of combined vs. isolated cannabis and nicotine on brain resting state networks. Brain Struct Funct 2018; 223:3317-3326. [PMID: 29882015 PMCID: PMC6286234 DOI: 10.1007/s00429-018-1690-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/26/2018] [Indexed: 01/30/2023]
Abstract
Concomitant cannabis and nicotine use is more prevalent than cannabis use alone; however, to date, most of the literature has focused on associations of isolated cannabis and nicotine use limiting the generalizability of existing research. To determine differential associations of concomitant use of cannabis and nicotine, isolated cannabis use and isolated nicotine use on brain network connectivity, we examined systems-level neural functioning via independent components analysis (ICA) on resting state networks (RSNs) in cannabis users (CAN, n = 53), nicotine users (NIC, n = 28), concomitant nicotine and cannabis users (NIC + CAN, n = 26), and non-users (CTRL, n = 30). Our results indicated that the CTRL group and NIC + CAN users had the greatest functional connectivity relative to CAN users and NIC users in 12 RSNs: anterior default mode network (DMN), posterior DMN, left frontal parietal network, lingual gyrus, salience network, right frontal parietal network, higher visual network, insular cortex, cuneus/precuneus, posterior cingulate gyrus/middle temporal gyrus, dorsal attention network, and basal ganglia network. Post hoc tests showed no significant differences between (1) CTRL and NIC + CAN and (2) NIC and CAN users. These findings of differential associations of isolated vs. combined nicotine and cannabis use demonstrate an interaction between cannabis and nicotine use on RSNs. These unique and combined mechanisms through which cannabis and nicotine influence cortical network functional connectivity are important to consider when evaluating the neurobiological pathways associated with cannabis and nicotine use.
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Affiliation(s)
- Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
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Wilson S, Malone SM, Hunt RH, Thomas KM, Iacono WG. Problematic alcohol use and hippocampal volume in a female sample: disentangling cause from consequence using a co-twin control study design. Psychol Med 2018; 48:1673-1684. [PMID: 29108528 PMCID: PMC5938157 DOI: 10.1017/s0033291717003166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although there is extensive evidence that problematic alcohol use is associated with smaller hippocampal volume, the typical cross-sectional study design cannot determine whether hippocampal deviations reflect pre-existing liability toward problematic alcohol use or instead reflect an alcohol exposure-related effect. We used the co-twin control study design, which capitalizes upon differences within a twin pair in levels of drinking, to differentiate pre-existing liability from an effect of alcohol exposure. METHODS The sample included 100 female twins, prospectively assessed from ages 11 to 24. Problematic alcohol use was assessed dimensionally and included indicators of quantity, frequency, and density of alcohol use and intoxication. Hippocampal volume was assessed using magnetic resonance imaging. RESULTS Problematic alcohol use (proximal and cumulative) was associated with significantly smaller left and right hippocampal volume. Follow-up co-twin control analyses that partitioned individual-level alcohol effects into pre-existing, familial liability and non-shared alcohol exposure-related effects indicated that this association reflected alcohol exposure. Greater alcohol using twins had smaller hippocampal volume relative to lesser alcohol using co-twins, beyond effects of their shared genetic and environmental liability toward problematic alcohol use. Results held accounting for recent alcohol use, other substance use, externalizing and internalizing psychopathology, personality traits, trauma exposure, and menstrual phase. CONCLUSIONS The association between problematic alcohol use and smaller hippocampal volume likely reflects an alcohol exposure-related effect. Differentiating pre-existing brain deviations that confer risk for problematic alcohol use from those that reflect effects of alcohol on the brain will inform etiological models of addiction and further prevention and intervention efforts.
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Affiliation(s)
- Sylia Wilson
- Department of Psychology, University of Minnesota, 75 East River Rd, Minneapolis, MN 55455, USA
| | - Stephen M. Malone
- Department of Psychology, University of Minnesota, 75 East River Rd, Minneapolis, MN 55455, USA
| | - Ruskin H. Hunt
- Department of Psychology, University of Minnesota, 75 East River Rd, Minneapolis, MN 55455, USA
| | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota, 51 E River Rd, Minneapolis, MN 55455, USA
| | - William G. Iacono
- Department of Psychology, University of Minnesota, 75 East River Rd, Minneapolis, MN 55455, USA
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Gaihre A, Rajesh SK. Effect of Add-On Yoga on Cognitive Functions among Substance Abusers in a Residential Therapeutic Center: Randomized Comparative Study. Ann Neurosci 2018; 25:38-45. [PMID: 29887681 DOI: 10.1159/000484165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/11/2017] [Indexed: 11/19/2022] Open
Abstract
Background Chronic vulnerability characterizes substance abuse disorder with consequent relapse. The process of abstinence depends on cognitive recovery. Hence, behavioral intervention should account for cognitive dimension of substance abusers. Recent studies highlight yoga-based intervention as a promising add-on therapy for treating and preventing addictive behaviors. Purpose The study aimed to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing cognitive functions, compared with physical exercise to newly admitted substance abusers seeking an inpatient treatment program. Methods The study was a single-blind, randomized, comparative design that included 96 male participants, between 18 and 40 years in a residential rehabilitation treatment unit. Partakers in the yoga or physical exercise group received supervised daily training for 12 weeks, in addition to standard rehabilitation treatment. Raters blind to the study assessed the patients on digit span task, cancellation test, and Stroop tests at the baseline and following 12 weeks of intervention. Results A significant enhancement in digit forward (yoga - p < 0.0005, d = 0.81; exercise - p < 0.0005, d = 0.73), digit backward (yoga - p < 0.0005, d = 0.88; exercise - p < 0.0005, d = 0.58), and letter cancellation test scores (yoga - p < 0.0005, d = 1.31; exercise - p < 0.0005, d = 1.4) were observed in both the yoga and the exercise groups. Stroop word and color task scores were seen significantly higher following yoga (p < 0.005, d = 0.74; p < 0.005, d = 1.13) and exercise (p < 0.0005, d = 0.62; p < 0.0005, d = 0.61). Furthermore, Stroop color-word test showed significant enhancement after yoga (p < 0.0005, d = 1.10) and exercise (p < 0.0005, d = 0.42), with degree of variation higher in the yoga group. Conclusion Our results suggest that the add-on yoga or exercise-based intervention show enhancement of cognitive functions. These findings provide the utility of yoga and exercise-based intervention in improving cognitive functions among substance abusers. Furthermore, rigorous trials are needed to explore the potential long-term effects of these procedures.
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Affiliation(s)
- Ananda Gaihre
- Department of Psychology, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Sasidharan K Rajesh
- Department of Psychology, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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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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Gillespie NA, Neale MC, Bates TC, Eyler LT, Fennema-Notestine C, Vassileva J, Lyons MJ, Prom-Wormley EC, McMahon KL, Thompson PM, de Zubicaray G, Hickie IB, McGrath JJ, Strike LT, Rentería ME, Panizzon MS, Martin NG, Franz CE, Kremen WS, Wright MJ. Testing associations between cannabis use and subcortical volumes in two large population-based samples. Addiction 2018; 113:10.1111/add.14252. [PMID: 29691937 PMCID: PMC6200645 DOI: 10.1111/add.14252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/26/2017] [Accepted: 04/06/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS Disentangling the putative impact of cannabis on brain morphology from other comorbid substance use is critical. After controlling for the effects of nicotine, alcohol and multi-substance use, this study aimed to determine whether frequent cannabis use is associated with significantly smaller subcortical grey matter volumes. DESIGN Exploratory analyses using mixed linear models, one per region of interest (ROI), were performed whereby individual differences in volume (outcome) at seven subcortical ROIs were regressed onto cannabis and comorbid substance use (predictors). SETTING Two large population-based twin samples from the United States and Australia. PARTICIPANTS A total of 622 young Australian adults [66% female; μage = 25.9, standard deviation SD) = 3.6] and 474 middle-aged US males (μage = 56.1SD = 2.6 ) of predominately Anglo-Saxon ancestry with complete substance use and imaging data. Subjects with a history of stroke or traumatic brain injury were excluded. MEASUREMENTS Magnetic resonance imaging (MRI) and volumetric segmentation methods were used to estimate volume in seven subcortical ROIs: thalamus, caudate nucleus, putamen, pallidum, hippocampus, amygdala and nucleus accumbens. Substance use measurements included maximum nicotine and alcohol use, total life-time multi-substance use, maximum cannabis use in the young adults and regular cannabis use in the middle-aged males. FINDINGS After correcting for multiple testing (P = 0.007), cannabis use was unrelated to any subcortical ROI. However, maximum nicotine use was associated with significantly smaller thalamus volumes in middle-aged males. CONCLUSIONS In exploratory analyses based on young adult and middle-aged samples, normal variation in cannabis use is unrelated statistically to individual differences in brain morphology as measured by subcortical volume.
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Affiliation(s)
- Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA, USA
- QIMR Berghofer Medical Research Institute, QLD, Australia
| | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA, USA
| | | | - Lisa T. Eyler
- Desert-Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, CA, USA
- Department of Psychiatry, University of California San Diego, CA, USA
| | | | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, VA, USA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | | | - Katie L. McMahon
- Centre for Advanced Imaging, The University of Queensland, QLD, Australia
| | - Paul M. Thompson
- Centre for Advanced Imaging, The University of Queensland, QLD, Australia
| | - Greig de Zubicaray
- School of Psychology, The University of Queensland, QLD, Australia
- Faculty of Health and Institute of Biomedical Innovation, Queensland University of Technology
| | - Ian B. Hickie
- Brain and Mind Research Institute, University of Sydney, NSW, Australia
| | - John J. McGrath
- Queensland Brain Institute, The University of Queensland, QLD, Australia
| | - Lachlan T. Strike
- QIMR Berghofer Medical Research Institute, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, QLD, Australia
- School of Psychology, The University of Queensland, QLD, Australia
| | | | | | | | - Carol E. Franz
- Department of Psychiatry, University of California San Diego, CA, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, CA, USA
| | - Margaret J. Wright
- QIMR Berghofer Medical Research Institute, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, QLD, Australia
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Lisdahl KM, Sher KJ, Conway KP, Gonzalez R, Feldstein Ewing SW, Nixon SJ, Tapert S, Bartsch H, Goldstein RZ, Heitzeg M. Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods. Dev Cogn Neurosci 2018; 32:80-96. [PMID: 29559216 PMCID: PMC6375310 DOI: 10.1016/j.dcn.2018.02.007] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 02/01/2018] [Accepted: 02/16/2018] [Indexed: 12/21/2022] Open
Abstract
One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States.
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Affiliation(s)
- Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 East Hartford Ave, 224 Garland Hall, Milwaukee, WI, 53211, United States.
| | - Kenneth J Sher
- Curators' Professor of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, United States
| | - Kevin P Conway
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse,6001 Executive Boulevard, Bethesda, MD 20892, United States
| | - Raul Gonzalez
- Department of Psychology, Florida International University,11200 SW 8th Street AHC-4, 461, Miami, FL 33199, United States
| | - Sarah W Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Mail code: DC7P, 3181 SW Sam Jackson Park Rd, Portland OR 97239, United States
| | - Sara Jo Nixon
- Department of Psychiatry, P.O. Box 100256, University of Florida, Gainesville, FL 32610, United States
| | - Susan Tapert
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, United States
| | - Hauke Bartsch
- Center for Multimodal Imaging and Genetics, Department of Radiology, University of California, San Diego,9452 Medical Center Drive, La Jolla, CA, 92037, United States
| | - Rita Z Goldstein
- Department of Psychiatry (primary) and Department of Neuroscience, Friedman Brain Institute (secondary), Chief, Brain Imaging Center (BIC), Icahn School of Medicine at Mount Sinai, The Leon and Norma Hess Center for Science and Medicine, 1470 Madison Ave, New York, NY 10029, United States
| | - Mary Heitzeg
- Department of Psychiatry, University of Michigan,4250 Plymouth Road, Ann Arbor, MI 48109, United States
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Amen DG, Darmal B, Raji CA, Bao W, Jorandby L, Meysami S, Raghavendra CS. Discriminative Properties of Hippocampal Hypoperfusion in Marijuana Users Compared to Healthy Controls: Implications for Marijuana Administration in Alzheimer's Dementia. J Alzheimers Dis 2018; 56:261-273. [PMID: 27886010 DOI: 10.3233/jad-160833] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have evaluated the impact of marijuana use on regional cerebral blood flow. OBJECTIVE To determine whether perfusion in specific brain regions on functional neuroimaging, including those affected by Alzheimer's disease pathology, are abnormal in marijuana users compared to controls. METHOD Persons with a diagnosis of cannabis use disorder by DSM-IV and DSM-V criteria (n = 982) were compared to controls (n = 92) with perfusion neuroimaging with SPECT at rest and at a concentration task. Perfusion estimates were quantified using a standard atlas. Cerebral perfusion differences were calculated using one-way ANOVA. Diagnostic separation was determined with discriminant analysis of all subjects. Feature selection with a minimum redundancy maximum relevancy (mRMR) identified predictive regions in a subset of marijuana users (n = 436) with reduced psychiatric co-morbidities. RESULTS Marijuana users showed lower cerebral perfusion on average (p < 0.05). Discriminant analysis distinguished marijuana users from controls with correct classification of 96% and leave one out cross-validation of 92%. With concentration SPECT regions, there was correct classification of 95% with a leave-one-out cross validation of 90%. AUC analysis for concentration SPECT regions showed 95% accuracy, 90% sensitivity, and 83% specificity. The mRMR analysis showed right hippocampal hypoperfusion on concentration SPECT imaging was the most predictive in separating marijuana subjects from controls. CONCLUSION Multiple brain regions show low perfusion on SPECT in marijuana users. The most predictive region distinguishing marijuana users from healthy controls, the hippocampus, is a key target of Alzheimer's disease pathology. This study raises the possibility of deleterious brain effects of marijuana use.
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Affiliation(s)
| | | | - Cyrus A Raji
- University of California San Francisco, San Francisco, CA, USA
| | - Weining Bao
- Department of Electrical Engineering, University of Southern California, Los Angeles, CA, USA
| | | | | | - Cauligi S Raghavendra
- Department of Electrical Engineering, University of Southern California, Los Angeles, CA, USA
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Abstract
PURPOSE/BACKGROUND In animal models, levels of the neurosteroid pregnenolone increase after tetrahydrocannabinol (THC) administration and pregnenolone appears to attenuate the brain effects of THC. Given these interactions between pregnenolone and THC, we evaluated baseline neurosteroid levels in participants with a history of a cannabis use disorders (CUDs). METHODS/PROCEDURES Bipolar depressed participants were enrolled in a randomized placebo-controlled clinical trial to evaluate the efficacy of add-on pregnenolone for depression and before receiving pregnenolone or placebo. Baseline serum levels of neurosteroids (pregnenolone, allopregnanolone, pregnanolone, and androsterone) were analyzed in 53 participants with highly sensitive and specific gas chromatography/mass spectrometry. Current, active substance use disorders, or a positive baseline urine drug screen, were exclusionary. Participants were classified by past cannabis abuse or dependence diagnosis using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Data were analyzed by independent t tests for separate neurosteroids. FINDINGS/RESULTS Participants with a history of CUD had higher serum pregnanolone, lower allopregnanolone, a higher pregnanolone to allopregnanolone ratio, and a lower pregnenolone to pregnanolone ratio compared with those without a history of cannabis use. Similar findings were not observed based on a history of other substance use disorders with the exception of lower allopregnanolone in those with opioid use disorders. Notably, the majority of those with an opioid use disorder also had a CUD (75%). IMPLICATIONS/CONCLUSIONS These findings potentially suggest either enduring changes in neurosteroids in people with past CUDs or represent a vulnerability marker for a CUD.
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Eggers ME, Lee YO, Jackson K, Wiley JL, Porter L, Nonnemaker JM. Youth use of electronic vapor products and blunts for administering cannabis. Addict Behav 2017; 70:79-82. [PMID: 28214740 DOI: 10.1016/j.addbeh.2017.02.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND The positive association between youth use of cannabis and tobacco is well-established, and reports show that some youth are using electronic vapor products (EVPs) to administer cannabis. This study examines the prevalence and correlates of youth consumption of cannabis via EVP and how this compares with co-use of cannabis with cigars (blunts) among a large statewide sample of youth. METHODS We used data from the Florida Youth Tobacco Survey (FYTS), a school-based, pencil-and-paper questionnaire given to Florida middle and high school students (N=12,320). We conducted weighted descriptive analyses and logistic regressions examining prevalence and correlates of EVP/cannabis and blunt use. RESULTS Ever EVP/cannabis use was lower among middle school students (3.4%) than high school students (11.5%). Blunt use was reported by 6.0% of middle school and 24.1% of high school students. Approximately one-third of youth who had ever administered cannabis via either mode reported using both EVP/cannabis and blunts. EVP/cannabis and blunt use were both associated with lower school performance and use of other tobacco products. EVP/cannabis use did not vary by race/ethnicity, but blunt use was higher among black and Hispanic youth than white, non-Hispanic youth. DISCUSSION A substantial percentage of youth in a statewide sample are using EVPs and blunts to administer cannabis, and overlap between these use patterns is common. Differences in the demographic risk profile for EVP/cannabis and blunt use suggest that EVPs may provide a novel route of administration for delivering cannabis that appeals to groups not otherwise susceptible to using cannabis via blunts.
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Cannabis-related hippocampal volumetric abnormalities specific to subregions in dependent users. Psychopharmacology (Berl) 2017; 234:2149-2157. [PMID: 28424833 DOI: 10.1007/s00213-017-4620-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/29/2017] [Indexed: 12/12/2022]
Abstract
RATIONALE Cannabis use is associated with neuroanatomical alterations in the hippocampus. While the hippocampus is composed of multiple subregions, their differential vulnerability to cannabis dependence remains unknown. OBJECTIVES The objective of the study is to investigate gray matter alteration in each of the hippocampal subregions (presubiculum, subiculum, cornu ammonis (CA) subfields CA1-4, and dentate gyrus (DG)) as associated with cannabis use and dependence. METHODS A total of 35 healthy controls (HC), 22 non-dependent (CB-nondep), and 39 dependent (CB-dep) cannabis users were recruited. We investigated group differences in hippocampal subregion volumes between HC, CB-nondep, and CB-dep users. We further explored the association between CB use variables (age of onset of regular use, monthly use, lifetime use) and hippocampal subregions in CB-nondep and CB-dep users separately. RESULTS The CA1, CA2/3, CA4/DG, as well as total hippocampal gray matter were reduced in volume in CB-dep but not in CB-nondep users, relative to HC. The right CA2/3 and CA4/DG volumes were also negatively associated with lifetime cannabis use in CB-dep users. CONCLUSIONS Our results suggest a regionally and dependence-specific influence of cannabis use on the hippocampus. Hippocampal alteration in cannabis users was specific to the CA and DG regions and confined to dependent users.
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Zimmermann K, Walz C, Derckx RT, Kendrick KM, Weber B, Dore B, Ochsner KN, Hurlemann R, Becker B. Emotion regulation deficits in regular marijuana users. Hum Brain Mapp 2017; 38:4270-4279. [PMID: 28560818 DOI: 10.1002/hbm.23671] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/12/2017] [Accepted: 05/22/2017] [Indexed: 01/17/2023] Open
Abstract
Effective regulation of negative affective states has been associated with mental health. Impaired regulation of negative affect represents a risk factor for dysfunctional coping mechanisms such as drug use and thus could contribute to the initiation and development of problematic substance use. This study investigated behavioral and neural indices of emotion regulation in regular marijuana users (n = 23) and demographically matched nonusing controls (n = 20) by means of an fMRI cognitive emotion regulation (reappraisal) paradigm. Relative to nonusing controls, marijuana users demonstrated increased neural activity in a bilateral frontal network comprising precentral, middle cingulate, and supplementary motor regions during reappraisal of negative affect (P < 0.05, FWE) and impaired emotion regulation success on the behavioral level (P < 0.05). Amygdala-focused analyses further revealed impaired amygdala downregulation in the context of decreased amygdala-dorsolateral prefrontal cortex functional connectivity (P < 0.05, FWE) during reappraisal in marijuana users relative to controls. Together, the present findings could reflect an unsuccessful attempt of compensatory recruitment of additional neural resources in the context of disrupted amygdala-prefrontal interaction during volitional emotion regulation in marijuana users. As such, impaired volitional regulation of negative affect might represent a consequence of, or risk factor for, regular marijuana use. Hum Brain Mapp 38:4270-4279, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Kaeli Zimmermann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, 53105, Germany
| | - Christina Walz
- Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, 53105, Germany.,Department of NeuroCognition, Life & Brain Center, Bonn, 53105, Germany
| | - Raissa T Derckx
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, 53105, Germany
| | - Keith M Kendrick
- Key Laboratory for NeuroInformation, School of Life Science and Technology and Center for Information in Medicine, University of Electronic Science and Technology of China, 610054, People's Republic of China
| | - Bernd Weber
- Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, 53105, Germany.,Department of NeuroCognition, Life & Brain Center, Bonn, 53105, Germany
| | - Bruce Dore
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, 19104
| | - Kevin N Ochsner
- Department of Psychology, Columbia University, New York, New York, 10027
| | - René Hurlemann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, 53105, Germany
| | - Benjamin Becker
- Key Laboratory for NeuroInformation, School of Life Science and Technology and Center for Information in Medicine, University of Electronic Science and Technology of China, 610054, People's Republic of China
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The effects of synthetic cannabinoids on executive function. Psychopharmacology (Berl) 2017; 234:1121-1134. [PMID: 28160034 DOI: 10.1007/s00213-017-4546-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/23/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS There is a growing use of novel psychoactive substances (NPSs) including synthetic cannabinoids. Synthetic cannabinoid products have effects similar to those of natural cannabis but the new synthetic cannabinoids are more potent and dangerous and their use has resulted in various adverse effects. The purpose of the study was to assess whether persistent use of synthetic cannabinoids is associating with impairments of executive function in chronic users. METHODS A total of 38 synthetic cannabinoids users, 43 recreational cannabis users, and 41 non-user subjects were studied in two centers in Hungary and Israel. Computerized cognitive function tests, the classical Stroop word-color task, n-back task, and a free-recall memory task were used. RESULTS Synthetic cannabinoid users performed significantly worse than both recreational and non-cannabis users on the n-back task (less accuracy), the Stroop task (overall slow responses and less accuracy), and the long-term memory task (less word recall). Additionally, they have also shown higher ratings of depression and anxiety compared with both recreational and non-users groups. DISCUSSION This study showed impairment of executive function in synthetic cannabinoid users compared with recreational users of cannabis and non-users. This may have major implications for our understanding of the long-term consequences of synthetic cannabinoid based drugs.
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Colle R, Segawa T, Chupin M, Tran Dong MNTK, Hardy P, Falissard B, Colliot O, Ducreux D, Corruble E. Early life adversity is associated with a smaller hippocampus in male but not female depressed in-patients: a case-control study. BMC Psychiatry 2017; 17:71. [PMID: 28202012 PMCID: PMC5312536 DOI: 10.1186/s12888-017-1233-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/07/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Three studies assessed the association of early life adversity (ELA) and hippocampal volumes in depressed patients, of which one was negative and the two others did not control for several potential confounding variables. Since the association of ELA and hippocampal volumes differ in male and female healthy volunteers, we investigated the association of ELA and hippocampal volumes in depressed patients, while focusing specifically on sex and controlling for several relevant socio-demographic and clinical variables. METHODS Sixty-three depressed in-patients treated in a psychiatric setting, with a current Major Depressive Episode (MDE) and a Major Depressive Disorder (MDD) were included and assessed for ELA. Hippocampal volumes were measured with brain magnetic resonance imaging (MRI) and automatic segmentation. They were compared between patients with (n = 28) or without (n = 35) ELA. After bivariate analyses, multivariate regression analyses tested the interaction of sex and ELA on hippocampal volume and were adjusted for several potential confounding variables. The subgroups of men (n = 26) and women (n = 37) were assessed separately. RESULTS Patients with ELA had a smaller hippocampus than those without ELA (4.65 (±1.11) cm3 versus 5.25 (±1.01) cm3), bivariate: p = 0.03, multivariate: HR = 0.40, 95%CI [0.23;0.71], p = 0.002), independently from other factors. This association was found in men (4.43 (±1.22) versus 5.67 (±0.77) cm3), bivariate: p = 0.006, multivariate HR = 0.23, 95%CI [0.06;0.82], p = 0.03) but not in women. CONCLUSION ELA is associated with a smaller hippocampus in male but not female depressed in-patients. The reasons for this association should be investigated in further studies.
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Affiliation(s)
- Romain Colle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275, Le Kremlin Bicêtre, France. .,Faculté de Médecine Paris Sud, Univ. Paris-Sud, 94275, Le Kremlin Bicêtre, France. .,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin Bicêtre, France.
| | - Tomoyuki Segawa
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Marie Chupin
- INSERM U1127, F-75013 Paris, France ,CNRS, UMR 7225, 75013 Paris, France ,0000 0001 1955 3500grid.5805.8Sorbonne Universités, UPMC Univ. Paris 06, UMR S 1127, F-75013 Paris, France ,0000 0001 2175 1768grid.418189.dInstitut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France ,Inria, Aramis project-team, Centre de Recherche de Paris, Paris, France ,0000 0001 2150 9058grid.411439.aDepartments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Minh Ngoc Thien Kim Tran Dong
- CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France ,Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- INSERM, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Olivier Colliot
- INSERM U1127, F-75013 Paris, France ,CNRS, UMR 7225, 75013 Paris, France ,0000 0001 1955 3500grid.5805.8Sorbonne Universités, UPMC Univ. Paris 06, UMR S 1127, F-75013 Paris, France ,0000 0001 2175 1768grid.418189.dInstitut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France ,Inria, Aramis project-team, Centre de Recherche de Paris, Paris, France ,0000 0001 2150 9058grid.411439.aDepartments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Denis Ducreux
- CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France ,Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team “Depression and Antidepressants”, 94275 Le Kremlin Bicêtre, France ,0000 0001 2171 2558grid.5842.bFaculté de Médecine Paris Sud, Univ. Paris-Sud, 94275 Le Kremlin Bicêtre, France ,Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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Havemann-Reinecke U, Hoch E, Preuss UW, Kiefer F, Batra A, Gerlinger G, Hauth I. [On the legalization debate of non-medical cannabis consumption : Position paper of the German Association for Psychiatry, Psychotherapy and Psychosomatics]. DER NERVENARZT 2016; 88:291-298. [PMID: 27981374 DOI: 10.1007/s00115-016-0248-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Calls are increasing for the legalization of cannabis. Some legal experts, various politicians, political parties and associations are demanding a change in drug policy. The legalization debate is lively and receiving wide coverage in the media. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) comments on the most important questions from a medical scientific perspective: can cannabis consumption trigger mental illnesses, what consequences would legalization have for the healthcare system and where is more research needed?
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Affiliation(s)
- U Havemann-Reinecke
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland. .,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland.
| | - E Hoch
- Abt. Psychotherapie & Psychosomatik, Klinik und Poliklinik für Psychiatrie und Psychotherapie, LMU München, München, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - U W Preuss
- Vitos Klinik für Psychiatrie und Psychotherapie Herborn, Herborn, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - F Kiefer
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - A Batra
- Universitätsklinik für Psychiatrie und Psychotherapie, Eberhard-Karls-Universität Tübingen, Tübingen, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - G Gerlinger
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - I Hauth
- Zentrum für Neurologie, Psychiatrie, Psychotherapie und Psychosomatik, Alexianer St. Joseph Krankenhaus, Berlin, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
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Wright NE, Scerpella D, Lisdahl KM. Marijuana Use Is Associated with Behavioral Approach and Depressive Symptoms in Adolescents and Emerging Adults. PLoS One 2016; 11:e0166005. [PMID: 27835662 PMCID: PMC5106002 DOI: 10.1371/journal.pone.0166005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/23/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Repeated CB1 binding due to THC results in downregulation of the endocannabinoid system in cortex and limbic regions, perhaps disrupting frontolimbic functioning. This is particularly a concern in young adults who are still undergoing neurodevelopment in frontal and limbic regions. Such disruptions may be linked to increased depressive symptoms, anxiety symptoms, and executive dysfunction, and decreased behavioral approach. OBJECTIVES Here we examine the influence of young adult marijuana use on anxiety, depressive symptoms, behavioral approach, and executive dysfunction. The influence of alcohol and gender were also assessed. METHODS 84 participants (42 MJ, 42 controls) aged 18-25 were balanced for gender (39 F). Exclusion criteria included: MRI contraindications, left handed, comorbid Axis-I disorders, major medical or neurologic disorders, prenatal issues, or prenatal alcohol/illicit drug exposure, or excessive other drug use. Participants completed the FrsBE, BIS/BAS, State-Trait Anxiety Inventory (State), and BDI-II. Multiple regressions were run to predict anxiety, depressive symptoms, behavioral approach, and executive dysfunction from MJ group status, past year alcohol use, gender, and MJ*gender interactions, controlling for cotinine and ecstasy. RESULTS MJ group predicted increased depressive symptoms (p =.049). Decreased fun-seeking (p =.04), reward response (p =.01), and BAS total (p =.01) were predicted by MJ group. Gender predicted decreased reward responsiveness in females (p =.049) and decreased BIS in females (p =.03). Female marijuana users had increased anxiety symptoms (p =.04) and increased disinhibition (p =.04). Increased cotinine predicted increased drive (p =.046), reward responsiveness (p =.008) and BAS Total (p =.02). Apathy and Executive Dysfunction were not predicted by any measures. All results had small effect sizes. CONCLUSIONS/IMPORTANCE Depressive symptoms were greater in MJ users, while behavioral approach was decreased. Cotinine levels predicted increased behavioral approach. Female MJ users also had greater anxiety and disinhibition. In sum, these findings suggest sub-clinical threshold deficits related to regular marijuana use that are indicative of a need to prevent marijuana use in adolescents and young adults.
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Affiliation(s)
- Natasha E. Wright
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Danny Scerpella
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
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Brellenthin AG, Koltyn KF. Exercise as an adjunctive treatment for cannabis use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:481-489. [PMID: 27314543 PMCID: PMC5055462 DOI: 10.1080/00952990.2016.1185434] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/22/2016] [Accepted: 04/29/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users. OBJECTIVES The aim of this paper is to inform the topic regarding exercise's potential as an adjunctive treatment for individuals with CUD. METHODS We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD. RESULTS Cannabis use is widespread and increasing in the United States. Chronic, heavy cannabis use may dysregulate the endogenous cannabinoid system, which has implications for several psychobiological processes that interact with the eCB system such as reward processing and the stress response. Given that exercise is a potent activator of the eCB system, it is mechanistically plausible that exercise could be an optimal method to supplement cessation efforts by reducing psychophysical withdrawal, managing stress, and attenuating drug cravings. CONCLUSION We suggest there is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD. Moreover, it will be especially important to include the investigation of psychobiological mechanisms (e.g., eCBs, hippocampal volume), which have been associated with both exercise and SUDs, to examine the broader impact of exercise on behavioral and physiological responses to treatment.
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Affiliation(s)
| | - Kelli F Koltyn
- a Department of Kinesiology , University of Wisconsin-Madison , Madison , WI , USA
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Schuster RM, Mermelstein RJ, Hedeker D. Ecological momentary assessment of working memory under conditions of simultaneous marijuana and tobacco use. Addiction 2016; 111:1466-76. [PMID: 26857917 PMCID: PMC4940223 DOI: 10.1111/add.13342] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 01/15/2016] [Accepted: 02/03/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS The neuropsychological correlates of simultaneous marijuana and tobacco use are largely unknown, which is surprising as both substances have similar neural substrates and have opposing influences on working memory (WM). This study examined the effects of marijuana alone, tobacco alone and simultaneous marijuana and tobacco use on WM. DESIGN Primary aims were tested using a within-subject design, controlling for multiple subject- and momentary-level confounds via ecological momentary assessment (EMA). SETTING Data collection occurred in the Chicago, USA area in participants' natural environments. PARTICIPANTS Participants were 287 community young adults from a larger natural history study, oversampled for ever smoking, all of whom event-recorded at least one substance use occasion during the study week. MEASUREMENTS Momentary tobacco, marijuana and alcohol use were recorded during multiple EMA across 1 week of data capture. WM was assessed at the end of each EMA assessment. Contextual variables that may influence WM were recorded via EMA. FINDINGS There were main effects for marijuana and tobacco: WM was poorer with marijuana [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.84-0.99] and better with tobacco (OR = 1.11, 95% CI = 1.04-1.18). These effects were not qualified by an interaction (OR = 1.03, 95% CI = 0.84-1.26). Alcohol also reduced WM (OR = 0.87, 95% CI = 0.79-0.95), and the tobacco × alcohol interaction was significant (OR = 0.81, 95% CI = 0.66-0.99), indicating that the facilitative effect of tobacco disappeared with concurrent alcohol use. CONCLUSIONS Relative to when individuals did not use these substances, working memory decreased with acute marijuana and alcohol use and increased with acute tobacco use. However, the putative effect of marijuana on working memory and the facilitative effect of tobacco on working memory were no longer present when used simultaneously with tobacco and alcohol, respectively. Data suggest that tobacco use may compensate for working memory decrements from marijuana among young adults and highlight the importance of investigating further the negative impact of alcohol use on cognition.
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Affiliation(s)
- Randi Melissa Schuster
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Robin J. Mermelstein
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois,Institute for Health Research and Policy, Chicago, Illinois
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
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Abstract
Background Tetrahydrocannabinol (Δ9-THC), the primary ingredient in marijuana, exerts its effects across several neurological and biological systems that interact with the endocrine system. Thus, differential effects of Δ9-THC are likely to exist based on sex and hormone levels. Methods We reviewed the existing literature to determine sex-based effects of Δ9-THC on neural structure and functioning. Results The literature demonstrates differences in male and female marijuana users on brain structure, reward processing, attention, motor coordination, and sensitivity to withdrawal. However, inconsistencies exist in the literature regarding how marijuana affects men and women differentially, and more work is needed to understand these mechanisms. While extant literature remains inconclusive, differentiation between male and female marijuana users is likely due to neurological sexual dimorphism and differential social factors at play during development and adulthood. Conclusions Sex has important implications for marijuana use and the development of cannabis use disorders and should be considered in the development of prevention and treatment strategies.
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Affiliation(s)
- Ariel Ketcherside
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
| | - Jessica Baine
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
| | - Francesca Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
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Ketcherside A, Jeon-Slaughter H, Baine JL, Filbey FM. Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users. Psychiatry Res 2016; 238:356-362. [PMID: 27086256 PMCID: PMC4834927 DOI: 10.1016/j.psychres.2016.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 01/14/2016] [Accepted: 02/15/2016] [Indexed: 01/05/2023]
Abstract
Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies.
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Affiliation(s)
- Ariel Ketcherside
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | | | - Jessica L. Baine
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA.
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Subramaniam P, McGlade E, Yurgelun-Todd D. Comorbid Cannabis and Tobacco Use in Adolescents and Adults. CURRENT ADDICTION REPORTS 2016; 3:182-188. [PMID: 27175326 DOI: 10.1007/s40429-016-0101-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of comorbid cannabis and tobacco use has been increasing among adolescents and adults and has been shown to be associated with a range of changes or deficits in physical, psychological and behavioral outcomes. Moreover, comorbid use has been shown to have a differential effect on the structure and function of the brain, especially as it relates to the reward circuitry and learning and memory. This interaction might be mediated by the involvement of the endocannabinoid system and alterations in dopamine signaling in regions associated with reward and cognitive functioning. While current findings demonstrate a differential effect of comorbid use on neurobiological and behavioral correlates compared with single substance use, additional studies are needed controlling for potential psychiatric comorbidities, age of onset of use and use of other substances. Understanding the neurobiological mechanisms associated with comorbid cannabis and tobacco use will be important in developing successful treatment outcomes in the future.
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Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA; Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA
| | - Erin McGlade
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA; Department of Psychiatry, University of Utah, Salt Lake City, UT; George E. Whalen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC), Salt Lake City, UT, USA
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA; Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA; Department of Psychiatry, University of Utah, Salt Lake City, UT; George E. Whalen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC), Salt Lake City, UT, USA
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