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Poyatos-Pedrosa C, Bernabe-Valero G, Pelacho-Ríos L, Iborra-Marmolejo I. Cannabis and anhedonia: A systematic review. Psychiatry Res 2024; 339:116041. [PMID: 38959579 DOI: 10.1016/j.psychres.2024.116041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/08/2024] [Accepted: 06/13/2024] [Indexed: 07/05/2024]
Abstract
This paper employs a systematic review to examine the correlation between anhedonia and marijuana use, exploring whether individuals with anhedonia use marijuana as a coping mechanism or if marijuana use plays a role in the onset of anhedonia. The search utilised PubMed and Web of Science databases, following PRISMA guidelines for paper selection. A total of 21 papers were selected to address this inquiry, and assessments were carried out using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool. The results revealed that 17 studies exhibited moderate and low risk of bias. The evaluation encompassed a total of 12,427 participants, including both animals and humans. Experimental animal studies focused on exploring the association between cannabidiol (CBD) and anhedonia, while human studies primarily employed observational research, examining various forms of anhedonia in individuals with or without mental disorders such as depression or psychosis. These studies also delved into understanding the effects of anhedonia during adolescence and explored the causal relationship between these concepts. The findings indicate a reciprocal rather than unidirectional relationship, establishing that initial anhedonia predisposes individuals to cannabis use, and subsequent consumption significantly intensifies the anhedonia experienced. Particularly, the studies placed special emphasis on adolescents and individuals with mental disorders.
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Affiliation(s)
- C Poyatos-Pedrosa
- Mind, Emotion and Behavior Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia, San Vicente Mártir, Spain
| | - G Bernabe-Valero
- Mind, Emotion and Behavior Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia, San Vicente Mártir, Spain.
| | - L Pelacho-Ríos
- Mind, Emotion and Behavior Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia, San Vicente Mártir, Spain
| | - I Iborra-Marmolejo
- Mind, Emotion and Behavior Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia, San Vicente Mártir, Spain
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2
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Boer OD, El Marroun H, Muetzel RL. Adolescent substance use initiation and long-term neurobiological outcomes: insights, challenges and opportunities. Mol Psychiatry 2024:10.1038/s41380-024-02471-2. [PMID: 38409597 DOI: 10.1038/s41380-024-02471-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024]
Abstract
The increased frequency of risk taking behavior combined with marked neuromaturation has positioned adolescence as a focal point of research into the neural causes and consequences of substance use. However, little work has provided a summary of the links between adolescent initiated substance use and longer-term brain outcomes. Here we review studies exploring the long-term effects of adolescent-initiated substance use with structural and microstructural neuroimaging. A quarter of all studies reviewed conducted repeated neuroimaging assessments. Long-term alcohol use, as well as tobacco use were consistently associated with smaller frontal cortices and altered white matter microstructure. This association was mostly observed in the ACC, insula and subcortical regions in alcohol users, and for the OFC in tobacco users. Long-term cannabis use was mostly related to altered frontal cortices and hippocampal volumes. Interestingly, cannabis users scanned more years after use initiation tended to show smaller measures of these regions, whereas those with fewer years since initiation showed larger measures. Long-term stimulant use tended to show a similar trend as cannabis in terms of years since initiation in measures of the putamen, insula and frontal cortex. Long-term opioid use was mostly associated with smaller subcortical and insular volumes. Of note, null findings were reported in all substance use categories, most often in cannabis use studies. In the context of the large variety in study designs, substance use assessment, methods, and sample characteristics, we provide recommendations on how to interpret these findings, and considerations for future studies.
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Affiliation(s)
- Olga D Boer
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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3
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Xu H, Li J, Huang H, Yin B, Li DD. Abnormal developmental of structural covariance networks in young adults with heavy cannabis use: a 3-year follow-up study. Transl Psychiatry 2024; 14:45. [PMID: 38245512 PMCID: PMC10799944 DOI: 10.1038/s41398-024-02764-8] [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: 07/20/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Heavy cannabis use (HCU) exerts adverse effects on the brain. Structural covariance networks (SCNs) that illustrate coordinated regional maturation patterns are extensively employed to examine abnormalities in brain structure. Nevertheless, the unexplored aspect remains the developmental alterations of SCNs in young adults with HCU for three years, from the baseline (BL) to the 3-year follow-up (FU). These changes demonstrate dynamic development and hold potential as biomarkers. A total of 20 young adults with HCU and 22 matched controls were recruited. All participants underwent magnetic resonance imaging (MRI) scans at both the BL and FU and were evaluated using clinical measures. Both groups used cortical thickness (CT) and cortical surface area (CSA) to construct structural covariance matrices. Subsequently, global and nodal network measures of SCNs were computed based on these matrices. Regarding global network measures, the BL assessment revealed significant deviations in small-worldness and local efficiency of CT and CSA in young adults with HCU compared to controls. However, no significant differences between the two groups were observed at the FU evaluation. Young adults with HCU displayed changes in nodal network measures across various brain regions during the transition from BL to FU. These alterations included abnormal nodal degree, nodal efficiency, and nodal betweenness in widespread areas such as the entorhinal cortex, superior frontal gyrus, and parahippocampal cortex. These findings suggest that the topography of CT and CSA plays a role in the typical structural covariance topology of the brain. Furthermore, these results indicate the effect of HCU on the developmental changes of SCNs in young adults.
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Affiliation(s)
- Hui Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325007, China.
| | - Jiahao Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Huang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan-Dong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
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4
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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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Soleimani G, Towhidkhah F, Saviz M, Ekhtiari H. Cortical Morphology in Cannabis Use Disorder: Implications for Transcranial Direct Current Stimulation Treatment. Basic Clin Neurosci 2023; 14:647-662. [PMID: 38628838 PMCID: PMC11016884 DOI: 10.32598/bcn.2021.3400.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/18/2021] [Accepted: 05/27/2023] [Indexed: 04/19/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) has been studied as an adjunctive treatment option for substance use disorders (SUDs). Alterations in brain structure following SUD may change tDCS-induced electric field (EF) and subsequent responses; however, group-level differences between healthy controls (HC) and participants with SUDs in terms of EF and its association with cortical architecture have not yet been modeled quantitatively. This study provides a methodology for group-level analysis of computational head models to investigate the influence of cortical morphology metrics on EFs. Methods Whole-brain surface-based morphology was conducted, and cortical thickness, volume, and surface area were compared between participants with cannabis use disorders (CUD) (n=20) and age-matched HC (n=22). Meanwhile, EFs were simulated for bilateral tDCS over the dorsolateral prefrontal cortex. The effects of structural alterations on EF distribution were investigated based on individualized computational head models. Results Regarding EF, no significant difference was found within the prefrontal cortex; however, EFs were significantly different in left-postcentral and right-superior temporal gyrus (P<0.05) with higher levels of variance in CUD compared to HC [F(39, 43)=5.31, P<0.0001, C=0.95]. Significant differences were observed in cortical area (caudal anterior cingulate and rostral middle frontal), thickness (lateral orbitofrontal), and volume (paracentral and fusiform) between the two groups. Conclusion Brain morphology and tDCS-induced EFs may be changed following CUD; however, differences between CUD and HCs in EFs do not always overlap with brain areas that show structural alterations. To sufficiently modulate stimulation targets, whether individuals with CUD need different stimulation doses based on tDCS target location should be checked.
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Affiliation(s)
- Ghazaleh Soleimani
- Department of Biomedical Engineering, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Farzad Towhidkhah
- Department of Biomedical Engineering, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mehrdad Saviz
- Department of Biomedical Engineering, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Hamed Ekhtiari
- Laureate Institute of Brain Research, Tulsa, United States of America
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6
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Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Child Adolesc Psychiatr Clin N Am 2023; 32:21-42. [PMID: 36410904 DOI: 10.1016/j.chc.2022.06.002] [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: 11/30/2022]
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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7
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Lee JE, Walton D, O’Connor CP, Wammes M, Burton JP, Osuch EA. Drugs, Guts, Brains, but Not Rock and Roll: The Need to Consider the Role of Gut Microbiota in Contemporary Mental Health and Wellness of Emerging Adults. Int J Mol Sci 2022; 23:ijms23126643. [PMID: 35743087 PMCID: PMC9223871 DOI: 10.3390/ijms23126643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 02/01/2023] Open
Abstract
Emerging adulthood (ages 18–25) is a critical period for neurobiological development and the maturation of the hypothalamic–pituitary–adrenal axis. Recent findings also suggest that a natural perturbation of the gut microbiota (GM), combined with other factors, may create a unique vulnerability during this period of life. The GM of emerging adults is thought to be simpler, less diverse, and more unstable than either younger or older people. We postulate that this plasticity in the GM suggests a role in the rising mental health issues seen in westernized societies today via the gut–brain–microbiota axis. Studies have paid particular attention to the diversity of the microbiota, the specific function and abundance of bacteria, and the production of metabolites. In this narrative review, we focus specifically on diet, physical activity/exercise, substance use, and sleep in the context of the emerging adult. We propose that this is a crucial period for establishing a stable and more resilient microbiome for optimal health into adulthood. Recommendations will be made about future research into possible behavioral adjustments that may be beneficial to endorse during this critical period to reduce the probability of a “dysbiotic” GM and the emergence and severity of mental health concerns.
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Affiliation(s)
- Ju Eun Lee
- London Health Science Centre—Victoria Hospital, Department of Psychiatry, B8-102, London, ON N6A 5W9, Canada;
| | - David Walton
- Rm. EC1443 School of Physical Therapy, 1201 Western Rd., London, ON N6G 1H1, Canada;
| | - Colleen P. O’Connor
- School of Food and Nutritional Sciences, Brescia University College, London, ON N6G 1H2, Canada;
| | - Michael Wammes
- London Health Sciences Centre, Department of Psychiatry, Lawson Health Research Institute, Schulich School of Medicine and Dentistry, Western University, 860 Richmond Street, FEMAP, London, ON N6A 3H8, Canada;
| | - Jeremy P. Burton
- Departments of Surgery, Microbiology and Immunology, Lawson Health Research Institute, Western University, London, ON N6A 3K7, Canada;
| | - Elizabeth A. Osuch
- London Health Sciences Centre, Department of Psychiatry, Lawson Health Research Institute, Schulich School of Medicine and Dentistry, Western University, 860 Richmond Street, FEMAP, London, ON N6A 3H8, Canada;
- Correspondence: ; Tel.: +519-646-6000 (ext. 65188)
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8
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Tapert SF, Eberson-Shumate S. Alcohol and the Adolescent Brain: What We've Learned and Where the Data Are Taking Us. Alcohol Res 2022; 42:07. [PMID: 35465194 PMCID: PMC8999519 DOI: 10.35946/arcr.v42.1.07] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world's largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, "Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research," devoted to key topics within the field of alcohol research. This article is based on Dr. Tapert's presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.
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Affiliation(s)
- Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
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9
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Claus ED, Blaine SK, Witkiewitz K, Ansell EB. Sex moderates effects of alcohol and cannabis co-use on alcohol and stress reactivity. Alcohol Clin Exp Res 2022; 46:530-541. [PMID: 35229336 PMCID: PMC9018602 DOI: 10.1111/acer.14797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Simultaneous or concurrent use (co-use) of alcohol and cannabis is associated with greater use of both substances over time, academic difficulties, more severe substance use consequences, and adverse impacts on cognitive functioning than the use of a single substance or no substance use. This study examined potential neural mechanisms underlying co-use behaviors in comparison to single substance use. Specifically, we compared alcohol cue reactivity and stress-cue reactivity among individuals who reported frequent same-day co-use of alcohol and cannabis and individuals who reported only alcohol use. METHODS The sample included 88 individuals (41 women) who reported only alcohol use and 24 individuals (8 women) who reported co-use of alcohol and cannabis on at least 50% of drinking occasions. All participants completed fMRI stress and alcohol cue reactivity tasks. Because of known sex effects on stress reactivity and alcohol cue reactivity, we tested sex by co-use interactions. RESULTS During alcohol cue presentation, co-users had less activation in the thalamus and dorsomedial prefrontal cortex than alcohol-only users, effects that were driven by differences in responses to neutral cues. Examination of stress cue reactivity revealed sex by co-use interactions in the lingual gyrus, with women co-users showing a greater difference between negative and neutral cue reactivity than all other groups. In addition, women co-users had greater connectivity between the nucleus accumbens and both the medial orbitofrontal cortex and the rostral anterior cingulate cortex during negative cue presentation than the other groups. CONCLUSIONS These results provide preliminary evidence of enhanced stress cue reactivity in individuals reporting co-use of alcohol and cannabis, particularly women co-users.
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Affiliation(s)
- Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sara K Blaine
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Emily B Ansell
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
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Lichenstein SD, Manco N, Cope LM, Egbo L, Garrison KA, Hardee J, Hillmer AT, Reeder K, Stern EF, Worhunsky P, Yip SW. Systematic review of structural and functional neuroimaging studies of cannabis use in adolescence and emerging adulthood: evidence from 90 studies and 9441 participants. Neuropsychopharmacology 2022; 47:1000-1028. [PMID: 34839363 PMCID: PMC8938408 DOI: 10.1038/s41386-021-01226-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 11/09/2022]
Abstract
Cannabis use peaks in adolescence, and adolescents may be more vulnerable to the neural effects of cannabis and cannabis-related harms due to ongoing brain development during this period. In light of ongoing cannabis policy changes, increased availability, reduced perceptions of harm, heightened interest in medicinal applications of cannabis, and drastic increases in cannabis potency, it is essential to establish an understanding of cannabis effects on the developing adolescent brain. This systematic review aims to: (1) synthesize extant literature on functional and structural neural alterations associated with cannabis use during adolescence and emerging adulthood; (2) identify gaps in the literature that critically impede our ability to accurately assess the effect of cannabis on adolescent brain function and development; and (3) provide recommendations for future research to bridge these gaps and elucidate the mechanisms underlying cannabis-related harms in adolescence and emerging adulthood, with the long-term goal of facilitating the development of improved prevention, early intervention, and treatment approaches targeting adolescent cannabis users (CU). Based on a systematic search of Medline and PsycInfo and other non-systematic sources, we identified 90 studies including 9441 adolescents and emerging adults (n = 3924 CU, n = 5517 non-CU), which provide preliminary evidence for functional and structural alterations in frontoparietal, frontolimbic, frontostriatal, and cerebellar regions among adolescent cannabis users. Larger, more rigorous studies are essential to reconcile divergent results, assess potential moderators of cannabis effects on the developing brain, disentangle risk factors for use from consequences of exposure, and elucidate the extent to which cannabis effects are reversible with abstinence. Guidelines for conducting this work are provided.
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Affiliation(s)
| | - Nick Manco
- Medical University of South Carolina, Charleston, SC, USA
| | - Lora M Cope
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Leslie Egbo
- Neuroscience and Behavior Program, Wesleyan University, Middletown, CT, USA
| | | | - Jillian Hardee
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Ansel T Hillmer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Kristen Reeder
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA
| | - Elisa F Stern
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Patrick Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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11
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Kumari R, Ranjan JK, Verma S. Cannabis use, polysubstance use, and psychosis prodrome among first-degree relatives of patients with schizophrenia. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1989510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rajbala Kumari
- Department of Psychology, Banaras Hindu University, Varanasi, India
| | - Jay Kumar Ranjan
- Department of Psychology, Banaras Hindu University, Varanasi, India
| | - Saroj Verma
- Department of Psychology, Banaras Hindu University, Varanasi, India
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12
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Abstract
PURPOSE Alcohol and cannabis are the most commonly used substances during adolescence and are typically initiated during this sensitive neurodevelopmental period. The aim of this review is to provide a comprehensive overview of the most recent literature focused on understanding how these substances affect the developing brain. SEARCH METHODS Articles included in this review were identified by entering 30 search terms focused on substance use, adolescence, and neurodevelopment into MEDLINE, Embase, PsycINFO, ProQuest Central, and Web of Science. Studies were eligible for inclusion if they longitudinally examined the effect of adolescent alcohol and/or cannabis use on structural or functional outcomes in 50 or more participants. SEARCH RESULTS More than 700 articles were captured by the search, and 43 longitudinal studies met inclusion criteria, including 18 studies focused on alcohol use, 13 on cannabis use, and 12 on alcohol and cannabis co-use. DISCUSSION AND CONCLUSIONS Existing studies suggest heavy alcohol and cannabis use during adolescence are related to small to moderate disruptions in brain structure and function, as well as neurocognitive impairment. The effects of alcohol use include widespread decreases in gray matter volume and cortical thickness across time; slowed white matter growth and poorer integrity; disrupted network efficiency; and poorer impulse and attentional control, learning, memory, visuospatial processing, and psychomotor speed. The severity of some effects is dependent on dose. Heavy to very heavy cannabis use is associated with decreased subcortical volume and increased frontoparietal cortical thickness, disrupted functional development, and decreased executive functioning and IQ compared to non-using controls. Overall, co-use findings suggest more pronounced effects related to alcohol use than to cannabis use. Several limitations exist in the literature. Sample sizes are relatively small and demographically homogenous, with significant heterogeneity in substance use patterns and methodologies across studies. More research is needed to clarify how substance dosing and interactions between substances, as well as sociodemographic and environmental factors, affect outcomes. Larger longitudinal studies, already underway, will help clarify the relationship between brain development and substance use.
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Affiliation(s)
- Briana Lees
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Jennifer Debenham
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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13
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Neuroimaging evidence for structural correlates in adolescents resilient to polysubstance use: A five-year follow-up study. Eur Neuropsychopharmacol 2021; 49:11-22. [PMID: 33770525 DOI: 10.1016/j.euroneuro.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/13/2022]
Abstract
Early initiation of polysubstance use (PSU) is a strong predictor of subsequent addiction, however scarce individuals present resilience capacity. This neuroimaging study aimed to investigate structural correlates associated with cessation or reduction of PSU and determine the extent to which brain structural features accounted for this resilient outcome. Participants from a European community-based cohort self-reported their alcohol, tobacco and cannabis use frequency at ages 14, 16 and 19 and had neuroimaging sessions at ages 14 and 19. We included three groups in the study: the resilient-to-PSU participants showed PSU at 16 and/or 14 but no more at 19 (n = 18), the enduring polysubstance users at 19 displayed PSU continuation from 14 or 16 (n = 193) and the controls were abstinent or low drinking participants (n = 460). We conducted between-group comparisons of grey matter volumes on whole brain using voxel-based morphometry and regional fractional anisotropy using tract-based spatial statistics. Random-forests machine-learning approach generated individual-level PSU-behavior predictions based on personality and neuroimaging features. Adolescents resilient to PSU showed significant larger grey matter volumes in the bilateral cingulate gyrus compared with enduring polysubstance users and controls at ages 19 and 14 (p<0.05 corrected) but no difference in fractional anisotropy. The larger cingulate volumes and personality trait "openness to experience" were the best precursors of resilience to PSU. Early in adolescence, a larger cingulate gyrus differentiated adolescents resilient to PSU, and this feature was critical in predicting this outcome. This study encourages further research into the neurobiological bases of resilience to addictive behaviors.
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Debenham J, Birrell L, Champion K, Lees B, Yücel M, Newton N. Neuropsychological and neurophysiological predictors and consequences of cannabis and illicit substance use during neurodevelopment: a systematic review of longitudinal studies. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:589-604. [PMID: 33991473 DOI: 10.1016/s2352-4642(21)00051-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022]
Abstract
Adolescence and early adulthood are crucial periods of neurodevelopment characterised by functional, structural, and cognitive maturation, which helps prepare young people for adulthood. This systematic review of longitudinal studies aims to delineate neural predictors from neural consequences of cannabis and illicit substance use, as well as investigate the potential for the developing brain (at ages 10-25 years) to recover after damage. Five databases were searched to yield a total of 38 eligible studies, with some assessing multiple outcome techniques, including 22 neuroimaging, two neurophysiological, and 22 neuropsychological findings. High-quality evidence suggested that delayed or irregular neurodevelopment in executive functioning, particularly emotional perception, might predispose young people to higher frequency substance use. There was evidence of functional, structural, and cognitive deficits proceeding substance use, with harm potentially dependent on the frequency of use and recovery potentially dependent on the duration of use. Identifying aberrant neurodevelopment in young people is crucial for preventing substance use-related harm.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia.
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
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15
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Albaugh MD, Ottino-Gonzalez J, Sidwell A, Lepage C, Juliano A, Owens MM, Chaarani B, Spechler P, Fontaine N, Rioux P, Lewis L, Jeon S, Evans A, D’Souza D, Radhakrishnan R, Banaschewski T, Bokde ALW, Quinlan EB, Conrod P, Desrivières S, Flor H, Grigis A, Gowland P, Heinz A, Ittermann B, Martinot JL, Paillère Martinot ML, Nees F, Papadopoulos Orfanos D, Paus T, Poustka L, Millenet S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Potter A, Garavan H. Association of Cannabis Use During Adolescence With Neurodevelopment. JAMA Psychiatry 2021; 78:2781289. [PMID: 34132750 PMCID: PMC8209561 DOI: 10.1001/jamapsychiatry.2021.1258] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/18/2021] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Animal studies have shown that the adolescent brain is sensitive to disruptions in endocannabinoid signaling, resulting in altered neurodevelopment and lasting behavioral effects. However, few studies have investigated ties between cannabis use and adolescent brain development in humans. OBJECTIVE To examine the degree to which magnetic resonance (MR) imaging-assessed cerebral cortical thickness development is associated with cannabis use in a longitudinal sample of adolescents. DESIGN, SETTING, AND PARTICIPANTS Data were obtained from the community-based IMAGEN cohort study, conducted across 8 European sites. Baseline data used in the present study were acquired from March 1, 2008, to December 31, 2011, and follow-up data were acquired from January 1, 2013, to December 31, 2016. A total of 799 IMAGEN participants were identified who reported being cannabis naive at study baseline and had behavioral and neuroimaging data available at baseline and 5-year follow-up. Statistical analysis was performed from October 1, 2019, to August 31, 2020. MAIN OUTCOMES AND MEASURES Cannabis use was assessed at baseline and 5-year follow-up with the European School Survey Project on Alcohol and Other Drugs. Anatomical MR images were acquired with a 3-dimensional T1-weighted magnetization prepared gradient echo sequence. Quality-controlled native MR images were processed through the CIVET pipeline, version 2.1.0. RESULTS The study evaluated 1598 MR images from 799 participants (450 female participants [56.3%]; mean [SD] age, 14.4 [0.4] years at baseline and 19.0 [0.7] years at follow-up). At 5-year follow-up, cannabis use (from 0 to >40 uses) was negatively associated with thickness in left prefrontal (peak: t785 = -4.87, cluster size = 1558 vertices; P = 1.10 × 10-6, random field theory cluster corrected) and right prefrontal (peak: t785 = -4.27, cluster size = 1551 vertices; P = 2.81 × 10-5, random field theory cluster corrected) cortices. There were no significant associations between lifetime cannabis use at 5-year follow-up and baseline cortical thickness, suggesting that the observed neuroanatomical differences did not precede initiation of cannabis use. Longitudinal analysis revealed that age-related cortical thinning was qualified by cannabis use in a dose-dependent fashion such that greater use, from baseline to follow-up, was associated with increased thinning in left prefrontal (peak: t815.27 = -4.24, cluster size = 3643 vertices; P = 2.28 × 10-8, random field theory cluster corrected) and right prefrontal (peak: t813.30 = -4.71, cluster size = 2675 vertices; P = 3.72 × 10-8, random field theory cluster corrected) cortices. The spatial pattern of cannabis-related thinning was associated with age-related thinning in this sample (r = 0.540; P < .001), and a positron emission tomography-assessed cannabinoid 1 receptor-binding map derived from a separate sample of participants (r = -0.189; P < .001). Analysis revealed that thinning in right prefrontal cortices, from baseline to follow-up, was associated with attentional impulsiveness at follow-up. CONCLUSIONS AND RELEVANCE Results suggest that cannabis use during adolescence is associated with altered neurodevelopment, particularly in cortices rich in cannabinoid 1 receptors and undergoing the greatest age-related thickness change in middle to late adolescence.
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Affiliation(s)
- Matthew D. Albaugh
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | | | - Amanda Sidwell
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Claude Lepage
- McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
| | - Anthony Juliano
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Max M. Owens
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Bader Chaarani
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Philip Spechler
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Nicholas Fontaine
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Pierre Rioux
- McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
| | - Lindsay Lewis
- McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
| | - Seun Jeon
- McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
| | - Alan Evans
- McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
| | - Deepak D’Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arun L. W. Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Erin Burke Quinlan
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Social, Genetic & Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Patricia Conrod
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Social, Genetic & Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Antoine Grigis
- NeuroSpin, Commissariat à l’Energie Atomique, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
- corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | | | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale U A10 “Trajectoires développementales en psychiatrie” Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 “Trajectoires développementales en psychiatrie,” Paris, France
- Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Paris, France
- AP-HP Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | | | - Tomáš Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H. Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
- corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Social, Genetic & Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology, and Neuroscience, Social, Genetic & Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- Centre for Population Neuroscience and Precision Medicine Research Group, Department of Psychiatry and Psychotherapy, Campus Charite Mitte, Humboldt University, Berlin, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Institute for Science and Technology of Brain-inspired Intelligence, Fudan University, Shanghai, PR China
| | - Alexandra Potter
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington
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16
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Meruelo AD, Brumback T, Nagel BJ, Baker FC, Brown SA, Tapert SF. Neuroimaging markers of adolescent depression in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. J Affect Disord 2021; 287:380-386. [PMID: 33836366 PMCID: PMC8117976 DOI: 10.1016/j.jad.2021.03.071] [Citation(s) in RCA: 2] [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] [Received: 02/18/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Adolescents are at increased risk of developing major depressive disorder (MDD) than many other age groups. Although the neural correlates of MDD in adults have been studied prospectively, such adolescent depression studies are mainly cross-sectional. We extracted data regarding the relationship between cortical thickness and later development of adolescent MDD from a national community study that uses an accelerated longitudinal design to examine the psychological, environmental, and neural differences related to drinking and brain development. METHODS 692 subjects (age 12-21 years; 50% female) without a history of MDD were assessed with structural neuroimaging at baseline. We compared those 101 subjects who transitioned to MDD by 1-year follow-up to those who remained non-depressed over the same time period. FreeSurfer's autosegmentation process estimated vertex-wide cortical thicknesses and its Query, Design, Estimate, Contrast (Qdec) application investigated cortical thickness between those who later developed MDD and those who remained without MDD (Monte Carlo corrected for multiple comparisons, vertex-wise cluster threshold of 1.3, p < 0.01). RESULTS Those who transitioned in the next year to MDD had, at baseline, thinner cortices in the superior frontal cortex, precentral and postcentral regions, and superior temporal cortex, above and beyond effects attributable to age and sex. No cortical thickness sex differences or sex-by-depression interactions were observed. LIMITATIONS A larger sample size could improve statistical power and future investigations will be needed to confirm our results. CONCLUSIONS Thinner cortices over frontal and temporal regions may be linked to enhanced vulnerability for future depression during the adolescent-young adulthood transition.
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Affiliation(s)
| | - Ty Brumback
- Northern Kentucky University, United States.
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17
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Rossetti MG, Mackey S, Patalay P, Allen NB, Batalla A, Bellani M, Chye Y, Conrod P, Cousijn J, Garavan H, Goudriaan AE, Hester R, Martin-Santos R, Solowij N, Suo C, Thompson PM, Yücel M, Brambilla P, Lorenzetti V. Sex and dependence related neuroanatomical differences in regular cannabis users: findings from the ENIGMA Addiction Working Group. Transl Psychiatry 2021; 11:272. [PMID: 33958576 PMCID: PMC8102553 DOI: 10.1038/s41398-021-01382-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/25/2021] [Accepted: 04/09/2021] [Indexed: 12/25/2022] Open
Abstract
Males and females show different patterns of cannabis use and related psychosocial outcomes. However, the neuroanatomical substrates underlying such differences are poorly understood. The aim of this study was to map sex differences in the neurobiology (as indexed by brain volumes) of dependent and recreational cannabis use. We compared the volume of a priori regions of interest (i.e., amygdala, hippocampus, nucleus accumbens, insula, orbitofrontal cortex (OFC), anterior cingulate cortex and cerebellum) between 129 regular cannabis users (of whom 70 were recreational users and 59 cannabis dependent) and 114 controls recruited from the ENIGMA Addiction Working Group, accounting for intracranial volume, age, IQ, and alcohol and tobacco use. Dependent cannabis users, particularly females, had (marginally significant) smaller volumes of the lateral OFC and cerebellar white matter than recreational users and controls. In dependent (but not recreational) cannabis users, there was a significant association between female sex and smaller volumes of the cerebellar white matter and OFC. Volume of the OFC was also predicted by monthly standard drinks. No significant effects emerged the other brain regions of interest. Our findings warrant future multimodal studies that examine if sex and cannabis dependence are specific key drivers of neurobiological alterations in cannabis users. This, in turn, could help to identify neural pathways specifically involved in vulnerable cannabis users (e.g., females with cannabis dependence) and inform individually tailored neurobiological targets for treatment.
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Affiliation(s)
- Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, IOE and Population Health Sciences, UCL, London, UK
| | | | - Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montreal, QC, Canada
| | - Janna Cousijn
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, Netherlands
| | - Robert Hester
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Lorenzetti
- Neuroscience of Addiction & Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural & Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
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18
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Bedi A, McGlinchey RE, Salat DH, Currao A, Fonda JR, Milberg WP, Fortier CB. Age of onset of adolescent binge drinking is differentially associated with cortical thickness in post-9/11 adult Veterans. Alcohol Clin Exp Res 2021; 45:1065-1077. [PMID: 33756020 DOI: 10.1111/acer.14606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescence is a critical period for neural development and has been associated with high rates of alcohol abuse. This research examined potential long-term brain and behavioral effects of early versus late-onset adolescent binge drinking in an adult sample of post-9/11 Veterans. METHODS We compared cortical thickness measures in Veterans with a history of binge drinking that began before the age of 15 (n = 50; mean age = 32.1 years) to those with a history of binge drinking with onset after the age of 15 (n = 300; mean age = 32.1 years). Data processing was conducted with FreeSurfer. A targeted neuropsychological battery (Digit Span test, Delis-Kaplan Executive Function System Color-Word Interference Test, California Verbal Learning Test-II) was used to examine the relationships between cortical thickness and attention, memory, and inhibition. A reference group of social drinkers with no history of early binge drinking (n = 31) was used to provide normative data. RESULTS Early-onset adolescent binge drinkers (EBD) had greater cortical thickness in several regions than late-onset adolescent binge drinkers (LBD); both binge-drinking groups had greater cortical thickness than the reference group. There was a stronger negative association between cortical thickness and age in EBDs than LBDs in the (i) lateral orbitofrontal cortex, (ii) supramarginal gyrus, (iii) paracentral lobule, and (iv) anterior caudal cingulate. Poorer performance on the attention and inhibition tasks in the EBDs was also associated with thicker cortices. CONCLUSIONS This study demonstrates greater cortical thickness across frontoparietal regions in adults who began binge drinking in early versus late adolescence. A stronger negative association between cortical thickness and age in the EBDs suggests that early-onset adolescent binge drinking may be associated with accelerated cortical thinning. Thicker cortex in these regions, which are known to mediate inhibitory control, may increase impulsive behavior and contribute to the risk of alcohol addiction.
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Affiliation(s)
- Amrita Bedi
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David H Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA.,Anthinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - Alyssa Currao
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Jennifer R Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Catherine Brawn Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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19
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Mahedy L, Wootton R, Suddell S, Skirrow C, Field M, Heron J, Hickman M, Munafò MR. Testing the association between tobacco and cannabis use and cognitive functioning: Findings from an observational and Mendelian randomization study. Drug Alcohol Depend 2021; 221:108591. [PMID: 33618197 PMCID: PMC8047806 DOI: 10.1016/j.drugalcdep.2021.108591] [Citation(s) in RCA: 3] [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] [Received: 08/19/2020] [Revised: 12/17/2020] [Accepted: 01/17/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although studies have examined the association between tobacco and cannabis use in adolescence with subsequent cognitive functioning, study designs are usually not able to distinguish correlation from causation. METHODS Separate patterns of tobacco and cannabis use were derived using longitudinal latent class analysis based on measures assessed on five occasions from age 13-18 in a large UK population cohort (Avon Longitudinal Study of Parents and Children). Cognitive functioning measures comprised of working memory, response inhibition, and emotion recognition assessed at 24 years of age. Mendelian randomization was used to examine the possible causal relationship between smoking initiation, lifetime cannabis use and cognitive functioning. RESULTS We found evidence of a relationship between tobacco and cannabis use and diminished cognitive functioning for each of the outcomes in the observational analyses. There was evidence to suggest that late-onset regular tobacco smokers (b=-0.29, 95 %CI=-0.45 to -0.13), early-onset regular tobacco smokers (b=-0.45, 95 %CI=-0.84 to -0.05), and early-onset regular cannabis users (b=-0.62, 95 %CI=-0.93 to -0.31) showed poorer working memory. Early-onset regular tobacco smokers (b = 0.18, 95 %CI = 0.07 to 0.28), and early-onset regular cannabis users (b = 0.30, 95 %CI = 0.08 to 0.52) displayed poorer ability to inhibit responses. Late-onset regular (b=-0.02, 95 %CI=-0.03 to - 0.00), and early-onset regular tobacco smokers (b=-0.04, 95 %CI=-0.08 to -0.01) showed poorer ability to recognise emotions. Mendelian randomization analyses were imprecise and did not provide additional support for the observational results. CONCLUSION There was some evidence to suggest that adolescent tobacco and cannabis use were associated with deficits in working memory, response inhibition and emotion recognition. Better powered genetic studies are required to determine whether these associations are causal.
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Affiliation(s)
- Liam Mahedy
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Robyn Wootton
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Steph Suddell
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Caroline Skirrow
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; Cambridge Cognition, Cambridge, UK.
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK.
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
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20
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Delfin C, Andiné P, Wallinius M, Björnsdotter M. Structural Brain Correlates of the Externalizing Spectrum in Young Adults. Neuroscience 2021; 463:1-13. [PMID: 33774123 DOI: 10.1016/j.neuroscience.2021.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/20/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
The externalizing spectrum, including traits and behaviors such as aggression, reduced inhibitiory control and substance abuse, is associated with altered prefrontal brain morphology. However, the degree to which different manifestations of the externalizing spectrum are associated with distinct or overlapping variations in individual brain morphology is unclear. Here, we therefore used structural magnetic resonance imaging, self-report assessment, and a response inhibition task in a sample of 59 young adults to examine how cortical thickness in the anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and dorsolateral prefrontal cortex (DLPFC) relate to four different manifestations of the externalizing spectrum: disinhibition, callous aggression, substance abuse, and behavioral inhibitory control. Using Bayesian linear regression models controlling for age, gender, and years of education, we found that the different manifestations of the externalizing spectrum were associated with both distinct and overlapping morphology variations. Specifically, both callous aggression and inhibitory control was associated with increased cortical thickness of the OFC, a region involved in reward processing, decision-making, and regulation of anxiety and fear. Both disinhibition and substance abuse were associated with DLPFC thickness, although with opposite association patterns, possibly reflecting processes related to inhibitory control, working memory and attention. Moreover, disinhibition, but not callous aggression or substance abuse, was associated with behavioral inhibitory control. Our results provide further support for the link between externalizing behaviors and prefrontal brain morphology, while identifying distinct prefrontal areas associated with different clinically relevant manifestations. These findings may help guide further research aimed at developing novel treatment and intervention strategies for externalizing behaviors and disorders.
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Affiliation(s)
- Carl Delfin
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
| | - Peter Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Märta Wallinius
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden; Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Malin Björnsdotter
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Affective Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
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21
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Abstract
Academic performance significantly influences educational advancement, career opportunities, and life outcomes. The extent to which adolescent substance use and brain morphology predict academic achievement has not been extensively explored. We examined grade point average (GPA) at the time alcohol and cannabis use often starts (7th - 9th grade) and subsequently during 11th and 12th grade in a 170 physically healthy adolescents in a longitudinal study. Covariance analysis examined predictive features from 36 metrics of middle school academic performance and initiation of alcohol and cannabis use. Using a machine learning approach, GPA from 7th, 8th, and 9th grade strongly predicted 11th and 12th grade GPA, followed in predictive power by alcohol use age of onset. A machine learning approach determined 16 (from 336) baseline neuroimaging features that reflected lower thickness, area, or volume in average high school GPA drinkers compared to nondrinkers. Features that distinguished average performing drinkers from nondrinkers suggested accelerated gray matter loss during adolescence for drinkers, while high performing drinkers compared to nondrinkers may have attenuated gray matter maturation. Additional possibilities are discussed.
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22
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Stringfield SJ, Torregrossa MM. Disentangling the lasting effects of adolescent cannabinoid exposure. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110067. [PMID: 32791165 DOI: 10.1016/j.pnpbp.2020.110067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
Cannabis is the most widely used illicit substance among adolescents, and adolescent cannabis use is associated with various neurocognitive deficits that can extend into adulthood. A growing body of evidence supports the hypothesis that adolescence encompasses a vulnerable period of development where exposure to exogenous cannabinoids can alter the normative trajectory of brain maturation. In this review, we present an overview of studies of human and rodent models that examine lasting effects of adolescent exposure. We include evidence from meta-analyses, longitudinal, or cross-sectional studies in humans that consider age of onset as a factor that contributes to the behavioral dysregulation and altered structural or functional development in cannabis users. We also discuss evidence from preclinical rodent models utilizing well-characterized or innovative routes of exposure, investigating the effects of dose and timing to produce behavioral deficits or alterations on a neuronal and behavioral level. Multiple studies from both humans and animals provide contrasting results regarding the magnitude of residual effects. Combined evidence suggests that exposure to psychoactive cannabinoids during adolescence has the potential to produce subtle, but lasting, alterations in neurobiology and behavior.
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Affiliation(s)
- Sierra J Stringfield
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA
| | - Mary M Torregrossa
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA.
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23
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Kwan Cheung KA, Mitchell MD, Heussler HS. Cannabidiol and Neurodevelopmental Disorders in Children. Front Psychiatry 2021; 12:643442. [PMID: 34093265 PMCID: PMC8175856 DOI: 10.3389/fpsyt.2021.643442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/19/2021] [Indexed: 12/17/2022] Open
Abstract
Neurodevelopmental and neuropsychiatric disorders (such as autism spectrum disorder) have broad health implications for children, with no definitive cure for the vast majority of them. However, recently medicinal cannabis has been successfully trialled as a treatment to manage many of the patients' symptoms and improve quality of life. The cannabinoid cannabidiol, in particular, has been reported to be safe and well-tolerated with a plethora of anticonvulsant, anxiolytic and anti-inflammatory properties. Lately, the current consensus is that the endocannabinoid system is a crucial factor in neural development and health; research has found evidence that there are a multitude of signalling pathways involving neurotransmitters and the endocannabinoid system by which cannabinoids could potentially exert their therapeutic effects. A better understanding of the cannabinoids' mechanisms of action should lead to improved treatments for neurodevelopmental disorders.
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Affiliation(s)
- Keith A Kwan Cheung
- Centre for Children's Health Research, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Murray D Mitchell
- Centre for Children's Health Research, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Helen S Heussler
- Centre for Clinical Trials in Rare Neurodevelopmental Disorders, Child Development Program, Children's Health Queensland, Brisbane, QLD, Australia.,Centre for Children's Health Research, University of Queensland, Brisbane, QLD, Australia
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24
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Allick A, Park G, Kim K, Vintimilla M, Rathod K, Lebo R, Nanavati J, Hammond CJ. Age- and Sex-Related Cortical Gray Matter Volume Differences in Adolescent Cannabis Users: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies. Front Psychiatry 2021; 12:745193. [PMID: 34925090 PMCID: PMC8671465 DOI: 10.3389/fpsyt.2021.745193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Adolescent-onset cannabis use is rising in the era of marijuana legalization. Recent imaging studies have identified neuroanatomical differences between adult cannabis users and controls that are more prominent in early-onset users. Other studies point to sex-dependent effects of cannabis. Methods: A systematic review following PRISMA guidelines and subsequent effect-size seed-based d mapping (SDM) meta-analyses were conducted to investigate relationships between age (across the 12-to-21-year-old developmental window), sex, and gray matter volume (GMV) differences between cannabis using (CU) and typically developing (TD) youth. Results: Our search identified 1,326 citations, 24 of which were included in a qualitative analysis. A total of 6 whole-brain voxel-based morphometry (VBM) studies comparing regional GMV between 357 CU [mean (SD) age = 16.68 (1.28); 71% male] and 404 TD [mean (SD) age = 16.77 (1.36); 63% male] youth were included in the SDM-meta-analysis. Meta-analysis of whole-brain VBM studies identified no regions showing significant GMV difference between CU and TD youth. Meta-regressions showed divergent effects of age and sex on cortical GMV differences in CU vs. TD youth. Age effects were seen in the superior temporal gyrus (STG), with older-aged CU youth showing decreased and younger-aged CU youth showing increased STG GMV compared to age-matched TD youth. Parallel findings in the STG were also observed in relation to duration of CU (years) in supplemental meta-regressions. Regarding sex effects, a higher proportion of females in studies was associated with increased GMV in the middle occipital gyrus in CU vs. TD youth. Conclusions: These findings suggest that GMV differences between CU and TD youth, if present, are subtle, and may vary as a function of age, cumulative cannabis exposure, and sex in young people. Whether age- and sex-related GMV differences are attributable to common predispositional factors, cannabis-induced neuroadaptive changes, or both warrant further investigation.
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Affiliation(s)
- Aliyah Allick
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Grace Park
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kwon Kim
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michelle Vintimilla
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Krutika Rathod
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rachael Lebo
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,I.D. Weeks Library, Health Sciences Department, University of South Dakota, Vermillion, SD, United States
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christopher J Hammond
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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25
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Wittemann M, Brielmaier J, Rubly M, Kennel J, Werler F, Schmitgen MM, Kubera KM, Hirjak D, Wolf ND, Reith W, Wolf RC. Cognition and Cortical Thickness in Heavy Cannabis Users. Eur Addict Res 2021; 27:115-122. [PMID: 33080597 DOI: 10.1159/000509987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acute and long-term adverse effects of heavy cannabis use (HCU) on neurocognitive function have been suggested, as much as regional changes of brain volume. However, little is known about the relationship between impaired cognition and brain structure in individuals with HCU. OBJECTIVE Here, we investigated associations between cognition and cortical thickness (CT) in males with HCU and male controls. METHODS Twenty-six individuals with HCU and 20 controls were examined using a comprehensive neuropsychological test battery and high-resolution structural MRI at 3T. CT was calculated using the Computational Anatomy Toolbox (CAT12). RESULTS Individuals with HCU differed from controls with respect to verbal learning performance and verbal working memory only. Individuals with HCU showed reduced CT in medial temporal, orbitofrontal, and cingulate regions, as well as in areas of the middle temporal and fusiform cortex (peak voxel family-wise error-corrected p < 0.001, followed by empirically determined correction for spatial extent) compared to HC. Verbal learning performance was associated with right entorhinal and left orbitofrontal CT reductions. Entorhinal CT was also significantly associated with amount and frequency of current weekly cannabis use. CONCLUSIONS The data support the notion of domain-specific cognitive impairment in individuals with HCU and provide a neuromechanistic understanding of such deficits, particularly with respect to abnormal CT in brain areas associated with long-term memory processing.
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Affiliation(s)
- Miriam Wittemann
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jule Brielmaier
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany.,Department of Obstetrics and Gynecology, RKH Clinic Ludwigsburg, Ludwigsburg, Germany
| | - Mathias Rubly
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jennifer Kennel
- Department of Psychiatry and Psychotherapy, SHG-Kliniken Saarbrücken, Saarbrücken, Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadine D Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University, Saarbrücken, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,
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26
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Turco CV, Arsalan SO, Nelson AJ. The Influence of Recreational Substance Use in TMS Research. Brain Sci 2020; 10:E751. [PMID: 33080965 PMCID: PMC7603156 DOI: 10.3390/brainsci10100751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/30/2022] Open
Abstract
(1) Background: Transcranial magnetic stimulation (TMS) approaches are widely used to study cortical and corticospinal function. However, responses to TMS are subject to significant intra-and inter-individual variability. Acute and chronic exposure to recreational substances alters the excitability of the sensorimotor system and may contribute to the variability in TMS outcome measures. The increasing prevalence of recreational substance use poses a significant challenge for executing TMS studies, but there is a lack of clarity regarding the influence of these substances on sensorimotor function. (2) Methods: The literature investigating the influence of alcohol, nicotine, caffeine and cannabis on TMS outcome measures of corticospinal, intracortical and interhemispheric excitability was reviewed. (3) Results: Both acute and chronic use of recreational substances modulates TMS measures of excitability. Despite the abundance of research in this field, we identify knowledge gaps that should be addressed in future studies to better understand the influence of these substances on TMS outcomes. (4) Conclusions: This review highlights the need for TMS studies to take into consideration the history of participant substance use and to control for acute substance use prior to testing.
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Affiliation(s)
| | | | - Aimee J. Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (C.V.T.); (S.O.A.)
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27
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Subramaniam P, Yurgelun-Todd D. Neural and behavioral correlates associated with adolescent marijuana use. CURRENT ADDICTION REPORTS 2020; 7:475-485. [PMID: 33777643 DOI: 10.1007/s40429-020-00335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose of Review Marijuana (MJ) is one of the most commonly used drugs among adolescents. Exposure to MJ during adolescence can lead to alterations in brain development, and, subsequently to the behavioral correlates regulated by the affected brain regions. In this review, we discuss findings from preclinical and human studies examining the relationship between adolescent MJ use and the neurobiological and behavioral correlates associated with it. Recent Findings Current findings indicate that adolescent MJ use is associated with alterations in brain structure and function, especially in regions that express high levels of the cannabinoid 1 receptor such as the prefrontal cortex, hippocampus, cerebellum and limbic regions. These alterations are correlated with changes in affective, cognitive and reward-seeking behavior. Furthermore, evidence suggests that exposure to MJ during adolescence can have long-lasting and pronounced neural and behavioral effects into adulthood. Summary The wide ranging neural and behavioral correlates associated with MJ use during adolescence highlight the need for further studies to better understand the potential risk factors and/or neurotoxic effects of adolescent MJ use.
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Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT.,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City VA Health Care System, Salt Lake City, UT, USA
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28
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Marijuana use and major depressive disorder are additively associated with reduced verbal learning and altered cortical thickness. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 19:1047-1058. [PMID: 30809764 DOI: 10.3758/s13415-019-00704-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Marijuana (MJ) use and major depressive disorder (MDD) have both been associated with deficits in verbal learning and memory as well as structural brain abnormalities. It is not known if MJ use by those with MDD confers additional impairment. The goal of this study was to examine unique and combined effects of MDD and MJ use on verbal memory and brain structure. Young adults (n=141) aged 18-25 years with MJ use and no lifetime MDD (MJ, n=46), MDD and no MJ use (MDD, n=23), MJ use and lifetime MDD (MDD+MJ, n=24), and healthy controls without MDD or MJ use (CON, n=48) were enrolled. Participants completed the California Verbal Learning Test, Second Edition (CVLT-II), a measure of verbal learning and memory. A sub-sample of 82 participants also underwent a structural magnetic resonance imaging (MRI) scan. Group differences in CVLT-II performance, cortical thickness, and hippocampal volume were assessed. We found an additive effect of MDD and MJ on memory recall. Only MDD, but not MJ, was associated with poorer initial learning, fewer words recalled, more intrusion errors, and lower percent retention. There was also an additive effect of MDD and MJ use on reduced cortical thickness in the middle temporal gyrus. Findings indicate that MJ use and MDD have additive adverse associations with verbal recall and cortical thickness in the middle temporal gyrus, suggesting that MJ use among those with MDD may be contraindicated. Prospective studies are warranted to determine whether this association may be causal.
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29
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Hamidullah S, Thorpe HHA, Frie JA, Mccurdy RD, Khokhar JY. Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates. Front Hum Neurosci 2020; 14:298. [PMID: 32848673 PMCID: PMC7418456 DOI: 10.3389/fnhum.2020.00298] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/03/2020] [Indexed: 12/11/2022] Open
Abstract
Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.
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Affiliation(s)
| | - Hayley H A Thorpe
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Richard D Mccurdy
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
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30
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Chye Y, Kirkham R, Lorenzetti V, McTavish E, Solowij N, Yücel M. Cannabis, Cannabinoids, and Brain Morphology: A Review of the Evidence. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:627-635. [PMID: 32948510 DOI: 10.1016/j.bpsc.2020.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Abstract
Cannabis and cannabinoid-based products are increasingly being accepted and commodified globally. Yet there is currently limited understanding of the effect of the varied cannabinoid compounds on the brain. Exogenous cannabinoids interact with the endogenous cannabinoid system that underpins vital functions in the brain and body, and they are thought to perturb key brain and cognitive function. However, much neuroimaging research has been confined to observational studies of cannabis users, without examining the specific role of the various cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, etc.). This review summarizes the brain structural imaging evidence to date associated with cannabis use, its major cannabinoids (e.g., Δ9-tetrahydrocannabinol, cannabidiol), and synthetic cannabinoid products that have emerged as recreational drugs. In doing so, we seek to highlight some of the key issues to consider in understanding cannabinoid-related brain effects, emphasizing the dual neurotoxic and neuroprotective role of cannabinoids, and the need to consider the distinct role of the varied cannabinoids in establishing their effect on the brain.
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Affiliation(s)
- Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Kirkham
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia; School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, New South Wales, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia.
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31
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Adolescent cannabis use, cognition, brain health and educational outcomes: A review of the evidence. Eur Neuropsychopharmacol 2020; 36:169-180. [PMID: 32268974 DOI: 10.1016/j.euroneuro.2020.03.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/10/2020] [Accepted: 03/13/2020] [Indexed: 01/13/2023]
Abstract
We review the findings of systematic reviews and meta-analyses of case-control studies that examine brain functioning and cognitive correlates of adolescent cannabis use using structural and functional neuroimaging tools and standardised neuropsychological tests. We also examine prospective epidemiological studies on the possible effects of adolescent and young adult cannabis use on cognitive performance in adult life and the completion of secondary education. We summarize the findings of studies in each of these areas that have been published since the most recent systematic review. Systematic reviews find that adolescent cannabis use is inconsistently associated with alterations in the structure of prefrontal and temporal brain regions. Meta-analyses reveal functional alterations in the parietal cortex and putamen. Differences in the orbitofrontal cortex predate cannabis use; it is unclear if they are affected by continued cannabis use and prolonged abstinence. Longitudinal and twin studies report larger declines in IQ among cannabis users than their non-using peers but it is unclear whether these findings can be attributed to cannabis use or to genetic, mental health and environmental factors. Several longitudinal studies and a meta-analysis of cross-sectional studies suggest that there is some cognitive recovery after abstinence from cannabis. Longitudinal studies and some twin studies have found that cannabis users are less likely to complete secondary school than their non-using controls. This association might reflect an effect of cannabis use and/or the social environment of cannabis users and their cannabis using peers. Cognitive performance is altered in some domains (e.g. IQ, verbal learning) in young people while they are regularly using cannabis. There are two important messages to adolescents and young adults: First, cannabis has potentially detrimental effects on cognition, brain and educational outcomes that persist beyond acute intoxication. Second, impaired cognitive function in cannabis users appears to improve with sustained abstinence.
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32
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Cannabis Use as a Risk Factor for Depression, Anxiety, and Suicidality: Epidemiological Associations and Implications for Nurses. J Addict Nurs 2020; 31:92-101. [PMID: 32487935 DOI: 10.1097/jan.0000000000000334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Psychiatric disorders and substance use disorders commonly co-occur and are major public health concerns given the morbidity and mortality associated with them. Globally, cannabis is among the most commonly used drugs, and cannabis use frequently begins in adolescence or emerging adulthood, both important periods of development and periods in which psychiatric symptoms and disorders frequently emerge. Thus, the relationships between cannabis use and mental illnesses are essential for nurses and other healthcare professionals and researchers to explore and understand. This literature review examines the relationships between cannabis use and depression, anxiety, and suicide. It includes a primer on the neurobiology of cannabis effects; an overview on the epidemiological evidence on the associations between cannabis use and depression, anxiety, and suicide; and a discussion of implications for nurses, particularly important given changes in the medical and recreational cannabis legislation in North America. Overall, this review found consistent evidence showing a cross-sectional association between recreational cannabis use and depression, anxiety, and suicide, despite some limitations and conflicts in the literature. In addition, most evidence from longitudinal or case control studies suggested cannabis use preceded the development of depressive symptoms and suicidal behaviors, although the quality of this evidence was mixed. Implications for future research and nursing practice are discussed.
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33
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Cabeen RP, Allman JM, Toga AW. THC Exposure is Reflected in the Microstructure of the Cerebral Cortex and Amygdala of Young Adults. Cereb Cortex 2020; 30:4949-4963. [PMID: 32377689 DOI: 10.1093/cercor/bhaa087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The endocannabinoid system serves a critical role in homeostatic regulation through its influence on processes underlying appetite, pain, reward, and stress, and cannabis has long been used for the related modulatory effects it provides through tetrahydrocannabinol (THC). We investigated how THC exposure relates to tissue microstructure of the cerebral cortex and subcortical nuclei using computational modeling of diffusion magnetic resonance imaging data in a large cohort of young adults from the Human Connectome Project. We report strong associations between biospecimen-defined THC exposure and microstructure parameters in discrete gray matter brain areas, including frontoinsular cortex, ventromedial prefrontal cortex, and the lateral amygdala subfields, with independent effects in behavioral measures of memory performance, negative intrusive thinking, and paternal substance abuse. These results shed new light on the relationship between THC exposure and microstructure variation in brain areas related to salience processing, emotion regulation, and decision making. The absence of effects in some other cannabinoid-receptor-rich brain areas prompts the consideration of cellular and molecular mechanisms that we discuss. Further studies are needed to characterize the nature of these effects across the lifespan and to investigate the mechanistic neurobiological factors connecting THC exposure and microstructural parameters.
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Affiliation(s)
- Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
| | - John M Allman
- Division of Biology, California Institute of Technology, Pasadena, CA 91125, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
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Thayer RE, Hansen NS, Prashad S, Karoly HC, Filbey FM, Bryan AD, Feldstein Ewing SW. Recent tobacco use has widespread associations with adolescent white matter microstructure. Addict Behav 2020; 101:106152. [PMID: 31639638 DOI: 10.1016/j.addbeh.2019.106152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 09/01/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
IMPORTANCE Given the prevalence of alcohol, cannabis, and tobacco use during adolescence, it is important to explore the relative relationship of these three substances with brain structure. OBJECTIVE To determine associations between recent alcohol, cannabis, and tobacco use and white and gray matter in a large sample of adolescents. DESIGN, SETTING, AND PARTICIPANTS MRI data were collected in N = 200 adolescents ages 14-18 (M = 15.82 years; 67% male; 61% Hispanic/Latino). On average, during the past month, participants reported consuming 2.05 drinks per 1.01 drinking day, 0.64 g per 6.98 cannabis use days, and 2.49 cigarettes per 12.32 smoking days. MAIN OUTCOMES AND MEASURES General linear models were utilized to examine past 30-day average quantities of alcohol, cannabis, and tobacco use, age, sex, and sex by substance interactions in skeletonized white matter (fractional anisotropy and axial, radial, and mean diffusivity) and voxel-based morphometry of gray matter (volume/density). RESULTS Tobacco use was negatively associated with white matter integrity (radial and mean diffusivity) with peak effects in inferior and superior longitudinal fasciculi. Cannabis use was negatively associated with white matter integrity (axial diffusivity) in a small cluster in the left superior longitudinal fasciculus. No associations were observed between recent alcohol use and white or gray matter overall, but interactions showed significant negative associations between alcohol use and white matter in females. CONCLUSIONS AND RELEVANCE It is important to note that recent tobacco use, particularly given the popularity of e-tobacco/vaping in this age group, had widespread associations with brain structure in this sample of adolescents.
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Meruelo AD, Jacobus J, Idy E, Nguyen-Louie T, Brown G, Tapert SF. Early adolescent brain markers of late adolescent academic functioning. Brain Imaging Behav 2020; 13:945-952. [PMID: 29911279 DOI: 10.1007/s11682-018-9912-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Academic performance in adolescence strongly influences adult prospects. Intelligence quotient (IQ) has historically been considered a strong predictor of academic performance. Less objectively explored have been morphometric features. We analyzed brain MRI morphometry metrics in early adolescence (age 12-14 years) as quantitative predictors of academic performance over high school using a naïve Bayesian classifier approach with n = 170 subjects. Based on the mean GPA, subjects were divided into high (GPA ≥3.54; n = 87) and low (GPA <3.54; n = 83) academic performers. Covariance analysis was performed to look at the influence of subject demographics. We examined predictive features from the 343 available regions (surface areas, cortical thickness, and subcortical volumes) and applied 4 algorithms for selection and reduction of attributes using Weka. Cortical thickness measures performed better than surface areas or subcortical volumes as predictors of academic performance. We identified 15 cortical thickness regions most predictive of academic performance, three of which have not been described in the literature predictive of academic performance. These were in the left hemisphere fusiform, bilateral insula, and left hemisphere paracentral regions. Prediction had a sensitivity of 0.65 and specificity of 0.73 with independent validation. Follow-up independent t-test analyses between high and low academic achievers on 10 of 15 regions showed between-group significance at the p < 0.05 level. High achievers demonstrated thicker cortices than low achievers. These newly identified regions may help pinpoint new targets for further study in understanding the developing adolescent brain in the classroom setting.
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Affiliation(s)
- Alejandro Daniel Meruelo
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive #0603V, La Jolla, CA, 92093, USA.
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive #0603V, La Jolla, CA, 92093, USA
| | - Erick Idy
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive #0603V, La Jolla, CA, 92093, USA
| | - Tam Nguyen-Louie
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Gregory Brown
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive #0603V, La Jolla, CA, 92093, USA.,VA San Diego Healthcare System, La Jolla, CA, USA
| | - Susan Frances Tapert
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive #0603V, La Jolla, CA, 92093, USA
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Karoly HC, Ross JM, Ellingson JM, Feldstein Ewing SW. Exploring Cannabis and Alcohol Co-Use in Adolescents: A Narrative Review of the Evidence. J Dual Diagn 2020; 16:58-74. [PMID: 31519143 PMCID: PMC7007306 DOI: 10.1080/15504263.2019.1660020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Amidst the evolving policy surrounding cannabis legalization in the United States, cannabis use is becoming increasingly prevalent as perceptions of harm decrease, particularly among adolescents. Cannabis and alcohol are commonly used by adolescents and are often used together. However, developmental research has historically taken a "single substance" approach to examine the association of substance use and adolescent brain and behavior rather than examining co-(or poly-substance) use of multiple substances, such as cannabis and alcohol. Thus, the acute effects of cannabis and alcohol, and the impact of co-use of cannabis and alcohol on the adolescent brain, cognitive function and subsequent psychosocial outcomes remains understudied. This narrative review aims to examine the effects of cannabis and alcohol on adolescents across a number of behavioral and neurobiological outcomes. Methods: The PubMed and Google Scholar databases were searched for the last 10 years to identify articles reporting on acute effects of cannabis and alcohol administration, and the effects of cannabis and alcohol on neuropsychological, neurodevelopmental, neural (e.g., structural and functional neuroimaging), and psychosocial outcomes in adolescents. When adolescent data were not available, adult studies were included as support for potential areas of future direction in adolescent work. Results: Current studies of the impact of cannabis and alcohol on adolescent brain and behavior have yielded a complicated pattern. Some suggest that the use of cannabis in addition to alcohol during adolescence may have a "protective" effect, yielding neuropsychological and structural brain outcomes that are better than those for adolescents who use only alcohol. However, other adolescent studies suggest that cannabis and alcohol co-use is associated with negative health and social outcomes such as poorer academic performance and impaired driving. Conclusion: Variation in study methodologies, policy-level limitations and our limited understanding of the developmental neurobiological effects of cannabis preclude the straightforward interpretation of the existing data on adolescent cannabis and alcohol use. Further research on this topic is requisite to inform the development of effective intervention and prevention programs for adolescent substance users, which hinge on a more comprehensive understanding of how cannabis-and its intersection with alcohol-impacts the developing brain and behavior.
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Affiliation(s)
- Hollis C Karoly
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - J Megan Ross
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Jarrod M Ellingson
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sarah W Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
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Abstract
Objective: Shifting policies and widespread acceptance of cannabis for medical and/or recreational purposes have fueled worries of increased cannabis initiation and use in adolescents. In particular, the adolescent period is thought to be associated with an increased susceptibility to the potential harms of repeated cannabis use, due to being a critical period for neuromaturational events in the brain. This review investigates the neuroimaging evidence of brain harms attributable to adolescent cannabis use. Methods: PubMed and Scopus searches were conducted for empirical articles that examined neuroimaging effects in both adolescent cannabis users and adult user studies that explored the effect of age at cannabis use onset on the brain. Results: We found 43 studies that examined brain effect (structural and functional magnetic resonance imaging) in adolescent cannabis users and 20 that examined the link between onset age of cannabis use and brain effects in adult users. Studies on adolescent cannabis users relative to nonusers mainly implicate frontal and parietal regions and associated brain activation in relation to inhibitory control, reward, and memory. However, studies in adults are more mixed, many of which did not observe an effect of onset age of cannabis use on brain imaging metrics. Conclusions: While there is some evidence of compromised frontoparietal structure and function in adolescent cannabis use, it remains unclear whether the observed effects are specifically attributable to adolescent onset of use or general cannabis use-related factors such as depressive symptoms. The relative contribution of adolescent onset of cannabis use and use chronicity will have to be more comprehensively examined in prospective, longitudinal studies with more rigorous measures of cannabis use (dosage, exposure, dependence, constituent compounds such as the relative cannabinoid levels).
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Affiliation(s)
- Yann Chye
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Erynn Christensen
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Murat Yücel
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
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Manza P, Yuan K, Shokri-Kojori E, Tomasi D, Volkow ND. Brain structural changes in cannabis dependence: association with MAGL. Mol Psychiatry 2020; 25:3256-3266. [PMID: 31695165 PMCID: PMC7200265 DOI: 10.1038/s41380-019-0577-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/20/2019] [Accepted: 10/23/2019] [Indexed: 12/16/2022]
Abstract
Cannabis use is rising, yet there is poor understanding of biological processes that might link chronic cannabis use to brain structural abnormalities. To lend insight into this topic, we examined white matter microstructural integrity and gray matter cortical thickness/density differences between 89 individuals with cannabis dependence (CD) and 89 matched controls (64 males, 25 females in each group) from the Human Connectome Project. We tested whether cortical patterns for expression of genes relevant for cannabinoid signaling (from Allen Human Brain Atlas postmortem tissue) were associated with spatial patterns of cortical thickness/density differences in CD. CD had lower fractional anisotropy than controls in white matter bundles innervating posterior cingulate and parietal cortex, basal ganglia, and temporal cortex. The CD group also had significantly less gray matter thickness and density in precuneus, relative to controls. Sibling-pair analysis found support for causal and graded liability effects of cannabis on precuneus structure. Spatial patterns of gray matter differences in CD were significantly associated with regional differences in monoacylglycerol lipase (MAGL) expression in postmortem brain tissue, such that regions with higher MAGL expression (but not fatty-acid amide hydrolase or FAAH) were more vulnerable to cortical thinning. In sum, chronic cannabis use is associated with structural differences in white and gray matter, which was most prominent in precuneus and associated white matter tracts. Regions with high MAGL expression, and therefore with potentially physiologically restricted endogenous cannabinoid signaling, may be more vulnerable to the effects of chronic cannabis use on cortical thickness.
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Affiliation(s)
- Peter Manza
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD, USA.
| | - Kai Yuan
- grid.94365.3d0000 0001 2297 5165National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD USA ,grid.440736.20000 0001 0707 115XSchool of Life Science and Technology, Xidian University, 710071 Xi’an, Shaanxi PR China
| | - Ehsan Shokri-Kojori
- grid.94365.3d0000 0001 2297 5165National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD USA
| | - Dardo Tomasi
- grid.94365.3d0000 0001 2297 5165National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD USA
| | - Nora D. Volkow
- grid.94365.3d0000 0001 2297 5165National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD USA ,grid.94365.3d0000 0001 2297 5165National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD USA
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Sariah A, Pu W, Xue Z, Liu Z, Huang X. Reduced Cortical Thickness in the Right Caudal Middle Frontal Is Associated With Symptom Severity in Betel Quid-Dependent Chewers. Front Psychiatry 2020; 11:654. [PMID: 32754064 PMCID: PMC7366340 DOI: 10.3389/fpsyt.2020.00654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/24/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Findings from brain structural imaging studies on betel quid dependence have supported relations between betel quid chewing and alterations in gray matter volume and white matter integrity. However, the effect of betel quid chewing on cortical thickness and the link between cortical thickness and symptom severity remains unascertained. METHODS In this observational study, we compared cortical thickness measures from 24 male betel quid-dependent chewers with 27 male healthy controls. Using FreeSufer, we obtained three-dimensional T1-weighted images that were used to compute the thickness of the cerebral cortex throughout the cortical layer. RESULTS Compared to healthy controls, betel quid dependent chewers displayed significant decreased cortical thickness in the precuneus, entorhinal, right paracentral, middle temporal, and caudal middle frontal gyri. Betel quid dependence scale scores negatively correlated (r = -0.604; p = 0.002) with reduced cortical thickness in the right caudal middle frontal of betel quid-dependent chewers. CONCLUSION The findings provide evidence for cortical thickness abnormality in betel dependent chewers and further propose that the severity of betel quid symptoms may be a critical aspect associated with the cortical alterations. The observed alterations may serve as potential mechanisms to explain why BQ chewing behavior is persistent among individuals with betel quid dependence.
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Affiliation(s)
- Adellah Sariah
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Weidan Pu
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhimin Xue
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaojun Huang
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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Kwan Cheung KA, Peiris H, Wallace G, Holland OJ, Mitchell MD. The Interplay between the Endocannabinoid System, Epilepsy and Cannabinoids. Int J Mol Sci 2019; 20:E6079. [PMID: 31810321 PMCID: PMC6929011 DOI: 10.3390/ijms20236079] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/29/2019] [Accepted: 11/29/2019] [Indexed: 12/25/2022] Open
Abstract
Epilepsy is a neurological disorder that affects approximately 50 million people worldwide. There is currently no definitive epilepsy cure. However, in recent years, medicinal cannabis has been successfully trialed as an effective treatment for managing epileptic symptoms, but whose mechanisms of action are largely unknown. Lately, there has been a focus on neuroinflammation as an important factor in the pathology of many epileptic disorders. In this literature review, we consider the links that have been identified between epilepsy, neuroinflammation, the endocannabinoid system (ECS), and how cannabinoids may be potent alternatives to more conventional pharmacological therapies. We review the research that demonstrates how the ECS can contribute to neuroinflammation, and could therefore be modulated by cannabinoids to potentially reduce the incidence and severity of seizures. In particular, the cannabinoid cannabidiol has been reported to have anti-convulsant and anti-inflammatory properties, and it shows promise for epilepsy treatment. There are a multitude of signaling pathways that involve endocannabinoids, eicosanoids, and associated receptors by which cannabinoids could potentially exert their therapeutic effects. Further research is needed to better characterize these pathways, and consequently improve the application and regulation of medicinal cannabis.
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Affiliation(s)
- Keith A. Kwan Cheung
- Institute of Health and Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research (CCHR), 62 Graham Street, South Brisbane, Queensland 4101, Australia; (K.A.K.C.); (H.P.); (O.J.H.)
| | - Hassendrini Peiris
- Institute of Health and Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research (CCHR), 62 Graham Street, South Brisbane, Queensland 4101, Australia; (K.A.K.C.); (H.P.); (O.J.H.)
| | - Geoffrey Wallace
- Children’s Health Queensland (CHQ) and University of Queensland (UQ), Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Queensland 4101, Australia;
| | - Olivia J. Holland
- Institute of Health and Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research (CCHR), 62 Graham Street, South Brisbane, Queensland 4101, Australia; (K.A.K.C.); (H.P.); (O.J.H.)
- School of Medical Science, Griffith University, 1 Parklands Dr, Southport, Queensland 4215, Australia
| | - Murray D. Mitchell
- Institute of Health and Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research (CCHR), 62 Graham Street, South Brisbane, Queensland 4101, Australia; (K.A.K.C.); (H.P.); (O.J.H.)
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41
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Chye Y, Suo C, Lorenzetti V, Batalla A, Cousijn J, Goudriaan AE, Martin-Santos R, Whittle S, Solowij N, Yücel M. Cortical surface morphology in long-term cannabis users: A multi-site MRI study. Eur Neuropsychopharmacol 2019; 29:257-265. [PMID: 30558823 DOI: 10.1016/j.euroneuro.2018.11.1110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/09/2018] [Indexed: 11/29/2022]
Abstract
Cannabis exerts its psychoactive effect through cannabinoid receptors that are widely distributed across the cortical surface of the human brain. It is suggested that cannabis use may contribute to structural alterations across the cortical surface. In a large, multisite dataset of 120 controls and 141 cannabis users, we examined whether differences in key characteristics of the cortical surface - including cortical thickness, surface area, and gyrification index were related to cannabis use characteristics, including (i) cannabis use vs. non-use, (ii) cannabis dependence vs. non-dependence vs. non-use, and (iii) early adolescent vs. late adolescent onset of cannabis use vs. non-use. Our results revealed that cortical morphology was not associated with cannabis use, dependence, or onset age. The lack of effect of regular cannabis use, including problematic use, on cortical structure in our study is contrary to previous evidence of cortical morphological alterations (particularly in relation to cannabis dependence and cannabis onset age) in cannabis users. Careful reevaluation of the evidence on cannabis-related harm will be necessary to address concerns surrounding the long-term effects of cannabis use and inform policies in a changing cannabis regulation climate.
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Affiliation(s)
- Yann Chye
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Chao Suo
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychology, Faculty of Health Sciences, Australian Catholic University
| | - Albert Batalla
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Janna Cousijn
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia; The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, Australia
| | - Murat Yücel
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
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Wade NE, Bagot KS, Cota CI, Fotros A, Squeglia LM, Meredith LR, Jacobus J. Orbitofrontal cortex volume prospectively predicts cannabis and other substance use onset in adolescents. J Psychopharmacol 2019; 33:1124-1131. [PMID: 31215833 PMCID: PMC6864237 DOI: 10.1177/0269881119855971] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Identifying neural characteristics that predict cannabis initiation is important for prevention efforts. The orbitofrontal cortex is critical for reward response and may be vulnerable to substance-induced alterations. AIMS We measured orbitofrontal cortex thickness, surface area, and volume prior to the onset of use to predict cannabis involvement during an average nine-year follow-up. METHODS Adolescents (n=118) aged 12-15 years completed baseline behavioral assessment and magnetic resonance imaging scans, then were followed up to 13 years with annual substance use interviews. Logistic regression examined baseline (pre-substance use) bilateral medial and lateral orbitofrontal cortex characteristics (volume, surface area, or cortex thickness) as predictors of regular cannabis use by follow-up. Post-hoc multinomial logistic regression assessed whether orbitofrontal cortex characteristics significantly predicted either alcohol use alone or cannabis+alcohol co-use. Brain-behavior relationships were assessed through follow-up correlations of baseline relationships between orbitofrontal cortex and executive functioning, reward responsiveness, and behavioral approach traits. RESULTS Larger left lateral orbitofrontal cortex volume predicted classification as cannabis user by follow-up (p=0.025, odds ratio=1.808). Lateral orbitofrontal cortex volume also predicted cannabis+alcohol co-user status (p=0.008, odds ratio=2.588), but not alcohol only status. Larger lateral orbitofrontal cortex volume positively correlated with greater baseline reward responsiveness (p=0.030, r=0.348). There were no significant results by surface area or cortex thickness (ps>0.05). CONCLUSIONS Larger left lateral orbitofrontal cortex measured from ages 12-15 years and prior to initiation of substance use was related to greater reward responsiveness at baseline and predicted classification as a cannabis user and cannabis+alcohol co-user by final follow-up. Larger lateral orbitofrontal cortex volume may represent aberrant orbitofrontal cortex maturation and increasing vulnerability for later substance use.
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Affiliation(s)
- Natasha E. Wade
- Department of Psychiatry, University of California, San Diego
| | - Kara S. Bagot
- Department of Psychiatry, University of California, San Diego
| | - Claudia I. Cota
- Department of Psychiatry, University of California, San Diego
| | - Aryandokht Fotros
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Lindsay M. Squeglia
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Charleston, SC, USA
| | - Lindsay R. Meredith
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Charleston, SC, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego,Correspondence and reprint requests to: Joanna Jacobus, Ph.D., Assistant Professor, Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA 92093, Office: 858.534.3479,
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43
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Jacobus J, Courtney KE, Hodgdon EA, Baca R. Cannabis and the developing brain: What does the evidence say? Birth Defects Res 2019; 111:1302-1307. [PMID: 31385460 DOI: 10.1002/bdr2.1572] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
Cannabis use during adolescence has been linked to deleterious effects on brain integrity. This article summarizes findings from two prospective investigations (3 and 6 years, on average) on adolescent cannabis use from our laboratory that utilize structural neuroimaging and neurocognitive assessment approaches. Across most studies, findings suggest recency, frequency, and age of onset of cannabis use are likely key variables in predicting poorer neural health outcomes. There is some evidence that preexisting differences in brain architecture may also contribute to vulnerability and outcome differences. Ongoing large-scale prospective studies of youth will be able to disentangle how both cannabis use as well as pre and postexposure differences play a role in divergent outcomes among youth who use cannabis.
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Affiliation(s)
- Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, California
| | - Kelly E Courtney
- Department of Psychiatry, University of California, San Diego, California
| | | | - Rachel Baca
- Department of Psychiatry, University of California, San Diego, California
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44
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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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Claus ED, Feldstein Ewing SW, Magnan RE, Montanaro E, Hutchison KE, Bryan AD. Neural mechanisms of risky decision making in adolescents reporting frequent alcohol and/or marijuana use. Brain Imaging Behav 2019; 12:564-576. [PMID: 28429160 DOI: 10.1007/s11682-017-9723-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Because adolescence is a period of heightened exploration of new behaviors, there is a natural increase in risk taking including initial use of alcohol and marijuana. In order to better understand potential differences in neurocognitive functioning among adolescents who use drugs, the current study aimed to identify the neural substrates of risky decision making that differ among adolescents who are primary users of alcohol or marijuana, primary users of both alcohol and marijuana, and controls who report primary use of neither drug. Participants completed the Balloon Analogue Risk Task (BART) while undergoing functional magnetic resonance imaging. Comparison of brain activation during risky decisions versus non-risky decisions across all subjects revealed greater response to risky decisions in dorsal anterior cinguate cortex (dACC), anterior insula, ventral striatum, and lateral prefrontal cortex. Group comparisons across non-using controls, primary marijuana, primary alcohol, and alcohol and marijuana users revealed several notable differences in the recruitment of brain regions. Adolescents who use both alcohol and marijauna show decreased response during risky decision making compared to controls in insula, striatum, and thalamus, and reduced differentiation of increasing risk in dACC, insula, striatum, and superior parietal lobe compared to controls. These results provide evidence of differential engagement of risky decision making circuits among adolescents with varying levels of alcohol and marijuana use, and may provide useful targets for longitudinal studies that explicitly address causality of these differences.
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Affiliation(s)
- Eric D Claus
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.
| | - Sarah W Feldstein Ewing
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code: DC7P, Portland, OR, 97239, USA
| | - Renee E Magnan
- Psychology Department, Washington State University Vancouver, 14204 NE Salmon Creek Ave, VCLS 208, Vancouver, WA, 98686-9600, USA
| | - Erika Montanaro
- Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT, 06510-2483, USA
| | - Kent E Hutchison
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.,Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA
| | - Angela D Bryan
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA.,Department of Psychology and Neuroscience, University of Colorado Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA
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Cannabis use during pregnancy: Are we at the verge of defining a "fetal cannabis spectrum disorder"? Med Hypotheses 2019; 124:53-55. [PMID: 30798916 DOI: 10.1016/j.mehy.2019.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/19/2018] [Accepted: 02/02/2019] [Indexed: 01/19/2023]
Abstract
Cannabis is probably the drug most commonly used globally since ancient times. Following the trend of legalization of access to cannabis in several Western countries, its use has increased in North America over the past few years. In spite of warnings of the potential hazards associated with in-utero exposure to cannabis, approximately 10% of pregnant women in an American study reported using cannabis in recent years, and most of them on a daily basis. Significant effects of prenatal cannabis exposure have been found on children's sleep, cognitive functions (memory and scholastic skills), as well as on executive (frontal lobe) functions (reasoning, attention, impulsivity, and motivation), and affective (depression) and anxiety symptoms throughout the stages of development. Following the presentation of two case vignettes, we integrate the published information on outcomes of maternal use of cannabis during pregnancy on the developing fetus and the "soft" neurological deficits and neuro-behavioral disturbances manifested by them from early childhood and evolving to peaks in adolescence. Taken together, these data serve to define what we call a heretofore unspecified "fetal cannabis spectrum disorder".
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Abstract
BACKGROUND Although alterations in medial temporal lobe structures have been previously associated with use of cannabis, one of the most widely used illicit drugs, whether such alterations are a cause or effect of cannabis use has been unclear. METHODS In this cross-sectional observational study involving 404 twins/siblings, we have compared cortical thickness and surface area between groups of gender-matched sibling-pairs (concordant cannabis unexposed, concordant exposed and discordant for cannabis exposure) using permutation tests after controlling for potential confounds. Bi-variate polygenic model was used to assess the genetic and environmental contributions underlying cortical morphological phenotypes and frequency of cannabis use. RESULTS Cortical thickness of the right entorhinal cortex was significantly lower in the concordant exposed siblings compared to both discordant unexposed and discordant exposed groups [false discovery rate (FDR)-corrected, q < 0.05]. The association between the right entorhinal cortex thickness and frequency of cannabis use is due to the contribution of significant shared additive genetic (ρg = -0.19 ± 0.08; p = 0.02) factors but not unique environment (ρe = 0.05 ± 0.09; p = 0.53). Significantly lower surface area of the right entorhinal cortex in discordant exposed group compared with the discordant unexposed group furnishes preliminary evidence in support of causal effect of cannabis use (FDR-corrected, q < 0.05). However, bi-variate polygenic model-based analysis did not show any significant effect. CONCLUSIONS Shared genetic liability may underlie the association between cannabis exposure and thinner right entorhinal cortex. Prospective longitudinal studies are necessary to definitively disentangle the cause-effect relationships of cannabis use.
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Affiliation(s)
- Subhadip Paul
- Institute of Psychiatry,Psychology & Neuroscience,King's College London,UK
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48
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Impact of neuroimmune activation induced by alcohol or drug abuse on adolescent brain development. Int J Dev Neurosci 2018; 77:89-98. [PMID: 30468786 DOI: 10.1016/j.ijdevneu.2018.11.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/19/2018] [Accepted: 11/19/2018] [Indexed: 12/27/2022] Open
Abstract
Evidence obtained in recent decades has demonstrated that the brain still matures in adolescence. Changes in neural connectivity occur in different regions, including cortical and subcortical structures, which undergo modifications in white and gray matter densities. These alterations concomitantly occur in some neurotransmitter systems and hormone secretion, which markedly influence the refinement of certain brain areas and neural circuits. The immaturity of the adolescent brain makes it more vulnerable to the effects of alcohol and drug abuse, whose use can trigger long-term behavioral dysfunction. This article reviews the action of alcohol and drug abuse (cannabis, cocaine, opioids, amphetamines, anabolic androgenic steroids) in the adolescent brain, and their impact on both cognition and behavioral dysfunction, including predisposition to drug abuse in later life. It also discusses recent evidence that indicates the role of the neuroimmune system response and neuroinflammation as mechanisms that participate in many actions of ethanol and drug abuse in adolescence, including the neurotoxicity and alterations in neurocircuitry that contribute to the dysfunctional behaviors associated with addiction. The new data suggest the therapeutic potential of anti-inflammatory targets to prevent the long-term consequences of drug abuse in adolescence.
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Luby JL, Agrawal A, Belden A, Whalen D, Tillman R, Barch D. Developmental Trajectories of the Orbitofrontal Cortex and Anhedonia in Middle Childhood and Risk for Substance Use in Adolescence in a Longitudinal Sample of Depressed and Healthy Preschoolers. Am J Psychiatry 2018; 175:1010-1021. [PMID: 29558817 PMCID: PMC6150861 DOI: 10.1176/appi.ajp.2018.17070777] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Deficits in reward processing are established in mood and substance use disorders and are known risk factors for these disorders. Volume reductions of the orbitofrontal cortex and the striatum, regions that subserve neural response to reward, have been shown to be related to anhedonia in depressive and substance use disorders. The authors sought to investigate how structural maturation of these regions in childhood varies with level of anhedonia and predicts later substance use. METHOD The study employed data from a sample of depressed and healthy preschoolers studied longitudinally that included three waves of neuroimaging from school age to adolescence. Three years after scan 3, at ages 13-18, participants underwent a comprehensive behavioral and substance use assessment. Multilevel modeling was used to investigate the relationship between anhedonia and the growth trajectories of the striatum and orbitofrontal cortex. Zero-inflated Poisson regression models were then used to determine whether the intercepts and slopes of these trajectories predicted later alcohol and marijuana use frequency in adolescence. RESULTS The anhedonia-by-age interaction was significant in the multilevel modeling of orbitofrontal cortical but not striatal volume. Higher anhedonia ratings were significantly associated with steeper decline in orbitofrontal cortical volume with age. Orbitofrontal cortical volume and thickness at age 12 and trajectory over time significantly and negatively predicted subsequent alcohol and marijuana use frequency but not depression during adolescence. CONCLUSIONS The findings suggest that the development of the orbitofrontal cortex during childhood is strongly linked to experiences of anhedonia and that these growth trajectories predict substance use during a developmentally critical period.
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Affiliation(s)
- Joan L. Luby
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA,Corresponding Author: Joan L. Luby, M.D.; Washington University School of Medicine, Department of Psychiatry, Box 8511, 660 S. Euclid, St. Louis, MO, 63110; phone 314-286-2730; fax 314-286-2732;
| | - Arpana Agrawal
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Andy Belden
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Diana Whalen
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Deanna Barch
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA,Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Dr., St. Louis, MO, 63130, USA
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50
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Nock NL, Minnes S, Alberts JL. Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders. Birth Defects Res 2018; 109:1711-1729. [PMID: 29251846 DOI: 10.1002/bdr2.1182] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 12/17/2022]
Abstract
Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low-income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural "imbalance" between frontal/regulatory and cortical-subcortical circuits, leading to further heightened impulsive and reward-driven behaviors. Exercise increases growth and brain-derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the "naïve" or underdeveloped connections between neurological reward and regulatory processes in adolescence from the "bottom up" and "offset" reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly "assisted" exercise, which we have shown increases neural activity in cortical-subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.
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Affiliation(s)
- Nora L Nock
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
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