1
|
Najafi L, Moasses Z, Bahmanpour S. The marijuana, cannabinoids, and female reproductive system. J Appl Toxicol 2024. [PMID: 38754862 DOI: 10.1002/jat.4630] [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: 09/26/2023] [Revised: 04/13/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024]
Abstract
The marijuana is considered as widely used recreational illicit drug that has become popular among women of reproductive age. It is believed that the marijuana use may have negative impacts on the female fertility. However, the exact mechanisms of its reproductive toxicity remain unclear. The studies suggest that the exogenous cannabinoids may interfere with endocannabinoid system and disrupt hypothalamic-pituitary-ovary axis. Consequently, it impacts the female fertility by disruption of normal secretion of ovarian sex hormones and menstrual cycles. However, other studies have shown that medical marijuana is useful analgesic agent for pain management. But, given that the wide range of cannabinoids side effects are reported, it seems that caution should be taken in the recreational use of these substances. In summary, this article aimed to review the possible impacts of marijuana and its derivatives on the main female reproductive organs and embryonic growth and development.
Collapse
Affiliation(s)
- Leila Najafi
- Department of Anatomical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zia Moasses
- Department of Anatomical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soghra Bahmanpour
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Anatomical Sciences, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
2
|
Hamilton HK, Mathalon DH, Ford JM. P300 in schizophrenia: Then and now. Biol Psychol 2024; 187:108757. [PMID: 38316196 DOI: 10.1016/j.biopsycho.2024.108757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
The 1965 discovery of the P300 component of the electroencephalography (EEG)-based event-related potential (ERP), along with the subsequent identification of its alteration in people with schizophrenia, initiated over 50 years of P300 research in schizophrenia. Here, we review what we now know about P300 in schizophrenia after nearly six decades of research. We describe recent efforts to expand our understanding of P300 beyond its sensitivity to schizophrenia itself to its potential role as a biomarker of risk for psychosis or a heritable endophenotype that bridges genetic risk and psychosis phenomenology. We also highlight efforts to move beyond a syndrome-based approach to understand P300 within the context of the clinical, cognitive, and presumed pathophysiological heterogeneity among people diagnosed with schizophrenia. Finally, we describe several recent approaches that extend beyond measuring the traditional P300 ERP component in people with schizophrenia, including time-frequency analyses and pharmacological challenge studies, that may help to clarify specific cognitive mechanisms that are disrupted in schizophrenia. Moreover, we discuss several promising areas for future research, including studies of animal models that can be used for treatment development.
Collapse
Affiliation(s)
- Holly K Hamilton
- University of Minnesota, Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Daniel H Mathalon
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Judith M Ford
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| |
Collapse
|
3
|
Warren CV, Kroll CF, Kopp B. Dopaminergic and norepinephrinergic modulation of endogenous event-related potentials: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 151:105221. [PMID: 37150485 DOI: 10.1016/j.neubiorev.2023.105221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/09/2023]
Abstract
Event-related potentials (ERPs) represent the cortical processing of sensory, motor or cognitive functions invoked by particular events or stimuli. A current theory posits that the catecholaminergic neurotransmitters dopamine (DA) and norepinephrine (NE) modulate a number of endogenous ERPs during various cognitive processes. This manuscript aims to evaluate a leading neurotransmitter hypothesis with a systematic overview and meta-analysis of pharmacologic DA and NE manipulation of specific ERPs in healthy subjects during executive function. Specifically, the frontally-distributed P3a, N2, and Ne/ERN (or error-related negativity) are supposedly modulated primarily by DA, whereas the parietally-distributed P3b is thought to be modulated by NE. Based on preceding research, we refer to this distinction between frontally-distributed DA-sensitive and parietally-distributed NE-sensitive ERP components as the Extended Neurobiological Polich (ENP) hypothesis. Our systematic review and meta-analysis indicate that this distinction is too simplistic and many factors interact with DA and NE to influence these specific ERPs. These may include genetic factors, the specific cognitive processes engaged, or elements of study design, i.e. session or sequence effects or data-analysis strategies.
Collapse
Affiliation(s)
- Claire V Warren
- Charlotte Fresenius Hochschule, Alte Rabenstraße 32, 20148 Hamburg, Germany; Professorship for Clinical Psychology, Helmut-Schmidt University/ Bundeswehr University Hamburg, Holstenhofweg 85, 22043 Hamburg, Germany.
| | - Charlotte F Kroll
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Minderbroedersberg 4-6. P.O. Box 616, Maastricht, MD, 6200, The Netherlands
| | - Bruno Kopp
- Clinic für Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| |
Collapse
|
4
|
Motaghi E, Ghasemi-Pirbaluti M, Rashidi M, Alasvand M, Di Ciano P, Bozorgi H. The effect of tetrahydrocannabinol:cannabidiol oromucosal spray on cognition: a systematic review. Eur J Clin Pharmacol 2023; 79:371-381. [PMID: 36700997 DOI: 10.1007/s00228-023-03454-y] [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: 10/14/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE Previous studies have shown that tetrahydrocannabinol (THC), the main psychoactive component of cannabis, can impair cognitive abilities. There is also some evidence that cannabidiol (CBD), the most abundant non-intoxicating constituent of cannabis, can attenuate these effects. The purpose of this study was to investigate the effects of THC:CBD oromucosal spray (with equal parts THC and CBD) on cognition compared with control conditions in human studies. METHODS A systematic literature search was performed on four major bibliographic databases. Studies were included in the present review if they evaluated the cognitive effects of THC:CBD oromucosal spray compared with a control condition. RESULTS Ten studies were identified (7 on patients with multiple sclerosis, 1 on those with Huntington, and 2 on healthy volunteers) with 510 participants in total. There was considerable heterogeneity among the studies in terms of dose and duration of administration. All studies have used an equal or nearly equal dose of THC and CBD. CONCLUSIONS Although the results across studies were somewhat inconsistent, most evidence revealed that there is no significant difference between THC:CBD oromucosal spray and control treatments in terms of cognitive outcomes. However, more trials are needed with longer follow-up periods, and dose considerations, particularly comparing lower and higher doses of the spray.
Collapse
Affiliation(s)
- Ehsan Motaghi
- Department of Physiology and Pharmacology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Masoumeh Ghasemi-Pirbaluti
- Department of Physiology and Pharmacology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohsen Rashidi
- Department of Physiology and Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Alasvand
- Department of Physiology and Pharmacology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Patricia Di Ciano
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, ON, M5S 3H7, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, M5T 1R8, Canada
| | - Hooman Bozorgi
- Research Center of Physiology, Department of Pharmacology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| |
Collapse
|
5
|
Murray CH, Glazer JE, Lee R, Nusslock R, de Wit H. Δ9-THC reduces reward-related brain activity in healthy adults. Psychopharmacology (Berl) 2022; 239:2829-2840. [PMID: 35612654 PMCID: PMC10560585 DOI: 10.1007/s00213-022-06164-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE Greater availability of cannabis in the USA has raised concerns about adverse effects of the drug, including possible amotivational states. Lack of motivation may be assessed by examining acute effects of cannabinoids on reward processing. OBJECTIVES This study examined single doses of delta-9-tetrahydrocannabinol (∆9-THC; 7.5, 15 mg oral) in healthy adults using a version of the monetary incentive delay (MID) task adapted for electroencephalography (EEG; e-MID) in a within-subjects, double blind design. METHODS Two phases of reward processing were examined: anticipation, which occurs with presentation of cues that indicate upcoming reward, punishment, or neutral conditions, and outcome, which occurs with feedback indicating hits or misses. During anticipation, we measured two event-related potential (ERP) components: the P300, which measures attention and motivation, and the LPP, which measures affective processing. During outcome processing, we measured P300 and LPP, as well as the RewP, which measures outcome evaluation. RESULTS We found that ∆9-THC modulated outcome processing, but not reward anticipation. Specifically, both doses of ∆9-THC (7.5 and 15 mg) reduced RewP amplitudes after outcome feedback (hits and misses) relative to placebo. ∆9-THC (15 mg) also reduced P300 and LPP amplitudes following hits compared to misses, relative to both placebo and 7.5 mg ∆9-THC. CONCLUSIONS These findings suggest that ∆9-THC dampens responses to both reward and loss feedback, which may reflect an "amotivational" state. Future studies are needed to determine generalizability of this effect, such as its pharmacological specificity and its specificity to monetary vs other types of reward.
Collapse
Affiliation(s)
- Conor H Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - James E Glazer
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA.
| |
Collapse
|
6
|
Sex differences in cognitive processing: An integrative review of electrophysiological findings. Biol Psychol 2022; 172:108370. [DOI: 10.1016/j.biopsycho.2022.108370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/20/2022] [Accepted: 05/26/2022] [Indexed: 01/14/2023]
|
7
|
Murray CH, Huang Z, Lee R, de Wit H. Adolescents are more sensitive than adults to acute behavioral and cognitive effects of THC. Neuropsychopharmacology 2022; 47:1331-1338. [PMID: 35110688 PMCID: PMC9117219 DOI: 10.1038/s41386-022-01281-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/09/2022]
Abstract
Increased cannabis availability has contributed to increased use with concomitant incidence of adverse effects. One risk factor for adverse drug reactions may be age. There is preclinical evidence that acute effects of delta-9-tetrahydrocannabinol (THC), the primary active constituent of cannabis, are greater during adolescence, but this has not been fully studied in humans. The present study sought to determine whether adolescent men and women are more sensitive than adults to acute THC. Adolescents aged 18-20 (N = 12) and adults aged 30-40 (N = 12), with less than 20 total lifetime uses of THC-containing products, received capsules of THC (7.5, 15 mg) and placebo across three study sessions in randomized order under double blind conditions. During each session, subjective, cardiovascular, behavioral, and EEG measures were obtained. Behavioral measures included Simple Reaction Time, Stop Task, Time Production and N-back and EEG measures included P300 amplitudes during an auditory oddball task and eyes-closed resting state. THC affected subjective state and heart rate similarly in both age groups. However, adolescents were more sensitive to performance impairing effects, exhibiting dose-dependent impairments on reaction time, response accuracy, and time perception. On EEG measures, THC dose-dependently decreased P300 amplitude in adolescents but not adults. Adolescents were more sensitive to behavioral and cognitive effects of THC, but not to cardiovascular effects or subjective measures. Thus, at doses that produce comparable ratings of intoxication, adolescents may exhibit greater cognitive impairment and alterations in brain function.
Collapse
Affiliation(s)
- Conor H. Murray
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Zhengyi Huang
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Royce Lee
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
| |
Collapse
|
8
|
Nardone R, Sebastianelli L, Versace V, Ferrazzoli D, Brigo F, Schwenker K, Saltuari L, Trinka E. TMS for the functional evaluation of cannabis effects and for treatment of cannabis addiction: A review. Psychiatry Res 2022; 310:114431. [PMID: 35219263 DOI: 10.1016/j.psychres.2022.114431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Abstract
The knowledge about the effects of cannabis on human cortical brain processes is increasing. In this regard, transcranial magnetic stimulation (TMS) enables the evaluation of central nervous system function, including drug effects. Moreover, repetitive TMS (rTMS) has been used therapeutically in several substance use disorders. In this scoping review, we summarize and discuss studies that have employed TMS and rTMS techniques in users of cannabis for recreational purposes. In subjects with a history of persistent cannabis use, TMS studies showed reduced short-interval cortical inhibition (SICI). This observation points more at neurobiological changes of chronic cannabis use than to a direct effect of cannabis on gamma-aminobutyric acid (GABA) A receptors. Moreover, individuals vulnerable to becoming long-term users of cannabis may also have underlying pre-existing abnormalities in SICI. Of note, the use of cannabis is associated with an increased risk of schizophrenia, and the down-regulation of GABAergic function may play a role. Less frequent cannabis use and spontaneous craving were observed following rTMS applied to the dorsolateral prefrontal cortex (DLPFC). There is emerging evidence that the posterior cingulate cortex and the precuneus are potential targets for rTMS intervention in cannabis use disorder. However, larger and randomized trials should corroborate these encouraging findings.
Collapse
Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Italy
| | - Kerstin Schwenker
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria; Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria; UMIT, University for Medical Informatics and Health Technology, Hall in Tirol, Austria
| |
Collapse
|
9
|
Abstract
As more states in the U.S legalize recreational and medicinal cannabis, rates of driving under the influence of this drug are increasing significantly. Aspects of this emerging public health issue potentially pit science against public policy. The authors believe that the legal cart is currently significantly ahead of the scientific horse. Issues such as detection procedures for cannabis-impaired drivers, and use of blood THC levels to gauge impairment, should rely heavily on current scientific knowledge. However, there are many, often unacknowledged research gaps in these and related areas, that need to be addressed in order provide a more coherent basis for public policies. This review focuses especially on those areas. In this article we review in a focused manner, current information linking cannabis to motor vehicle accidents and examine patterns of cannabis-impairment of driving related behaviors, their time courses, relationship to cannabis dose and THC blood levels, and compare cannabis and alcohol-impaired driving patterns directly. This review also delves into questions of alcohol-cannabis combinations and addresses the basis for of per-se limits in cannabis driving convictions. Finally, we distinguish between areas where research has provided clear answers to the above questions, areas that remain unclear, and make recommendations to fill gaps in current knowledge.
Collapse
Affiliation(s)
- Godfrey D. Pearlson
- Department of Psychiatry, Olin Neuropsychiatry Research Center, Institute of Living, Hartford Healthcare Corporation, Hartford, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
| | - Michael C. Stevens
- Department of Psychiatry, Olin Neuropsychiatry Research Center, Institute of Living, Hartford Healthcare Corporation, Hartford, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
10
|
Opposite Roles for Cannabidiol and δ-9-Tetrahydrocannabinol in Psychotomimetic Effects of Cannabis Extracts: A Naturalistic Controlled Study. J Clin Psychopharmacol 2021; 41:561-570. [PMID: 34412109 DOI: 10.1097/jcp.0000000000001457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although δ-9-tetrahydrocannabinol (THC), the main cannabinoid from the cannabis plant, is responsible for the psychotomimetic effects of cannabis, cannabidiol (CBD), the second most abundant cannabinoid in the cannabis plant, does not show any psychotomimetic effect. Cannabidiol has even been proposed to be antipsychotic and to counteract some of the psychotomimetic effects of THC. The aim of this study was to test the potential antipsychotomimetic effects of CBD. METHOD Eighteen members from a cannabis social club were tested for subjective and psychotomimetic effects under the effects of different full-spectrum cannabis extracts containing either THC, CBD, THC + CBD, or placebo in a naturalistic, randomized, double-blind, crossover, placebo-controlled study. RESULTS Results showed that participants under the effects of THC + CBD showed lower psychotomimetic scores in subjective scales when compared with THC alone. Subjective scores were lower under the effects of CBD and placebo when compared with THC + CBD. Cannabidiol and placebo did not show any psychotomimetic effect. CONCLUSIONS This study provides evidence for both the psychotomimetic effects of THC and the antipsychotomimetic effects of CBD when it is coadministered with THC in real-world situations, which can be very relevant for the clinical practice of medical cannabis. Ultimately, this study substantiates the link between the endocannabinoid system and psychotic-like symptoms and has important implications for the understanding of schizophrenia and the therapeutic potential of CBD as an antipsychotic. Lastly, we demonstrate how reliable methodologies can be implemented in real situations to collect valid ecological evidence outside classic laboratory settings.
Collapse
|
11
|
Gunasekera B, Davies C, Martin-Santos R, Bhattacharyya S. The Yin and Yang of Cannabis: A Systematic Review of Human Neuroimaging Evidence of the Differential Effects of Δ 9-Tetrahydrocannabinol and Cannabidiol. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:636-645. [PMID: 33414100 DOI: 10.1016/j.bpsc.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 12/23/2022]
Abstract
Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) have been the most investigated cannabinoids at the human and preclinical levels, although the neurobiological mechanisms underlying their effects remain unclear. Human experimental evidence complemented by observational studies suggests that THC may have psychotogenic effects while CBD may have antipsychotic effects. However, whether their effects on brain function are consistent with their opposing behavioral effects remains unclear. To address this, here we synthesize neuroimaging evidence investigating the acute effects of THC and CBD on human brain function using a range of neuroimaging techniques, with an aim to identify the key brain substrates where THC and CBD have opposing effects. After a systematic search, a review of the available studies indicated marked heterogeneity. However, an overall pattern of opposite effect profiles of the two cannabinoids was evident with some degree of consistency, primarily attributed to the head-to-head challenge studies of THC and CBD. While head-to-head comparisons are relatively few, collectively the evidence suggests that opposite effects of THC and CBD may be present in the striatum, parahippocampus, anterior cingulate/medial prefrontal cortex, and amygdala, with opposite effects less consistently identified in other regions. Broadly, THC seems to increase brain activation and blood flow, whereas CBD seems to decrease brain activation and blood flow. Given the sparse evidence, there is a particular need to understand the mechanisms underlying their opposite behavioral effects because it may not only offer insights into the underlying pathophysiological mechanisms of psychotic disorders but also suggest potentially novel targets and biomarkers for drug discovery.
Collapse
Affiliation(s)
- Brandon Gunasekera
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Rocio Martin-Santos
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| |
Collapse
|
12
|
Morie KP, Potenza MN. A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory. Front Psychiatry 2021; 12:657371. [PMID: 33967859 PMCID: PMC8100188 DOI: 10.3389/fpsyt.2021.657371] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 01/26/2023] Open
Abstract
Cannabis is commonly used, and use may be increasing in the setting of increasing legalization and social acceptance. The scope of the effects of cannabis products, including varieties with higher or lower levels of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD), on domains related to addictive behavior deserves attention, particularly as legalization continues. Cannabis use may impact neural underpinnings of cognitive functions linked to propensities to engage in addictive behaviors. Here we consider these neurocognitive processes within the framework of the dual-process model of addictions. In this mini-review, we describe data on the relationships between two main constituents of cannabis (THC and CBD) and neural correlates of reward processing, inhibitory control and working memory.
Collapse
Affiliation(s)
- Kristen P. Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
13
|
Hamilton HK, Roach BJ, Mathalon DH. Forecasting Remission From the Psychosis Risk Syndrome With Mismatch Negativity and P300: Potentials and Pitfalls. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:178-187. [PMID: 33431345 PMCID: PMC8128162 DOI: 10.1016/j.bpsc.2020.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022]
Abstract
Clinical outcomes vary for individuals at clinical high risk (CHR) for psychosis, ranging from conversion to a psychotic disorder to full remission from the risk syndrome. Given that most CHR individuals do not convert to psychosis, recent research efforts have turned toward identifying specific predictors of CHR remission, a task that is conceptually and empirically dissociable from the identification of predictors of conversion to psychosis, and one that may reveal specific biological characteristics that confer resilience to psychosis and provide further insights into the mechanisms associated with the pathogenesis of schizophrenia and those underlying a transient CHR syndrome. Such biomarkers may ultimately facilitate the development of novel early interventions and support the optimization of individualized care. In this review, we focus on two event-related brain potential measures, mismatch negativity and P300, that have attracted interest as predictors of future psychosis among CHR individuals. We describe several recent studies examining whether mismatch negativity and P300 predict subsequent CHR remission and suggest that intact mismatch negativity and P300 may reflect the integrity of specific neurocognitive processes that confer resilience against the persistence of the CHR syndrome and its associated risk for future transition to psychosis. We also highlight several major methodological concerns associated with these studies that apply to the broader literature examining predictors of CHR remission. Among them is the concern that studies that predict dichotomous remission versus nonremission and/or dichotomous conversion versus nonconversion outcomes potentially confound remission and conversion effects, a phenomenon we demonstrate with a data simulation.
Collapse
Affiliation(s)
- Holly K Hamilton
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California.
| | - Brian J Roach
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Northern California Institute for Research and Education, San Francisco, California
| | - Daniel H Mathalon
- San Francisco VA Health Care System, University of California San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California.
| |
Collapse
|
14
|
Hamilton HK, Boos AK, Mathalon DH. Electroencephalography and Event-Related Potential Biomarkers in Individuals at Clinical High Risk for Psychosis. Biol Psychiatry 2020; 88:294-303. [PMID: 32507388 PMCID: PMC8300573 DOI: 10.1016/j.biopsych.2020.04.002] [Citation(s) in RCA: 30] [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: 10/28/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/17/2023]
Abstract
Clinical outcomes vary among youths at clinical high risk for psychosis (CHR-P), with approximately 20% progressing to full-blown psychosis over 2 to 3 years and 30% achieving remission. Recent research efforts have focused on identifying biomarkers that precede psychosis onset and enhance the accuracy of clinical outcome prediction in CHR-P individuals, with the ultimate goal of developing staged treatment approaches based on the individual's level of risk. Identifying such biomarkers may also facilitate progress toward understanding pathogenic mechanisms underlying psychosis onset, which may support the development of mechanistically informed early interventions for psychosis. In recent years, electroencephalography-based event-related potential measures with established sensitivity to schizophrenia have gained traction in the study of CHR-P and its clinical outcomes. In this review, we describe the evidence for event-related potential abnormalities in CHR-P and discuss how they inform our understanding of information processing deficits as vulnerability markers for emerging psychosis and as indicators of future outcomes. Among the measures studied, P300 and mismatch negativity are notable because deficits predict conversion to psychosis and/or CHR-P remission. However, the accuracy with which these and other measures predict outcomes in CHR-P has been obscured in the prior literature by the tendency to only report group-level differences, underscoring the need for inclusion of individual predictive accuracy metrics in future studies. Nevertheless, both P300 and mismatch negativity show promise as electrophysiological markers of risk for psychosis, as target engagement measures for clinical trials, and as potential translational bridges between human studies and animal models focused on novel drug development for early psychosis.
Collapse
Affiliation(s)
- Holly K Hamilton
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, California
| | - Alison K Boos
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Northern California Institute for Research and Education, San Francisco, California
| | - Daniel H Mathalon
- San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, California.
| |
Collapse
|
15
|
Javitt DC, Siegel SJ, Spencer KM, Mathalon DH, Hong LE, Martinez A, Ehlers CL, Abbas AI, Teichert T, Lakatos P, Womelsdorf T. A roadmap for development of neuro-oscillations as translational biomarkers for treatment development in neuropsychopharmacology. Neuropsychopharmacology 2020; 45:1411-1422. [PMID: 32375159 PMCID: PMC7360555 DOI: 10.1038/s41386-020-0697-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/16/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
New treatment development for psychiatric disorders depends critically upon the development of physiological measures that can accurately translate between preclinical animal models and clinical human studies. Such measures can be used both as stratification biomarkers to define pathophysiologically homogeneous patient populations and as target engagement biomarkers to verify similarity of effects across preclinical and clinical intervention. Traditional "time-domain" event-related potentials (ERP) have been used translationally to date but are limited by the significant differences in timing and distribution across rodent, monkey and human studies. By contrast, neuro-oscillatory responses, analyzed within the "time-frequency" domain, are relatively preserved across species permitting more precise translational comparisons. Moreover, neuro-oscillatory responses are increasingly being mapped to local circuit mechanisms and may be useful for investigating effects of both pharmacological and neuromodulatory interventions on excitatory/inhibitory balance. The present paper provides a roadmap for development of neuro-oscillatory responses as translational biomarkers in neuropsychiatric treatment development.
Collapse
Affiliation(s)
- Daniel C Javitt
- Department of Psychiatry, Columbia University Medical Center, New York, NY, 10032, USA.
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10954, USA.
| | - Steven J Siegel
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Kevin M Spencer
- Research Service, VA Boston Healthcare System, and Dept. of Psychiatry, Harvard Medical School, Boston, MA, 02130, USA
| | - Daniel H Mathalon
- VA San Francisco Healthcare System, University of California, San Francisco, San Francisco, CA, 94121, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Antigona Martinez
- Department of Psychiatry, Columbia University Medical Center, New York, NY, 10032, USA
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10954, USA
| | - Cindy L Ehlers
- Department of Neuroscience, The Scripps Research Institute, 10550 N Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Atheir I Abbas
- VA Portland Health Care System, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Tobias Teichert
- Departments of Psychiatry and Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Peter Lakatos
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10954, USA
| | - Thilo Womelsdorf
- Department of Psychology, Vanderbilt University, Nashville, TN, 37203, USA
| |
Collapse
|
16
|
Kozela E, Krawczyk M, Kos T, Juknat A, Vogel Z, Popik P. Cannabidiol Improves Cognitive Impairment and Reverses Cortical Transcriptional Changes Induced by Ketamine, in Schizophrenia-Like Model in Rats. Mol Neurobiol 2019; 57:1733-1747. [PMID: 31823199 DOI: 10.1007/s12035-019-01831-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/01/2019] [Indexed: 12/26/2022]
Abstract
Cannabidiol (CBD), a non-psychotropic cannabinoid, demonstrates antipsychotic-like and procognitive activities in humans and in animal models of schizophrenia. The mechanisms of these beneficial effects of CBD are unknown. Here, we examined behavioral effects of CBD in a pharmacological model of schizophrenia-like cognitive deficits induced by repeated ketamine (KET) administration. In parallel, we assessed transcriptional changes behind CBD activities in the prefrontal cortex (PFC), the main brain area linked to schizophrenia-like pathologies. Male Sprague-Dawley rats were injected for 10 days with KET followed by 6 days of CBD. The cognitive performance was evaluated in the novel object recognition test followed by PFC dissections for next-generation sequencing (RNA-Seq) analysis and bioinformatics. We observed that KET-induced learning deficits were rescued by CBD (7.5 mg/kg). Similarly, CBD reversed transcriptional changes induced by KET. The majority of the genes affected by KET and KET-CBD were allocated to astroglial and microglial cells and associated with immune-like processes mediating synaptogenesis and neuronal plasticity. These genes include C1qc, C1qa, C1qb, C2, and C3 complement cascade elements, Irf8 factor and Gpr84, Gpr34, Cx3cr1, P2ry12, and P2ry6 receptors. The main pathway regulators predicted to be involved included TGFβ1 and IFNγ. In addition, CBD itself upregulated oxytocin mRNA in the PFC. The present data suggest that KET induces cognitive deficits and transcriptional changes in the PFC and that both effects are sensitive to a reversal by CBD treatment.
Collapse
Affiliation(s)
- Ewa Kozela
- The Dr Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
| | - Martyna Krawczyk
- Department of Behavioral Neuroscience & Drug Development, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Tomasz Kos
- Department of Behavioral Neuroscience & Drug Development, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Ana Juknat
- The Dr Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Zvi Vogel
- The Dr Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Piotr Popik
- Department of Behavioral Neuroscience & Drug Development, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| |
Collapse
|
17
|
Olla P, Rykulski N, Hurtubise JL, Bartol S, Foote R, Cutler L, Abeare K, McVinnie N, Sabelli AG, Hastings M, Erdodi LA. Short-term effects of cannabis consumption on cognitive performance in medical cannabis patients. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:647-657. [PMID: 31790276 DOI: 10.1080/23279095.2019.1681424] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This observational study examined the acute cognitive effects of cannabis. We hypothesized that cognitive performance would be negatively affected by acute cannabis intoxication. Twenty-two medical cannabis patients from Southwestern Ontario completed the study. The majority (n = 13) were male. Mean age was 36.0 years, and mean level of education was 13.7 years. Participants were administered the same brief neurocognitive battery three times during a six-hour period: at baseline ("Baseline"), once after they consumed a 20% THC cannabis product ("THC"), and once again several hours later ("Recovery"). The average self-reported level of cannabis intoxication prior to the second assessment (i.e., during THC) was 5.1 out of 10. Contrary to expectations, performance on neuropsychological tests remained stable or even improved during the acute intoxication stage (THC; d: .49-.65, medium effect), and continued to increase during Recovery (d: .45-.77, medium-large effect). Interestingly, the failure rate on performance validity indicators increased during THC. Contrary to our hypothesis, there was no psychometric evidence for a decline in cognitive ability following THC intoxication. There are several possible explanations for this finding but, in the absence of a control group, no definitive conclusion can be reached at this time.
Collapse
Affiliation(s)
| | - Nicholas Rykulski
- College of Human Medicine, Michigan State University, Lansing, MI, USA
| | | | - Stephen Bartol
- School of Medicine, Wayne State University, Detroit, MI, USA
| | | | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Kaitlyn Abeare
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Nora McVinnie
- Brain-Cognition-Neuroscience Program, University of Windsor, Windsor, ON, Canada
| | - Alana G Sabelli
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Maurissa Hastings
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laszlo A Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| |
Collapse
|
18
|
Freeman AM, Petrilli K, Lees R, Hindocha C, Mokrysz C, Curran HV, Saunders R, Freeman TP. How does cannabidiol (CBD) influence the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review. Neurosci Biobehav Rev 2019; 107:696-712. [PMID: 31580839 DOI: 10.1016/j.neubiorev.2019.09.036] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 01/08/2023]
Abstract
The recent liberalisation of cannabis regulation has increased public and scientific debate about its potential benefits and risks. A key focus has been the extent to which cannabidiol (CBD) might influence the acute effects of delta-9-tetrahydrocannabinol (THC), but this has never been reviewed systematically. In this systematic review of how CBD influences the acute effects of THC we identified 16 studies involving 466 participants. Ten studies were judged at low risk of bias. The findings were mixed, although CBD was found to reduce the effects of THC in several studies. Some studies found that CBD reduced intense experiences of anxiety or psychosis-like effects of THC and blunted some of the impairments on emotion and reward processing. However, CBD did not consistently influence the effects of THC across all studies and outcomes. There was considerable heterogeneity in dose, route of administration and THC:CBD ratio across studies and no clear dose-response profile emerged. Although findings were mixed, this review suggests that CBD may interact with some acute effects of THC.
Collapse
Affiliation(s)
- Abigail M Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Katherine Petrilli
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Rachel Lees
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, Gower Street, London, WC1E 6BT, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Rob Saunders
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK; National Addiction Centre, King's College London, London, SE5 8BB, UK
| |
Collapse
|
19
|
Martin RC, Gaston TE, Thompson M, Ampah SB, Cutter G, Bebin EM, Szaflarski JP. Cognitive functioning following long-term cannabidiol use in adults with treatment-resistant epilepsy. Epilepsy Behav 2019; 97:105-110. [PMID: 31220785 DOI: 10.1016/j.yebeh.2019.04.044] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
Abstract
Cognitive dysfunction is a common comorbidity in adults with treatment-resistant epilepsy (TRE). Recently, cannabidiol (CBD) has demonstrated efficacy in epilepsy treatment. However, our understanding of CBD's cognitive effects in epilepsy is limited. We examined long-term cognitive effects of CBD in adults with TRE as part of an ongoing prospective, open-label safety study. Twenty-sevenadults with TRE (mean age: 34[SD +14], female 52%) enrolled in the UAB CBD program completed standardized cognitive testing (NIH Toolbox Cognition Battery (NIHTB-CB)) at pre-CBD administration baseline and at one-yearfollow-up. Participants were receiving stable CBD dose at the time of one-year testing (mean=36.5mg/kg/day). The NIHTB-CB consisted of two global composite scales (Fluid and Crystallized) and seven individual tests measuring aspects of working memory, episodic memory, executive function, processing speed, and language. All participants had recorded Chalfont Seizure Severity Scale (CSSS) scores at each visit. Statistical analyses consisted of t-test, Pearson correlation coefficient, and linear regression. At baseline, cognitive test performance was below average for both global composite scales (Fluid: 71 [±18] range: 46-117) and Crystallized (76 [±15] range: 59-112)]. Longitudinal analysis revealed no significant group change across the two global composite scales. Of the seven individual cognitive tests, none changed significantly over time. No correlation was found between the cognitive change scores and CBD dose (all P's≥0.21). Change in cognitive test performance was not associated change in seizure severity rating. These findings are encouraging and indicate that long-term administration of pharmaceutical grade CBD is overall cognitively well-tolerated in adults with TRE.
Collapse
Affiliation(s)
- Roy C Martin
- University of Alabama at Birmingham, Department of Neurology, Birmingham, AL, USA.
| | - Tyler E Gaston
- University of Alabama at Birmingham, Department of Neurology, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA
| | | | - Steve B Ampah
- University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL, USA
| | - Gary Cutter
- University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL, USA
| | - E Martina Bebin
- University of Alabama at Birmingham, Department of Neurology, Birmingham, AL, USA
| | - Jerzy P Szaflarski
- University of Alabama at Birmingham, Department of Neurology, Birmingham, AL, USA
| |
Collapse
|
20
|
Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition. Psychopharmacology (Berl) 2019; 236:2713-2724. [PMID: 31044290 PMCID: PMC6695367 DOI: 10.1007/s00213-019-05246-8] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/09/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis. AIMS The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance. METHODS In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis. RESULTS/OUTCOMES Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction. CONCLUSIONS/INTERPRETATION Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.
Collapse
|
21
|
Melynyte S, Wang GY, Griskova-Bulanova I. Gender effects on auditory P300: A systematic review. Int J Psychophysiol 2018; 133:55-65. [PMID: 30130548 DOI: 10.1016/j.ijpsycho.2018.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 01/02/2023]
Abstract
The evidence suggests that gender-related effects could influence the electrophysiological P300 parameters and stand as an additional source of variation for both clinical and non-clinical subjects. The aim of this paper is to characterize gender-related differences in P300 potential as elicited with simple auditory paradigms. This knowledge (1) is important for the practical assessment of P300 potential in normal and clinical populations, and (2) can provide an insight into the understanding of gender differences in pathophysiology, particularly those with differential risk or prevalence in males and females. With this review it is shown that a limited number of studies encounter possible gender effects on parameters of auditory P300, and the findings need to be read with caution due to methodological limitations of the studies. Nevertheless, evidence supports that the P300 amplitude could be significantly modulated by gender, with greater amplitude in females relative to males. Noteworthy, gender has a minimal effect on the P300 latency, and it is often comparable between males and females. Furthermore, the effect of gender on P300 could be modulated by hormonal background, anatomy and some methodological aspects.
Collapse
Affiliation(s)
- Sigita Melynyte
- Institute of Biosciences, Life Sciences Centre, Vilnius University, Vilnius, Lithuania
| | - Grace Y Wang
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | | |
Collapse
|
22
|
Colizzi M, Bhattacharyya S. Neurocognitive effects of cannabis: Lessons learned from human experimental studies. PROGRESS IN BRAIN RESEARCH 2018; 242:179-216. [DOI: 10.1016/bs.pbr.2018.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
23
|
Mikulskaya E, Martin F. Visual attention to motion stimuli and its neural correlates in cannabis users. Eur J Neurosci 2017; 47:269-276. [PMID: 29266467 DOI: 10.1111/ejn.13810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 11/28/2022]
Abstract
Attention to motion stimuli and correct motion perception are vital for road safety. Although cannabis use has been associated with increased road crash risks, there is limited research on attentional processing of moving stimuli in cannabis users. This study investigated the neural correlates of the three-stimulus oddball task in cannabis users (n = 18) and non-users (n = 23) in response to moving stimuli. Stimulus contrast was under 16% against a low luminance background (M luminance < 16 cd/m2 ). The two groups did not differ in accuracy or in N2 peak amplitude; however, N2 latency was longer for target and standard stimuli in the cannabis group than in the control group. The cannabis group also showed a significantly reduced P3b amplitude in response to target stimuli. The AUDIT score was added as a random factor to the anova to rule out the effects of uneven alcohol consumption in the two groups. A significant group effect was found for N2 latency in response to target and standard stimuli and a significant interaction between the group, and the AUDIT score was found for the P3b peak amplitude for the distractor and standard stimuli, but not for the target stimuli. The results of this study suggest that cannabis use relates to reduced neural activity underlying attention to motion stimuli. Implications for regular early-onset cannabis use road safety are discussed.
Collapse
Affiliation(s)
- Elena Mikulskaya
- School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Tula University, TIEI, Tula, Russian
| | - Frances Martin
- School of Psychology, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
24
|
Ruggiero RN, Rossignoli MT, De Ross JB, Hallak JEC, Leite JP, Bueno-Junior LS. Cannabinoids and Vanilloids in Schizophrenia: Neurophysiological Evidence and Directions for Basic Research. Front Pharmacol 2017; 8:399. [PMID: 28680405 PMCID: PMC5478733 DOI: 10.3389/fphar.2017.00399] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 01/14/2023] Open
Abstract
Much of our knowledge of the endocannabinoid system in schizophrenia comes from behavioral measures in rodents, like prepulse inhibition of the acoustic startle and open-field locomotion, which are commonly used along with neurochemical approaches or drug challenge designs. Such methods continue to map fundamental mechanisms of sensorimotor gating, hyperlocomotion, social interaction, and underlying monoaminergic, glutamatergic, and GABAergic disturbances. These strategies will require, however, a greater use of neurophysiological tools to better inform clinical research. In this sense, electrophysiology and viral vector-based circuit dissection, like optogenetics, can further elucidate how exogenous cannabinoids worsen (e.g., tetrahydrocannabinol, THC) or ameliorate (e.g., cannabidiol, CBD) schizophrenia symptoms, like hallucinations, delusions, and cognitive deficits. Also, recent studies point to a complex endocannabinoid-endovanilloid interplay, including the influence of anandamide (endogenous CB1 and TRPV1 agonist) on cognitive variables, such as aversive memory extinction. In fact, growing interest has been devoted to TRPV1 receptors as promising therapeutic targets. Here, these issues are reviewed with an emphasis on the neurophysiological evidence. First, we contextualize imaging and electrographic findings in humans. Then, we present a comprehensive review on rodent electrophysiology. Finally, we discuss how basic research will benefit from further combining psychopharmacological and neurophysiological tools.
Collapse
Affiliation(s)
- Rafael N Ruggiero
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Matheus T Rossignoli
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Jana B De Ross
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil.,National Institute for Science and Technology-Translational Medicine, National Council for Scientific and Technological Development (CNPq)Ribeirão Preto, Brazil
| | - Joao P Leite
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Lezio S Bueno-Junior
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| |
Collapse
|
25
|
Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, Sherif M, McGuire P, D'Souza DC. Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology 2017. [PMID: 28634109 DOI: 10.1016/j.neuropharm.2017.06.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Prospective epidemiological studies have consistently demonstrated that cannabis use is associated with an increased subsequent risk of both psychotic symptoms and schizophrenia-like psychoses. Early onset of use, daily use of high-potency cannabis, and synthetic cannabinoids carry the greatest risk. The risk-increasing effects are not explained by shared genetic predisposition between schizophrenia and cannabis use. Experimental studies in healthy humans show that cannabis and its active ingredient, delta-9-tetrahydrocannabinol (THC), can produce transient, dose-dependent, psychotic symptoms, as well as an array of psychosis-relevant behavioral, cognitive and psychophysiological effects; the psychotogenic effects can be ameliorated by cannabidiol (CBD). Findings from structural imaging studies in cannabis users have been inconsistent but functional MRI studies have linked the psychotomimetic and cognitive effects of THC to activation in brain regions implicated in psychosis. Human PET studies have shown that acute administration of THC weakly releases dopamine in the striatum but that chronic users are characterised by low striatal dopamine. We are beginning to understand how cannabis use impacts on the endocannabinoid system but there is much still to learn about the biological mechanisms underlying how cannabis increases risk of psychosis. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
Collapse
Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
| | - A Englund
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - A Abi-Dargham
- Department of Psychiatry, School of Medicine, Stony Brook University, New York, USA
| | - D A Lewis
- Department of Psychiatry, University of Pittsburg, PA, USA
| | - M Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - C Davies
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - M Sherif
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| | - P McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - D C D'Souza
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| |
Collapse
|
26
|
Does Cannabis Composition Matter? Differential Effects of Delta-9-tetrahydrocannabinol and Cannabidiol on Human Cognition. CURRENT ADDICTION REPORTS 2017; 4:62-74. [PMID: 28580227 PMCID: PMC5435777 DOI: 10.1007/s40429-017-0142-2] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review The lack of clarity about the effect of cannabis use on cognition may be attributable to the considerable heterogeneity among studies in terms of cannabis composition. This article selectively reviews studies examining the distinctive effects of cannabinoids on human cognition, particularly those of delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). Recent Findings Research indicates that ∆9-THC administration acutely impairs cognition, particularly memory and emotional processing. Limited evidence suggests that CBD administration might improve cognition in cannabis users but not in individuals with neuropsychiatric disorders. Moreover, studies indicate that some acute Δ9-THC-induced cognitive impairments may be prevented if Δ9-THC is administered in combination or following CBD treatment. Δ9-THC and CBD have also shown opposite effects on cognition-related brain activation, possibly reflecting their antagonistic behavioral effects. Summary Research suggests greater cognitive impairments in individuals when exposed to high ∆9-THC or low CBD cannabis. It is unclear whether at specific concentrations CBD might outweigh any harmful effects of Δ9-THC on cognition.
Collapse
|
27
|
A systematic review of the effect of cannabidiol on cognitive function: Relevance to schizophrenia. Neurosci Biobehav Rev 2017; 72:310-324. [DOI: 10.1016/j.neubiorev.2016.11.012] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 10/25/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022]
|
28
|
Boggs DL, Peckham A, Boggs AA, Ranganathan M. Delta-9-tetrahydrocannabinol and cannabidiol: Separating the chemicals from the "weed," a pharmacodynamic discussion. Ment Health Clin 2016; 6:277-284. [PMID: 29955482 PMCID: PMC6007535 DOI: 10.9740/mhc.2016.11.277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cannabis is being increasingly used as a medical treatment for a variety of illnesses. However, the cannabis plant has more than 70 different phytocannabinoids with potential pharmacologic activity. Two of the most researched phytocannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Evidence suggests CBD can decrease some of the psychomimetic effects of THC. This has led to the development of a new drug, Nabiximols, for the treatment of moderate to severe spasticity due to multiple sclerosis. A discussion of evidence supporting proposed pharmacodynamic interplay between CBD and THC is presented.
Collapse
Affiliation(s)
- Douglas Lee Boggs
- Clinical Pharmacy Specialist-Outpatient Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut; Associate Research Scientist, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut,
| | - Alyssa Peckham
- PGY-2 Psychiatry Pharmacy Resident, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Angela A Boggs
- Clinical Pharmacy Specialist-Outpatient Psychiatry, VA Connecticut Healthcare System, Newington, Connecticut
| | - Mohini Ranganathan
- Attending Psychiatrist, VA Connecticut Healthcare System, West Haven, Connecticut; Abraham Ribicoff Research Facilities, and Assisstant Professor, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| |
Collapse
|
29
|
Spronk DB, De Bruijn ERA, van Wel JHP, Ramaekers JG, Verkes RJ. Acute effects of cocaine and cannabis on response inhibition in humans: an ERP investigation. Addict Biol 2016; 21:1186-1198. [PMID: 26037156 DOI: 10.1111/adb.12274] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Substance abuse has often been associated with alterations in response inhibition in humans. Not much research has examined how the acute effects of drugs modify the neurophysiological correlates of response inhibition, or how these effects interact with individual variation in trait levels of impulsivity and novelty seeking. This study investigated the effects of cocaine and cannabis on behavioural and event-related potential (ERP) correlates of response inhibition in 38 healthy drug using volunteers. A double-blind placebo-controlled randomized three-way crossover design was used. All subjects completed a standard Go/NoGo task after administration of the drugs. Compared with a placebo, cocaine yielded improved accuracy, quicker reaction times and an increased prefrontal NoGo-P3 ERP. Cannabis produced opposing results; slower reaction times, impaired accuracy and a reduction in the amplitude of the prefrontal NoGo-P3. Cannabis in addition decreased the amplitude of the parietally recorded P3, while cocaine did not affect this. Neither drugs specifically affected the N2 component, suggesting that pre-motor response inhibitory processes remain unaffected. Neither trait impulsivity nor novelty seeking interacted with drug-induced effects on measures of response inhibition. We conclude that acute drug effects on response inhibition seem to be specific to the later, evaluative stages of response inhibition. The acute effects of cannabis appeared less specific to response inhibition than those of cocaine. Together, the results show that the behavioural effects on response inhibition are reflected in electrophysiological correlates. This study did not support a substantial role of vulnerability personality traits in the acute intoxication stage.
Collapse
Affiliation(s)
- Desirée B. Spronk
- Department of Psychiatry; Radboud University Medical Centre; Nijmegen The Netherlands
- Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen; Nijmegen The Netherlands
| | - Ellen R. A. De Bruijn
- Department of Clinical Psychology, Leiden Institute for Brain and Cognition; Leiden University; Leiden The Netherlands
| | - Janelle H. P. van Wel
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - Robbert J. Verkes
- Department of Psychiatry; Radboud University Medical Centre; Nijmegen The Netherlands
- Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen; Nijmegen The Netherlands
- Pompestichting for Forensic Psychiatry; Nijmegen The Netherlands
| |
Collapse
|
30
|
Rentzsch J, Stadtmann A, Montag C, Kunte H, Plöckl D, Hellweg R, Gallinat J, Kronenberg G, Jockers-Scherübl MC. Attentional dysfunction in abstinent long-term cannabis users with and without schizophrenia. Eur Arch Psychiatry Clin Neurosci 2016; 266:409-21. [PMID: 26182894 DOI: 10.1007/s00406-015-0616-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 07/07/2015] [Indexed: 01/24/2023]
Abstract
Long-term cannabis use may confer cognitive deficits and increased risk of psychosis. However, the relationship between cannabis use and schizophrenia is complex. In particular, little is known about the effects of chronic cannabis use on the attention-related electric brain response in schizophrenia. We investigated auditory novelty and oddball P300 evoked potentials in a mixed sample of first-episode and chronic schizophrenic patients and healthy controls with (SZCA, n = 20; COCA, n = 20, abstinence ≥28 days) or without (SZ, n = 20; CO, n = 20) chronic cannabis use. Duration of regular cannabis use was 8.3 ± 5.6 (SZCA) and 9.1 ± 7.1 (COCA) years. In general, schizophrenic patients showed reduced P300 amplitudes. Cannabis use was associated with both a reduced early and late left-hemispheric novelty P300. There was a significant 'diagnosis × cannabis' interaction for the left-hemispheric late novelty P300 in that cannabis use was associated with a reduced amplitude in the otherwise healthy but not in the schizophrenic group compared with their relative control groups (corrected p < 0.02; p > 0.9, respectively). The left-hemispheric late novelty P300 in the otherwise healthy cannabis group correlated inversely with amount and duration of cannabis use (r = -0.50, p = 0.024; r = -0.57, p = 0.009, respectively). Our study confirms attentional deficits with chronic cannabis use. However, cannabis use may lead to different cognitive sequelae in patients with schizophrenia and in healthy controls, possibly reflecting preexisting alterations in the endocannabinoid system in schizophrenia.
Collapse
Affiliation(s)
- Johannes Rentzsch
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
| | - Ada Stadtmann
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050, Berlin, Germany
| | - Christiane Montag
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.,Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Große Hamburger Straße 5-11, 10115, Berlin, Germany
| | - Hagen Kunte
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Doris Plöckl
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Rainer Hellweg
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Jürgen Gallinat
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Golo Kronenberg
- Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | | |
Collapse
|
31
|
Sherif M, Radhakrishnan R, D'Souza DC, Ranganathan M. Human Laboratory Studies on Cannabinoids and Psychosis. Biol Psychiatry 2016; 79:526-38. [PMID: 26970363 DOI: 10.1016/j.biopsych.2016.01.011] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/14/2016] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
Abstract
Some of the most compelling evidence supporting an association between cannabinoid agonists and psychosis comes from controlled laboratory studies in humans. Randomized, double-blind, placebo-controlled, crossover laboratory studies demonstrate that cannabinoid agonists, including phytocannabinoids and synthetic cannabinoids, produce a wide range of positive, negative, and cognitive symptoms and psychophysiologic deficits in healthy human subjects that resemble the phenomenology of schizophrenia. These effects are time locked to drug administration, are dose related, and are transient and rarely necessitate intervention. The magnitude of effects is similar to the effects of ketamine but qualitatively distinct from other psychotomimetic drugs, including ketamine, amphetamine, and salvinorin A. Cannabinoid agonists have also been shown to transiently exacerbate symptoms in individuals with schizophrenia in laboratory studies. Patients with schizophrenia are more vulnerable than healthy control subjects to the acute behavioral and cognitive effects of cannabinoid agonists and experience transient exacerbation of symptoms despite treatment with antipsychotic medications. Furthermore, laboratory studies have failed to demonstrate any "beneficial" effects of cannabinoid agonists in individuals with schizophrenia-challenging the cannabis self-medication hypothesis. Emerging evidence suggests that polymorphisms of several genes related to dopamine metabolism (e.g., COMT, DAT1, and AKT1) may moderate the effects of cannabinoid agonists in laboratory studies. Cannabinoid agonists induce dopamine release, although the magnitude of release does not appear to be commensurate to the magnitude and spectrum of their acute psychotomimetic effects. Interactions between the endocannabinoid, gamma-aminobutyric acid, and glutamate systems and their individual and interactive effects on neural oscillations provide a plausible mechanism underlying the psychotomimetic effects of cannabinoids.
Collapse
Affiliation(s)
- Mohamed Sherif
- Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Rajiv Radhakrishnan
- Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Deepak Cyril D'Souza
- Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Mohini Ranganathan
- Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| |
Collapse
|
32
|
Ayhan Y, McFarland R, Pletnikov MV. Animal models of gene-environment interaction in schizophrenia: A dimensional perspective. Prog Neurobiol 2015; 136:1-27. [PMID: 26510407 DOI: 10.1016/j.pneurobio.2015.10.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 09/07/2015] [Accepted: 10/22/2015] [Indexed: 12/12/2022]
Abstract
Schizophrenia has long been considered as a disorder with multifactorial origins. Recent discoveries have advanced our understanding of the genetic architecture of the disease. However, even with the increase of identified risk variants, heritability estimates suggest an important contribution of non-genetic factors. Various environmental risk factors have been proposed to play a role in the etiopathogenesis of schizophrenia. These include season of birth, maternal infections, obstetric complications, adverse events at early childhood, and drug abuse. Despite the progress in identification of genetic and environmental risk factors, we still have a limited understanding of the mechanisms whereby gene-environment interactions (G × E) operate in schizophrenia and psychoses at large. In this review we provide a critical analysis of current animal models of G × E relevant to psychotic disorders and propose that dimensional perspective will advance our understanding of the complex mechanisms of these disorders.
Collapse
Affiliation(s)
- Yavuz Ayhan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; Hacettepe University Faculty of Medicine, Department of Psychiatry, Turkey
| | - Ross McFarland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, USA
| | - Mikhail V Pletnikov
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; Solomon H Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, USA; Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, USA; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, USA.
| |
Collapse
|
33
|
Impey D, El-Marj N, Parks A, Choueiry J, Fisher D, Knott VJ. Mismatch negativity in tobacco-naïve cannabis users and its alteration with acute nicotine administration. Pharmacol Biochem Behav 2015; 136:73-81. [PMID: 26188167 DOI: 10.1016/j.pbb.2015.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 11/29/2022]
Abstract
Chronic cannabis use may interact with factors, such as age of onset of cannabis use, family history, and genetic factors, to elicit schizophrenia (SZ)-like symptoms, including sensory and cognitive deficits. However, evidence of a relationship between cannabis use and cognitive impairment is confounded by concomitant use of tobacco. The objective of this study was to compare tobacco-naïve cannabis users with individuals without a history of tobacco/cannabis use on the auditory mismatch negativity (MMN) event-related potential (ERP), a neural measure of auditory deviance detection which is diminished in SZ. An exploratory arm of the study, conducted within a randomized, double-blind, placebo controlled design, examined the acute effects of nicotine gum (6mg) on MMN in cannabis users. MMN was recorded in response to 5 deviant stimuli within an optimal MMN paradigm in 44 healthy, non-tobacco smoking volunteers aged 18-26. Cannabis users (n=21) started smoking cannabis prior to age 17, at least 1 joint per month. To examine the effects of chronicity, users were grouped into relatively heavy long-term (HLT; n=11) users and light short-term (LST; n=10) users. Impaired deviance detection was shown in cannabis users vs. nonusers as reflected by a smaller MMN to duration deviants. Chronicity of use was also associated with MMN alterations, as HLTs displayed a reduced duration and gap MMN vs. LSTs. Compared with placebo, nicotine treatment enhanced select MMN deviants in cannabis user subgroups. As deficits associated with early and persistent cannabis use are similar to those seen in SZ, these dose-dependant disturbances in early sensory processing with cannabis use may be one cognitive pathway which mediates an increased risk for SZ in vulnerable youth, and be influenced by concurrent cigarette smoking behavior.
Collapse
Affiliation(s)
- Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Nicole El-Marj
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Andrea Parks
- Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Verner J Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
34
|
GABA Deficits Enhance the Psychotomimetic Effects of Δ9-THC. Neuropsychopharmacology 2015; 40:2047-56. [PMID: 25728472 PMCID: PMC4839528 DOI: 10.1038/npp.2015.58] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 02/09/2015] [Accepted: 02/18/2015] [Indexed: 11/08/2022]
|
35
|
Iseger TA, Bossong MG. A systematic review of the antipsychotic properties of cannabidiol in humans. Schizophr Res 2015; 162:153-61. [PMID: 25667194 DOI: 10.1016/j.schres.2015.01.033] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 12/25/2022]
Abstract
Despite extensive study over the past decades, available treatments for schizophrenia are only modestly effective and cause serious metabolic and neurological side effects. Therefore, there is an urgent need for novel therapeutic targets for the treatment of schizophrenia. A highly promising new pharmacological target in the context of schizophrenia is the endocannabinoid system. Modulation of this system by the main psychoactive component in cannabis, Δ9-tetrahydrocannabinol (THC), induces acute psychotic effects and cognitive impairment. However, the non-psychotropic, plant-derived cannabinoid agent cannabidiol (CBD) may have antipsychotic properties, and thus may be a promising new agent in the treatment of schizophrenia. Here we review studies that investigated the antipsychotic properties of CBD in human subjects. Results show the ability of CBD to counteract psychotic symptoms and cognitive impairment associated with cannabis use as well as with acute THC administration. In addition, CBD may lower the risk for developing psychosis that is related to cannabis use. These effects are possibly mediated by opposite effects of CBD and THC on brain activity patterns in key regions implicated in the pathophysiology of schizophrenia, such as the striatum, hippocampus and prefrontal cortex. The first small-scale clinical studies with CBD treatment of patients with psychotic symptoms further confirm the potential of CBD as an effective, safe and well-tolerated antipsychotic compound, although large randomised clinical trials will be needed before this novel therapy can be introduced into clinical practice.
Collapse
Affiliation(s)
- Tabitha A Iseger
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | - Matthijs G Bossong
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| |
Collapse
|
36
|
Taffe MA, Creehan KM, Vandewater SA. Cannabidiol fails to reverse hypothermia or locomotor suppression induced by Δ(9) -tetrahydrocannabinol in Sprague-Dawley rats. Br J Pharmacol 2015; 172:1783-91. [PMID: 25425111 DOI: 10.1111/bph.13024] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/17/2014] [Accepted: 11/18/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND PURPOSE Growing evidence shows cannabidiol (CBD) modulates some of the effects of Δ(9) -tetrahydrocannabinol (THC). CBD is a constituent of some strains of recreational cannabis but its content is highly variable. High CBD strains may have less memory-impairing effects than low-CBD strains and CBD can reverse behavioural effects of THC in monkeys. CBD/THC interactions in rodents are more complicated as CBD can attenuate or exacerbate the effects of THC. This study was undertaken to determine if CBD could reverse hypothermia or hypolocomotor effects caused by THC in rats. EXPERIMENTAL APPROACHES Male Sprague-Dawley rats were prepared with radiotelemetry devices and then given doses of THC (10-30 mg·kg(-1) , i.p.) with or without CBD. Experiments determined the effect of simultaneous or 30 min pretreatment with CBD in a 1:1 ratio with THC, as well as the effect of CBD in a 3:1 ratio. Additional experiments determined the effects of pretreatment with the cannabinoid CB1 receptor antagonist SR141716 (rimonabant). KEY RESULTS CBD did not attentuate THC-induced hypothermia or hypolocomotion but instead exaggerated these effects in some conditions. The antagonist SR141716 blocked hypolocomotor effects of THC for the first hour after injection and the hypothermia for 6 h; thus validating the pharmacological model. CONCLUSIONS AND IMPLICATIONS There is no evidence from this study that elevated CBD content in cannabis could provide protection from the physiological effects of THC, in rats.
Collapse
Affiliation(s)
- Michael A Taffe
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, USA
| | | | | |
Collapse
|
37
|
Wright MJ, Vandewater SA, Taffe MA. Cannabidiol attenuates deficits of visuospatial associative memory induced by Δ(9) tetrahydrocannabinol. Br J Pharmacol 2014; 170:1365-73. [PMID: 23550724 DOI: 10.1111/bph.12199] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 03/05/2013] [Accepted: 03/15/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Recent human studies suggest that recreational cannabis strains that are relatively high in cannabidiol (CBD) content produce less cognitive impairment than do strains with negligible CBD and similar Δ(9) tetrahydrocannabinol (THC) content. Self-selection in such studies means it is impossible to rule out additional variables which may determine both cannabis strain selection and basal cognitive performance level. Controlled laboratory studies can better determine a direct relationship. EXPERIMENTAL APPROACH In this study, adult male rhesus monkeys were assessed on visuospatial Paired Associates Learning and Self-Ordered Spatial Search memory tasks, as well as additional tests of motivation and manual dexterity. Subjects were challenged with THC (0.2, 0.5 mg·kg(-1) , i.m.) in randomized order and evaluated in the presence or absence of 0.5 mg·kg(-1) CBD. KEY RESULTS CBD attenuated the effects of THC on paired associates learning and a bimanual motor task without affecting the detrimental effects of THC on a Self-Ordered Spatial Search task of working memory. CBD did not significantly reverse THC-induced impairment of a progressive ratio or a rotating turntable task. CONCLUSIONS AND IMPLICATIONS This study provides direct evidence that CBD can oppose the cognitive-impairing effects of THC and that it does so in a task-selective manner when administered simultaneously in a 1:1 ratio with THC. The addition of CBD to THC-containing therapeutic products may therefore help to ameliorate unwanted cognitive side-effects. LINKED ARTICLE This article is commented on by Mechoulam and Parker, pp 1363-1364 of this issue. To view this commentary visit http://dx.doi.org/10.1111/bph.12400.
Collapse
Affiliation(s)
- M Jerry Wright
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, USA
| | | | | |
Collapse
|
38
|
Wilkinson ST, Radhakrishnan R, D'Souza DC. Impact of Cannabis Use on the Development of Psychotic Disorders. CURRENT ADDICTION REPORTS 2014; 1:115-128. [PMID: 25767748 DOI: 10.1007/s40429-014-0018-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The link between cannabis use and psychosis comprises three distinct relationships: acute psychosis associated with cannabis intoxication, acute psychosis that lasts beyond the period of acute intoxication, and persistent psychosis not time-locked to exposure. Experimental studies reveal that cannabis, tetrahydrocannabinol (THC) and synthetic cannabinoids reliably produce transient positive, negative, and cognitive symptoms in healthy volunteers. Case-studies indicate that cannabinoids can induce acute psychosis which lasts beyond the period of acute intoxication but resolves within a month. Exposure to cannabis in adolescence is associated with a risk for later psychotic disorder in adulthood; this association is consistent, temporally related, shows a dose-response, and is biologically plausible. However, cannabis is neither necessary nor sufficient to cause a persistent psychotic disorder. More likely it is a component cause that interacts with other factors to result in psychosis. The link between cannabis and psychosis is moderated by age at onset of cannabis use, childhood abuse and genetic vulnerability. While more research is needed to better characterize the relationship between cannabinoid use and the onset and persistence of psychosis, clinicians should be mindful of the potential risk of psychosis especially in vulnerable populations, including adolescents and those with a psychosis diathesis.
Collapse
Affiliation(s)
- Samuel T Wilkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA ; Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
39
|
Schubart CD, Sommer IEC, Fusar-Poli P, de Witte L, Kahn RS, Boks MPM. Cannabidiol as a potential treatment for psychosis. Eur Neuropsychopharmacol 2014; 24:51-64. [PMID: 24309088 DOI: 10.1016/j.euroneuro.2013.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/18/2022]
Abstract
Although cannabis use is associated with an increased risk of developing psychosis, the cannabis constituent cannabidiol (CBD) may have antipsychotic properties. This review concisely describes the role of the endocannabinoid system in the development of psychosis and provides an overview of currently available animal, human experimental, imaging, epidemiological and clinical studies that investigated the antipsychotic properties of CBD. In this targeted literature review we performed a search for English articles using Medline and EMBASE. Studies were selected if they described experiments with psychosis models, psychotic symptoms or psychotic disorders as outcome measure and involved the use of CBD as intervention. Evidence from several research domains suggests that CBD shows potential for antipsychotic treatment.
Collapse
Affiliation(s)
- C D Schubart
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - I E C Sommer
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - P Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - L de Witte
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - R S Kahn
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - M P M Boks
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands.
| |
Collapse
|
40
|
Radhakrishnan R, Wilkinson ST, D'Souza DC. Gone to Pot - A Review of the Association between Cannabis and Psychosis. Front Psychiatry 2014; 5:54. [PMID: 24904437 PMCID: PMC4033190 DOI: 10.3389/fpsyt.2014.00054] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/02/2014] [Indexed: 01/01/2023] Open
Abstract
Cannabis is the most commonly used illicit drug worldwide, with ~5 million daily users worldwide. Emerging evidence supports a number of associations between cannabis and psychosis/psychotic disorders, including schizophrenia. These associations-based on case-studies, surveys, epidemiological studies, and experimental studies indicate that cannabinoids can produce acute, transient effects; acute, persistent effects; and delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in schizophrenia. Acute exposure to both cannabis and synthetic cannabinoids (Spice/K2) can produce a full range of transient psychotomimetic symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to symptoms of schizophrenia. In individuals with an established psychotic disorder, cannabinoids can exacerbate symptoms, trigger relapse, and have negative consequences on the course of the illness. Several factors appear to moderate these associations, including family history, genetic factors, history of childhood abuse, and the age at onset of cannabis use. Exposure to cannabinoids in adolescence confers a higher risk for psychosis outcomes in later life and the risk is dose-related. Individuals with polymorphisms of COMT and AKT1 genes may be at increased risk for psychotic disorders in association with cannabinoids, as are individuals with a family history of psychotic disorders or a history of childhood trauma. The relationship between cannabis and schizophrenia fulfills many but not all of the standard criteria for causality, including temporality, biological gradient, biological plausibility, experimental evidence, consistency, and coherence. At the present time, the evidence indicates that cannabis may be a component cause in the emergence of psychosis, and this warrants serious consideration from the point of view of public health policy.
Collapse
Affiliation(s)
- Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Samuel T Wilkinson
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center , New Haven, CT , USA ; Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System , West Haven, CT , USA
| |
Collapse
|
41
|
Have the genetics of cannabis involvement gone to pot? NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 2014; 61:71-108. [PMID: 25306780 DOI: 10.1007/978-1-4939-0653-6_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
42
|
Fridberg DJ, Skosnik PD, Hetrick WP, O’Donnell BF. Neural correlates of performance monitoring in chronic cannabis users and cannabis-naive controls. J Psychopharmacol 2013; 27:515-25. [PMID: 23427191 PMCID: PMC3923357 DOI: 10.1177/0269881113477745] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic cannabis use is associated with residual negative effects on measures of executive functioning. However, little previous work has focused specifically on executive processes involved in performance monitoring in frequent cannabis users. The present study investigated event-related potential (ERP) correlates of performance monitoring in chronic cannabis users. The error-related negativity (ERN) and error positivity (Pe), ERPs sensitive to performance monitoring, were recorded from 30 frequent cannabis users (mean usage=5.52 days/week) and 32 cannabis-naïve control participants during a speeded stimulus discrimination task. The "oddball" P3 ERP was recorded as well. Users and controls did not differ on the amplitude or latency of the ERN; however, Pe amplitude was larger among users. Users also showed increased amplitude and reduced latency of the P3 in response to infrequent stimuli presented during the task. Among users, urinary cannabinoid metabolite levels at testing were unrelated to ERP outcomes. However, total years of cannabis use correlated negatively with P3 latency and positively with P3 amplitude, and age of first cannabis use correlated negatively with P3 amplitude. The results of this study suggest that chronic cannabis use is associated with alterations in neural activity related to the processing of motivationally-relevant stimuli (P3) and errors (Pe).
Collapse
Affiliation(s)
- Daniel J Fridberg
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA.
| | - Patrick D Skosnik
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | - Brian F O’Donnell
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| |
Collapse
|
43
|
Effects of cannabis use on event related potentials in subjects at ultra high risk for psychosis and healthy controls. Int J Psychophysiol 2013; 88:149-56. [DOI: 10.1016/j.ijpsycho.2013.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 02/18/2013] [Accepted: 03/20/2013] [Indexed: 01/10/2023]
|
44
|
Dose-related modulation of event-related potentials to novel and target stimuli by intravenous Δ⁹-THC in humans. Neuropsychopharmacology 2012; 37:1632-46. [PMID: 22334121 PMCID: PMC3358754 DOI: 10.1038/npp.2012.8] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cannabinoids induce a host of perceptual alterations and cognitive deficits in humans. However, the neural correlates of these deficits have remained elusive. The current study examined the acute, dose-related effects of delta-9-tetrahydrocannabinol (Δ⁹-THC) on psychophysiological indices of information processing in humans. Healthy subjects (n=26) completed three test days during which they received intravenous Δ⁹-THC (placebo, 0.015 and 0.03 mg/kg) in a within-subject, double-blind, randomized, cross-over, and counterbalanced design. Psychophysiological data (electroencephalography) were collected before and after drug administration while subjects engaged in an event-related potential (ERP) task known to be a valid index of attention and cognition (a three-stimulus auditory 'oddball' P300 task). Δ⁹-THC dose-dependently reduced the amplitude of both the target P300b and the novelty P300a. Δ⁹-THC did not have any effect on the latency of either the P300a or P300b, or on early sensory-evoked ERP components preceding the P300 (the N100). Concomitantly, Δ⁹-THC induced psychotomimetic effects, perceptual alterations, and subjective 'high' in a dose-dependent manner. Δ⁹-THC -induced reductions in P3b amplitude correlated with Δ⁹-THC-induced perceptual alterations. Lastly, exploratory analyses examining cannabis use status showed that whereas recent cannabis users had blunted behavioral effects to Δ(9)-THC, there were no dose-related effects of Δ⁹-THC on P300a/b amplitude between cannabis-free and recent cannabis users. Overall, these data suggest that at doses that produce behavioral and subjective effects consistent with the known properties of cannabis, Δ⁹-THC reduced P300a and P300b amplitudes without altering the latency of these ERPs. Cannabinoid agonists may therefore disrupt cortical processes responsible for context updating and the automatic orientation of attention, while leaving processing speed and earlier sensory ERP components intact. Collectively, the findings suggest that CB1R systems modulate top-down and bottom-up processing.
Collapse
|
45
|
Cannabidiol in humans-the quest for therapeutic targets. Pharmaceuticals (Basel) 2012; 5:529-52. [PMID: 24281562 PMCID: PMC3763649 DOI: 10.3390/ph5050529] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 05/14/2012] [Accepted: 05/15/2012] [Indexed: 12/20/2022] Open
Abstract
Cannabidiol (CBD), a major phytocannabinoid constituent of cannabis, is attracting growing attention in medicine for its anxiolytic, antipsychotic, antiemetic and anti-inflammatory properties. However, up to this point, a comprehensive literature review of the effects of CBD in humans is lacking. The aim of the present systematic review is to examine the randomized and crossover studies that administered CBD to healthy controls and to clinical patients. A systematic search was performed in the electronic databases PubMed and EMBASE using the key word “cannabidiol”. Both monotherapy and combination studies (e.g., CBD + ∆9-THC) were included. A total of 34 studies were identified: 16 of these were experimental studies, conducted in healthy subjects, and 18 were conducted in clinical populations, including multiple sclerosis (six studies), schizophrenia and bipolar mania (four studies), social anxiety disorder (two studies), neuropathic and cancer pain (two studies), cancer anorexia (one study), Huntington’s disease (one study), insomnia (one study), and epilepsy (one study). Experimental studies indicate that a high-dose of inhaled/intravenous CBD is required to inhibit the effects of a lower dose of ∆9-THC. Moreover, some experimental and clinical studies suggest that oral/oromucosal CBD may prolong and/or intensify ∆9-THC-induced effects, whereas others suggest that it may inhibit ∆9-THC-induced effects. Finally, preliminary clinical trials suggest that high-dose oral CBD (150–600 mg/d) may exert a therapeutic effect for social anxiety disorder, insomnia and epilepsy, but also that it may cause mental sedation. Potential pharmacokinetic and pharmacodynamic explanations for these results are discussed.
Collapse
|
46
|
van Dijk D, Koeter MWJ, Hijman R, Kahn RS, van den Brink W. Effect of cannabis use on the course of schizophrenia in male patients: a prospective cohort study. Schizophr Res 2012; 137:50-7. [PMID: 22313726 DOI: 10.1016/j.schres.2012.01.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 12/27/2011] [Accepted: 01/14/2012] [Indexed: 10/14/2022]
Abstract
BACKGROUND Findings on the impact of cannabis use on the course of schizophrenia are inconsistent and not conclusive. AIMS To study the effect of cannabis use on the course of schizophrenia taking into account the effects of the quantity of cannabis use and important confounders. METHODS Prospective cohort study with assessments of symptoms, confounders and hospitalizations at baseline, 6 month and 12 month follow up. RESULTS In a representative cohort of 145 male patients with schizophrenia, 68 (46.9%) used cannabis. Mean age at onset of schizophrenia in cannabis using patients was significantly lower than in non-cannabis using patients. No other cross-sectional demographic or clinical differences were observed between users and non-users. In a series of longitudinal analyses, cannabis use was not associated with differences in psychopathology, but relapse in terms of the number of hospitalizations was significantly higher in cannabis using patients compared to non-cannabis using patients. CONCLUSIONS Patients with schizophrenia using cannabis are more frequently hospitalized than non-cannabis using patients but do not differ with respect to psychopathology. Possible explanations for these findings are discussed.
Collapse
Affiliation(s)
- Daniel van Dijk
- General Mental Health Institute Duin en Bosch, Duinenbosch 3, 1901AH, Castricum, The Netherlands.
| | | | | | | | | |
Collapse
|
47
|
van Hell HH, Jager G, Bossong MG, Brouwer A, Jansma JM, Zuurman L, van Gerven J, Kahn RS, Ramsey NF. Involvement of the endocannabinoid system in reward processing in the human brain. Psychopharmacology (Berl) 2012; 219:981-90. [PMID: 21822593 PMCID: PMC3266503 DOI: 10.1007/s00213-011-2428-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 07/25/2011] [Indexed: 11/30/2022]
Abstract
RATIONALE Disturbed reward processing in humans has been associated with a number of disorders, such as depression, addiction, and attention-deficit hyperactivity disorder. The endocannabinoid (eCB) system has been implicated in reward processing in animals, but in humans, the relation between eCB functioning and reward is less clear. OBJECTIVES The current study uses functional magnetic resonance imaging (fMRI) to investigate the role of the eCB system in reward processing in humans by examining the effect of the eCB agonist Δ(9)-tetrahydrocannabinol (THC) on reward-related brain activity. METHODS Eleven healthy males participated in a randomized placebo-controlled pharmacological fMRI study with administration of THC to challenge the eCB system. We compared anticipatory and feedback-related brain activity after placebo and THC, using a monetary incentive delay task. In this task, subjects are notified before each trial whether a correct response is rewarded ("reward trial") or not ("neutral trial"). RESULTS Subjects showed faster reaction times during reward trials compared to neutral trials, and this effect was not altered by THC. THC induced a widespread attenuation of the brain response to feedback in reward trials but not in neutral trials. Anticipatory brain activity was not affected. CONCLUSIONS These results suggest a role for the eCB system in the appreciation of rewards. The involvement of the eCB system in feedback processing may be relevant for disorders in which appreciation of natural rewards may be affected such as addiction.
Collapse
Affiliation(s)
- Hendrika H. van Hell
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Gerry Jager
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Matthijs G. Bossong
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Annelies Brouwer
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - J. Martijn Jansma
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | | | | | - René S. Kahn
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick F. Ramsey
- Department of Neurology and Neurosurgery, G.03.124, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| |
Collapse
|
48
|
Neurophysiological functioning of occasional and heavy cannabis users during THC intoxication. Psychopharmacology (Berl) 2012; 220:341-50. [PMID: 21975580 PMCID: PMC3285765 DOI: 10.1007/s00213-011-2479-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 08/31/2011] [Indexed: 11/08/2022]
Abstract
RATIONALE Experienced cannabis users demonstrate tolerance to some of the impairing acute effects of cannabis. OBJECTIVES The present study investigates whether event-related potentials (ERPs) differ between occasional and heavy cannabis users after acute Δ9-tetrahydrocannabinol (THC) administration, as a result of tolerance. METHODS Twelve occasional and 12 heavy cannabis users participated in a double-blind, placebo-controlled, crossover study. On two separate days, they smoked a joint containing 0 or 500 μg/kg body weight THC. ERPs were measured while subjects performed a divided attention task (DAT) and stop signal task (SST). RESULTS In the DAT, THC significantly decreased P100 amplitude in occasional but not in heavy cannabis users. P300 amplitude in the DAT was significantly decreased by THC in both groups. The N200 peak in the SST was not affected by treatment in neither of the groups. Performance in the SST was impaired in both groups after THC treatment, whereas performance in the DAT was impaired by THC only in the occasional users group. CONCLUSIONS The present study confirms that heavy cannabis users develop tolerance to some of the impairing behavioral effects of cannabis. This tolerance was also evident in the underlying ERPs, suggesting that tolerance demonstrated on performance level is not (completely) due to behavioral compensation.
Collapse
|
49
|
Hillard CJ, Weinlander KM, Stuhr KL. Contributions of endocannabinoid signaling to psychiatric disorders in humans: genetic and biochemical evidence. Neuroscience 2011; 204:207-29. [PMID: 22123166 DOI: 10.1016/j.neuroscience.2011.11.020] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/05/2011] [Accepted: 11/08/2011] [Indexed: 11/28/2022]
Abstract
The endocannabinoid signaling system is a widespread, neuromodulatory system in brain and is also widely utilized in the periphery to modulate metabolic functions and the immune system. Preclinical data demonstrate that endocannabinoid signaling is an important stress buffer and modulates emotional and cognitive functions. These data suggest the hypothesis that endocannabinoid signaling could be dysfunctional in a number of mental disorders. Genetic polymorphisms in the human genes for two important proteins of the endocannabinoid signaling system, the CB1 cannabinoid receptor (CB1R) and fatty acid amide hydrolase (FAAH), have been explored in the context of normal and pathological conditions. In the case of the gene for FAAH, the mechanistic relationships among the common genetic polymorphism, the expression of the FAAH protein, and its likely impact on endocannabinoid signaling are understood. However, multiple polymorphisms in the gene for the CB1R occur and are associated with human phenotypic differences without an understanding of the functional relationships among the gene, mRNA, protein, and protein function. The endocannabinoid ligands are found in the circulation, and several studies have identified changes in their concentrations under various conditions. These data are reviewed for the purpose of generating hypotheses and to encourage further studies in this very interesting and important area.
Collapse
Affiliation(s)
- C J Hillard
- Department of Pharmacology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | | | |
Collapse
|
50
|
Rentzsch J, Buntebart E, Stadelmeier A, Gallinat J, Jockers-Scherübl MC. Differential effects of chronic cannabis use on preattentional cognitive functioning in abstinent schizophrenic patients and healthy subjects. Schizophr Res 2011; 130:222-7. [PMID: 21624823 DOI: 10.1016/j.schres.2011.05.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 05/08/2011] [Accepted: 05/16/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A number of studies indicate a higher risk for psychosis as well as for neurocognitive deficits in healthy cannabis users. However, little is known about the impact of cannabis use on outcome in schizophrenia. In fact, there is growing evidence that cannabis-using schizophrenic patients may show preserved or even better neurocognitive performance compared to schizophrenic non-users. METHODS We measured mismatch negativity (MMN) to investigate preattentional neurocognitive functioning in long-term abstinent chronic cannabis users with (SZCA n=27) and without schizophrenia (COCA n=32) compared to schizophrenic patients (SZ n=26) and healthy controls (CO n=34) without any chronic drug use. RESULTS Healthy cannabis users showed reduced frontal MMN compared to controls (p=0.036). In contrast, cannabis-using schizophrenic patients showed increased frontal MMN compared to schizophrenic patients without cannabis use (p=0.038). Comparing non-cannabis users, schizophrenic patients showed reduced frontal MMN (p=0.001). No significant differences were found between CO and SZCA (p=0.27), and COCA and SZCA (p=0.50). CONCLUSION Results suggest that chronic cannabis use may have different effects on preattentional neurocognitive functioning in schizophrenic patients when compared to healthy subjects. This may be related to preexisting differences in the endocannabinoid system between schizophrenic patients and healthy subjects. However, due to the naturalistic design of the study, the results must be interpreted with caution.
Collapse
Affiliation(s)
- Johannes Rentzsch
- Charité-Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Mitte, Charitéplatz 1, 10177 Berlin, Germany.
| | | | | | | | | |
Collapse
|