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Audi D, Hajeer S, Saab MB, Saab L, Harati H, Desoutter A, Al Ahmar E, Estephan E. Effects of Cannabis Use on Neurocognition: A Scoping Review of MRI Studies. J Psychoactive Drugs 2024:1-17. [PMID: 38944688 DOI: 10.1080/02791072.2024.2372377] [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: 11/28/2023] [Accepted: 05/06/2024] [Indexed: 07/01/2024]
Abstract
Cannabis is one of the most commonly utilized recreational drugs. However, increasing evidence from the literature suggests harmful implications on cognition. Thus, the main aim of the current review is to summarize literature findings pertaining to the impact of cannabis on neurocognitive skills, focusing on the imaging biomarkers provided by MRI. Two reviewers navigated the literature independently using four main search engines including PubMed and Cochrane. Articles were first evaluated through their title and abstract, followed by full-text assessment. Study characteristics and findings were extracted, and the studies' quality was appraised. 47 articles were included. The majority of the studies were of a case-control design (66%), and the most studied neurocognitive skill was memory (40.4%). With task-based fMRI being the most commonly utilized MRI technique, findings have shown significantly varying decreased and increased neuronal activity within brain regions associated with the cognitive tasks performed. Results suggest that cannabis users are significantly suffering from cognitive deficits. The major significance of this review is attributed to highlighting the role of MRI. Future research needs to delve more into validating the negative effects of cannabis, to enable stakeholders to take action to limit cannabis usage, to foster public health and wellbeing.
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Affiliation(s)
- Dima Audi
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Shorouk Hajeer
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Marie-Belle Saab
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Pedagogy, Lebanese University, Furn-El-Chebbak, Lebanon
| | - Lea Saab
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Hayat Harati
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Muscat University, Muscat, Sultanate of Oman
| | | | - Elie Al Ahmar
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- School of Engineering, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Elias Estephan
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- LBN, University Montpellier, Montpellier, France
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Xu H, Li J, Huang H, Yin B, Li DD. Abnormal developmental of structural covariance networks in young adults with heavy cannabis use: a 3-year follow-up study. Transl Psychiatry 2024; 14:45. [PMID: 38245512 PMCID: PMC10799944 DOI: 10.1038/s41398-024-02764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Heavy cannabis use (HCU) exerts adverse effects on the brain. Structural covariance networks (SCNs) that illustrate coordinated regional maturation patterns are extensively employed to examine abnormalities in brain structure. Nevertheless, the unexplored aspect remains the developmental alterations of SCNs in young adults with HCU for three years, from the baseline (BL) to the 3-year follow-up (FU). These changes demonstrate dynamic development and hold potential as biomarkers. A total of 20 young adults with HCU and 22 matched controls were recruited. All participants underwent magnetic resonance imaging (MRI) scans at both the BL and FU and were evaluated using clinical measures. Both groups used cortical thickness (CT) and cortical surface area (CSA) to construct structural covariance matrices. Subsequently, global and nodal network measures of SCNs were computed based on these matrices. Regarding global network measures, the BL assessment revealed significant deviations in small-worldness and local efficiency of CT and CSA in young adults with HCU compared to controls. However, no significant differences between the two groups were observed at the FU evaluation. Young adults with HCU displayed changes in nodal network measures across various brain regions during the transition from BL to FU. These alterations included abnormal nodal degree, nodal efficiency, and nodal betweenness in widespread areas such as the entorhinal cortex, superior frontal gyrus, and parahippocampal cortex. These findings suggest that the topography of CT and CSA plays a role in the typical structural covariance topology of the brain. Furthermore, these results indicate the effect of HCU on the developmental changes of SCNs in young adults.
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Affiliation(s)
- Hui Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325007, China.
| | - Jiahao Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Huang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan-Dong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
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Ertl N, Lawn W, Mokrysz C, Freeman TP, Alnagger N, Borissova A, Fernandez-Vinson N, Lees R, Ofori S, Petrilli K, Trinci K, Viding E, Curran HV, Wall MB. Associations between regular cannabis use and brain resting-state functional connectivity in adolescents and adults. J Psychopharmacol 2023; 37:904-919. [PMID: 37515469 DOI: 10.1177/02698811231189441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND/AIM Cannabis use is highly prevalent in adolescents; however, little is known about its effects on adolescent brain function. METHOD Resting-state functional magnetic resonance imaging was used in matched groups of regular cannabis users (N = 70, 35 adolescents: 16-17 years old, 35 adults: 26-29 years old) and non-regular-using controls (N = 70, 35 adolescents/35 adults). Pre-registered analyses examined the connectivity of seven major cortical and sub-cortical brain networks (default mode network, executive control network (ECN), salience network, hippocampal network and three striatal networks) using seed-based analysis methods with cross-sectional comparisons between user groups and age groups. RESULTS The regular cannabis use group (across both age groups), relative to controls, showed localised increases in connectivity only in the ECN analysis. All networks showed localised connectivity differences based on age group, with the adolescents generally showing weaker connectivity than adults, consistent with the developmental effects. Mean connectivity across entire network regions of interest (ROIs) was also significantly decreased in the ECN in adolescents. However, there were no significant interactions found between age group and user group in any of the seed-based or ROI analyses. There were also no associations found between cannabis use frequency and any of the derived connectivity measures. CONCLUSION Regular cannabis use is associated with changes in connectivity of the ECN, which may reflect allostatic or compensatory changes in response to regular cannabis intoxication. However, these associations were not significantly different in adolescents compared to adults.
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Affiliation(s)
- Natalie Ertl
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Will Lawn
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Naji Alnagger
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, University College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | | | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Essi Viding
- Clinical, Educational, and Health Psychology Research Department, University College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
- Clinical Psychopharmacology Unit, University College London, London, UK
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Lorenzetti V, McTavish E, Broyd S, van Hell H, Thomson D, Ganella E, Kottaram AR, Beale C, Martin J, Galettis P, Solowij N, Greenwood LM. Daily Cannabidiol Administration for 10 Weeks Modulates Hippocampal and Amygdalar Resting-State Functional Connectivity in Cannabis Users: A Functional Magnetic Resonance Imaging Open-Label Clinical Trial. Cannabis Cannabinoid Res 2023. [PMID: 37603080 DOI: 10.1089/can.2022.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Introduction: Cannabis use is associated with brain functional changes in regions implicated in prominent neuroscientific theories of addiction. Emerging evidence suggests that cannabidiol (CBD) is neuroprotective and may reverse structural brain changes associated with prolonged heavy cannabis use. In this study, we examine how an ∼10-week exposure of CBD in cannabis users affected resting-state functional connectivity in brain regions functionally altered by cannabis use. Materials and Methods: Eighteen people who use cannabis took part in a ∼10 weeks open-label pragmatic trial of self-administered daily 200 mg CBD in capsules. They were not required to change their cannabis exposure patterns. Participants were assessed at baseline and post-CBD exposure with structural magnetic resonance imaging (MRI) and a functional MRI resting-state task (eyes closed). Seed-based connectivity analyses were run to examine changes in the functional connectivity of a priori regions-the hippocampus and the amygdala. We explored if connectivity changes were associated with cannabinoid exposure (i.e., cumulative cannabis dosage over trial, and plasma CBD concentrations and Δ9-tetrahydrocannabinol (THC) plasma metabolites postexposure), and mental health (i.e., severity of anxiety, depression, and positive psychotic symptom scores), accounting for cigarette exposure in the past month, alcohol standard drinks in the past month and cumulative CBD dose during the trial. Results: Functional connectivity significantly decreased pre-to-post the CBD trial between the anterior hippocampus and precentral gyrus, with a strong effect size (d=1.73). Functional connectivity increased between the amygdala and the lingual gyrus pre-to-post the CBD trial, with a strong effect size (d=1.19). There were no correlations with cannabinoids or mental health symptom scores. Discussion: Prolonged CBD exposure may restore/reduce functional connectivity differences reported in cannabis users. These new findings warrant replication in a larger sample, using robust methodologies-double-blind and placebo-controlled-and in the most vulnerable people who use cannabis, including those with more severe forms of Cannabis Use Disorder and experiencing worse mental health outcomes (e.g., psychosis, depression).
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Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Samantha Broyd
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Hendrika van Hell
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Diny Thomson
- Turner Institute for Brain and Mental Health, School of Psychological Science, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Eleni Ganella
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Carlton South, Victoria, Australia
- Orygen, the National Center of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Akhil Raja Kottaram
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Center, School of Health and Behavioral Sciences, Australian Catholic University, Melbourne, Victoria, Australia
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Carlton South, Victoria, Australia
| | - Camilla Beale
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jennifer Martin
- John Hunter Hospital, Newcastle, New South Wales, Australia
- Center for Drug Repurposing and Medicines Research, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Peter Galettis
- Center for Drug Repurposing and Medicines Research, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
| | - Lisa-Marie Greenwood
- The Australian Center for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, New South Wales, Australia
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
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5
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Gazula H, Rootes-Murdy K, Holla B, Basodi S, Zhang Z, Verner E, Kelly R, Murthy P, Chakrabarti A, Basu D, Bhagyalakshmi Nanjayya S, Lenin Singh R, Lourembam Singh R, Kalyanram K, Kartik K, Kalyanaraman K, Ghattu K, Kuriyan R, Kurpad SS, Barker GJ, Bharath RD, Desrivieres S, Purushottam M, Orfanos DP, Sharma E, Hickman M, Toledano M, Vaidya N, Banaschewski T, Bokde ALW, Flor H, Grigis A, Garavan H, Gowland P, Heinz A, Brühl R, Martinot JL, Paillére Martinot ML, Artiges E, Nees F, Paus T, Poustka L, Fröhner JH, Robinson L, Smolka MN, Walter H, Winterer J, Whelan R, Turner JA, Sarwate AD, Plis SM, Benegal V, Schumann G, Calhoun VD. Federated Analysis in COINSTAC Reveals Functional Network Connectivity and Spectral Links to Smoking and Alcohol Consumption in Nearly 2,000 Adolescent Brains. Neuroinformatics 2023; 21:287-301. [PMID: 36434478 DOI: 10.1007/s12021-022-09604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
With the growth of decentralized/federated analysis approaches in neuroimaging, the opportunities to study brain disorders using data from multiple sites has grown multi-fold. One such initiative is the Neuromark, a fully automated spatially constrained independent component analysis (ICA) that is used to link brain network abnormalities among different datasets, studies, and disorders while leveraging subject-specific networks. In this study, we implement the neuromark pipeline in COINSTAC, an open-source neuroimaging framework for collaborative/decentralized analysis. Decentralized exploratory analysis of nearly 2000 resting-state functional magnetic resonance imaging datasets collected at different sites across two cohorts and co-located in different countries was performed to study the resting brain functional network connectivity changes in adolescents who smoke and consume alcohol. Results showed hypoconnectivity across the majority of networks including sensory, default mode, and subcortical domains, more for alcohol than smoking, and decreased low frequency power. These findings suggest that global reduced synchronization is associated with both tobacco and alcohol use. This proof-of-concept work demonstrates the utility and incentives associated with large-scale decentralized collaborations spanning multiple sites.
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Affiliation(s)
- Harshvardhan Gazula
- Martinos Center for Biomedical Imaging, MGH and Harvard Medical School, Boston, USA.
| | - Kelly Rootes-Murdy
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
- Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Sunitha Basodi
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Zuo Zhang
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
| | - Eric Verner
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Ross Kelly
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Rajkumar Lenin Singh
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Roshan Lourembam Singh
- Department of Psychology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | | | | | - Krishnaveni Ghattu
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Bengaluru, India
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
| | | | | | - Eesha Sharma
- Department of Child & Adolescent Psychiatry, NIMHANS, Bengaluru, India
| | | | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Nilakshi Vaidya
- Centre for Addiction Medicine, NIMHANS, Bengaluru, India
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, 68159, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, 68131, Germany
| | | | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont, 05405, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
| | - Marie-Laure Paillére Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
- AP-HP. Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, 68159, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | - Tomás Paus
- Department of Psychiatry, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, Göttingen, 37075, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Lauren Robinson
- Department of Psychological Medicine, Section for Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jeanne Winterer
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Jessica A Turner
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Anand D Sarwate
- Department of Electrical and Computer Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Sergey M Plis
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, P.R. China
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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6
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Sullivan RM, Wallace AL, Stinson EA, Montoto KV, Kaiver CM, Wade NE, Lisdahl KM. Assessment of Withdrawal, Mood, and Sleep Inventories After Monitored 3-Week Abstinence in Cannabis-Using Adolescents and Young Adults. Cannabis Cannabinoid Res 2022; 7:690-699. [PMID: 34678051 PMCID: PMC9587800 DOI: 10.1089/can.2021.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction: Among adolescents and young adults, cannabis use is prevalent. Prior studies characterizing withdrawal effects in this age range have primarily included treatment seeking or comorbid psychiatric samples; these studies have identified several affected domains, especially sleep, mood, and anxiety. The present study compared a community (i.e., nontreatment seeking) sample of cannabis-using and control participants on mood, anxiety, sleep, and withdrawal inventories during the course of a monitored 3-week cannabis abstinence period. Materials and Methods: Seventy-nine adolescent and young adult participants (cannabis-using group=37 and control group=42) were recruited from the community to undergo 3 weeks of confirmed abstinence (i.e., urine and sweat patch toxicology) and completion of Cannabis Withdrawal Symptom Criteria, State-Trait Anxiety Inventory, Beck's Depression Inventory, and Pittsburgh Sleep Quality Index across the study period. Repeated measures and cross-sectional regressions were used to examine main effects of group and interactions with time (where appropriate), while accounting for recent alcohol use and cotinine levels. Results: Cannabis-using participants reported higher mood (p=0.006), overall withdrawal (p=0.009), and sleep-related withdrawal (p<0.001) symptoms across abstinence compared to controls. Overall withdrawal severity (p=0.04) and sleep-related withdrawal symptoms (p=0.02) demonstrated a quadratic trajectory across the monitored abstinence periods, with an increase from baseline and subsequent decreases in symptom severity. No differences of anxiety scores (p=0.07) or trajectories (p=0.18) were observed. By study completion, groups did not differ among sleep quality components (all p's>.05). Conclusions: These findings revealed that nontreatment-seeking cannabis-using adolescents and young adults reported heightened total withdrawal symptoms during a 3-week sustained abstinence period relative to controls. Cannabis-using participants demonstrated an increase in withdrawal symptom trajectory during the first week followed by decreased symptoms from weeks 2 to 3, which contrasts with prior linear decreases observed in cannabis-using adolescent and young adults. More mood symptoms were observed in the cannabis-using group even while excluding for comorbid psychopathologies-along with significantly more sleep problems during the abstinence period. Implications include the necessity to provide psychoeducation for recreational, nontreatment-seeking cannabis-using individuals about cannabis withdrawal, mood symptoms, and sleep quality difficulties when cannabis cessation is attempted, to improve likelihood of long-term sustained abstinence.
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Affiliation(s)
- Ryan M. Sullivan
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Alexander L. Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Elizabeth A. Stinson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Karina V. Montoto
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Christine M. Kaiver
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Natasha E. Wade
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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7
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Augustin SM, Lovinger DM. Synaptic changes induced by cannabinoid drugs and cannabis use disorder. Neurobiol Dis 2022; 167:105670. [DOI: 10.1016/j.nbd.2022.105670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022] Open
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8
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Thomson H, Labuschagne I, Greenwood LM, Robinson E, Sehl H, Suo C, Lorenzetti V. Is resting-state functional connectivity altered in regular cannabis users? A systematic review of the literature. Psychopharmacology (Berl) 2022; 239:1191-1209. [PMID: 34415377 DOI: 10.1007/s00213-021-05938-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/13/2021] [Indexed: 12/23/2022]
Abstract
RATIONALE Regular cannabis use has been associated with brain functional alterations within frontal, temporal, and striatal pathways assessed during various cognitive tasks. Whether such alterations are consistently reported in the absence of overt task performance needs to be elucidated to uncover the core neurobiological mechanisms of regular cannabis use. OBJECTIVES We aim to systematically review findings from studies that examine spontaneous fluctuations of brain function using functional Magnetic Resonance Imaging (fMRI) resting-state functional connectivity (rsFC) in cannabis users versus controls, and the association between rsFC and cannabis use chronicity, mental health symptoms, and cognitive performance. METHODS We conducted a PROSPERO registered systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched eight databases. RESULTS Twenty-one studies were included for review. Samples comprised 1396 participants aged 16 to 42 years, of which 737 were cannabis users and 659 were controls. Most studies found greater positive rsFC in cannabis users compared to controls between frontal-frontal, fronto-striatal, and fronto-temporal region pairings. The same region pairings were found to be preliminarily associated with varying measures of cannabis exposure. CONCLUSIONS The evidence to date shows that regular cannabis exposure is consistently associated with alteration of spontaneous changes in Blood Oxygenation Level-Dependent signal without any explicit cognitive input or output. These findings have implications for interpreting results from task-based fMRI studies of cannabis users, which may additionally tax overlapping networks. Future longitudinal rsFC fMRI studies are required to determine the clinical relevance of the findings and their link to the chronicity of use, mental health, and cognitive performance.
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Affiliation(s)
- Hannah Thomson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia
| | - Izelle Labuschagne
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia
| | - Lisa-Marie Greenwood
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.,The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, NSW, Australia
| | - Emily Robinson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia
| | - Hannah Sehl
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia.
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9
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Lichenstein SD, Manco N, Cope LM, Egbo L, Garrison KA, Hardee J, Hillmer AT, Reeder K, Stern EF, Worhunsky P, Yip SW. Systematic review of structural and functional neuroimaging studies of cannabis use in adolescence and emerging adulthood: evidence from 90 studies and 9441 participants. Neuropsychopharmacology 2022; 47:1000-1028. [PMID: 34839363 PMCID: PMC8938408 DOI: 10.1038/s41386-021-01226-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 11/09/2022]
Abstract
Cannabis use peaks in adolescence, and adolescents may be more vulnerable to the neural effects of cannabis and cannabis-related harms due to ongoing brain development during this period. In light of ongoing cannabis policy changes, increased availability, reduced perceptions of harm, heightened interest in medicinal applications of cannabis, and drastic increases in cannabis potency, it is essential to establish an understanding of cannabis effects on the developing adolescent brain. This systematic review aims to: (1) synthesize extant literature on functional and structural neural alterations associated with cannabis use during adolescence and emerging adulthood; (2) identify gaps in the literature that critically impede our ability to accurately assess the effect of cannabis on adolescent brain function and development; and (3) provide recommendations for future research to bridge these gaps and elucidate the mechanisms underlying cannabis-related harms in adolescence and emerging adulthood, with the long-term goal of facilitating the development of improved prevention, early intervention, and treatment approaches targeting adolescent cannabis users (CU). Based on a systematic search of Medline and PsycInfo and other non-systematic sources, we identified 90 studies including 9441 adolescents and emerging adults (n = 3924 CU, n = 5517 non-CU), which provide preliminary evidence for functional and structural alterations in frontoparietal, frontolimbic, frontostriatal, and cerebellar regions among adolescent cannabis users. Larger, more rigorous studies are essential to reconcile divergent results, assess potential moderators of cannabis effects on the developing brain, disentangle risk factors for use from consequences of exposure, and elucidate the extent to which cannabis effects are reversible with abstinence. Guidelines for conducting this work are provided.
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Affiliation(s)
| | - Nick Manco
- Medical University of South Carolina, Charleston, SC, USA
| | - Lora M Cope
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Leslie Egbo
- Neuroscience and Behavior Program, Wesleyan University, Middletown, CT, USA
| | | | - Jillian Hardee
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Ansel T Hillmer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Kristen Reeder
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA
| | - Elisa F Stern
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Patrick Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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10
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May AC, Davis C, Kirlic N, Stewart JL. Mindfulness-Based Interventions for the Treatment of Aberrant Interoceptive Processing in Substance Use Disorders. Brain Sci 2022; 12:brainsci12020279. [PMID: 35204042 PMCID: PMC8870441 DOI: 10.3390/brainsci12020279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Altered interoception, or the processing of bodily signals, has been argued to play a role in the development and maintenance of substance use disorders (SUD). Therefore, interoceptive interventions focusing on bodily awareness, such as mindfulness meditation, may improve treatment outcomes for individuals with SUD. Here we review: (1) subjective, behavioral and brain evidence for altered interoceptive processing in SUD, focusing on insular and anterior cingulate cortices (INS, ACC), key regions for interoceptive processing; (2) research highlighting links between mindfulness and brain function; and (3) extant brain research investigating mindfulness-based interventions in SUD. SUD tend to be characterized by heightened INS and ACC responses to drug cues but blunted interoceptive awareness and attenuated INS and ACC responses during tasks involving bodily attention and/or perturbations. In contrast, mindfulness interventions in healthy individuals are linked to enhanced INS and ACC responses and heightened interoceptive awareness. It is crucial for future research to identify: (1) whether mindfulness-based treatments are efficacious across substance classes; (2) what particular approaches and dosages show the largest effect sizes in enhancing INS and ACC function to non-drug stimuli and reducing responsivity to substance cues, thereby improving SUD treatment outcomes (reducing drug craving and relapse).
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Affiliation(s)
- April C. May
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92037, USA
- Correspondence:
| | - Chrysantha Davis
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
| | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
- Department of Community Medicine, University of Tulsa, Tulsa, OK 74104, USA
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11
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Functional brain connectomes reflect acute and chronic cannabis use. Sci Rep 2022; 12:2449. [PMID: 35165360 PMCID: PMC8844352 DOI: 10.1038/s41598-022-06509-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/31/2022] [Indexed: 12/21/2022] Open
Abstract
AbstractResting state fMRI has been employed to identify alterations in functional connectivity within or between brain regions following acute and chronic exposure to Δ9-tetrahydrocannabinol (THC), the psychoactive component in cannabis. Most studies focused a priori on a limited number of local brain areas or circuits, without considering the impact of cannabis on whole-brain network organization. The present study attempted to identify changes in the whole-brain human functional connectome as assessed with ultra-high field (7T) resting state scans of cannabis users (N = 26) during placebo and following vaporization of cannabis. Two distinct data-driven methodologies, i.e. network-based statistics (NBS) and connICA, were used to identify changes in functional connectomes associated with acute cannabis intoxication and history of cannabis use. Both methodologies revealed a broad state of hyperconnectivity within the entire range of major brain networks in chronic cannabis users compared to occasional cannabis users, which might be reflective of an adaptive network reorganization following prolonged cannabis exposure. The connICA methodology also extracted a distinct spatial connectivity pattern of hypoconnectivity involving the dorsal attention, limbic, subcortical and cerebellum networks and of hyperconnectivity between the default mode and ventral attention network, that was associated with the feeling of subjective high during THC intoxication. Whole-brain network approaches identified spatial patterns in functional brain connectomes that distinguished acute from chronic cannabis use, and offer an important utility for probing the interplay between short and long-term alterations in functional brain dynamics when progressing from occasional to chronic use of cannabis.
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12
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Watson KK, Bryan AD, Thayer RE, Ellingson JM, Skrzynski CJ, Hutchison KE. Cannabis Use and Resting State Functional Connectivity in the Aging Brain. Front Aging Neurosci 2022; 14:804890. [PMID: 35221994 PMCID: PMC8868145 DOI: 10.3389/fnagi.2022.804890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Several lines of evidence suggest that older adults (aged 65+) sharply increased their cannabis use over the last decade, highlighting a need to understand the effects of cannabis in this age group. Pre-clinical models suggest that cannabinoids affect the brain and cognition in an age-dependent fashion, having generally beneficial effects on older animals and deleterious effects on younger ones. However, there is little research on how cannabis affects the brains of older adults or how older adults differ from younger adults who use cannabis. Resting state functional connectivity (rsFC) measures provide sensitive metrics of age-related cognitive decline. Here we compared rsFC in older adults who are either regular users of cannabis or non-users. We found stronger connectivity between sources in the hippocampus and parahippocampal cortex, and targets in the anterior lobes of the cerebellum in older adult cannabis users relative to non-users. A similar pattern of strengthened connectivity between hippocampal and cerebellar structures was also present in 25-35 year old non-users in comparison to 60-88 year old non-users. These findings suggest that future studies should examine both the potential risks of cannabinoids, as well as a potential benefits, on cognition and brain health for older adults.
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Affiliation(s)
- Karli K. Watson
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, United States
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Rachel E. Thayer
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Jarrod M. Ellingson
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Carillon J. Skrzynski
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Kent E. Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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13
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Tolomeo S, Yu R. Brain network dysfunctions in addiction: a meta-analysis of resting-state functional connectivity. Transl Psychiatry 2022; 12:41. [PMID: 35091540 PMCID: PMC8799706 DOI: 10.1038/s41398-022-01792-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
Resting-state functional connectivity (rsFC) provides novel insights into variabilities in neural networks associated with the use of addictive drugs or with addictive behavioral repertoire. However, given the broad mix of inconsistent findings across studies, identifying specific consistent patterns of network abnormalities is warranted. Here we aimed at integrating rsFC abnormalities and systematically searching for large-scale functional brain networks in substance use disorder (SUD) and behavioral addictions (BA), through a coordinate-based meta-analysis of seed-based rsFC studies. A total of fifty-two studies are eligible in the meta-analysis, including 1911 SUD and BA patients and 1580 healthy controls. In addition, we performed multilevel kernel density analysis (MKDA) for the brain regions reliably involved in hyperconnectivity and hypoconnectivity in SUD and BA. Data from fifty-two studies showed that SUD was associated with putamen, caudate and middle frontal gyrus hyperconnectivity relative to healthy controls. Eight BA studies showed hyperconnectivity clusters within the putamen and medio-temporal lobe relative to healthy controls. Altered connectivity in salience or emotion-processing areas may be related to dysregulated affective and cognitive control-related networks, such as deficits in regulating elevated sensitivity to drug-related stimuli. These findings confirm that SUD and BA might be characterized by dysfunctions in specific brain networks, particularly those implicated in the core cognitive and affective functions. These findings might provide insight into the development of neural mechanistic biomarkers for SUD and BA.
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Affiliation(s)
- Serenella Tolomeo
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China.
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
- Department of Physics, Hong Kong Baptist University, Hong Kong, China.
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14
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Ramaekers JG, Theunissen EL, van Ruitenbeek P, Mason NL. Cannabis Use and Neuroadaptation: A Call for Δ 9 -Tetrahydrocannabinol Challenge Studies. Front Psychiatry 2022; 13:870750. [PMID: 35492732 PMCID: PMC9046729 DOI: 10.3389/fpsyt.2022.870750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022] Open
Abstract
Currently, the assessment of the neurobehavioral consequences of repeated cannabis use is restricted to studies in which brain function of chronic cannabis users is compared to that of non-cannabis using controls. The assumption of such studies is that changes in brain function of chronic users are caused by repeated and prolonged exposure to acute cannabis intoxication. However, differences in brain function between chronic cannabis users and non-users might also arise from confounding factors such as polydrug use, alcohol use, withdrawal, economic status, or lifestyle conditions. We propose a methodology that highlights the relevance of acute Δ9-tetrahydrocannabinol (THC) dosing studies for a direct assessment of neuroadaptations in chronic cannabis users. The approach includes quantification of neurochemical, receptor, and functional brain network changes in response to an acute cannabis challenge, as well as stratification of cannabis using groups ranging from occasional to cannabis-dependent individuals. The methodology allows for an evaluation of THC induced neuroadaptive and neurocognitive changes across cannabis use history, that can inform neurobiological models on reward driven, compulsive cannabis use.
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Affiliation(s)
- Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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15
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Aloi J, McCusker MC, Lew BJ, Schantell M, Eastman JA, Frenzel MR, Wilson TW. Altered amygdala-cortical connectivity in individuals with Cannabis use disorder. J Psychopharmacol 2021; 35:1365-1374. [PMID: 34730052 PMCID: PMC9659472 DOI: 10.1177/02698811211054163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cannabis is one of the most commonly used substances in the United States. Prior literature using task-based functional magnetic resonance imaging (fMRI) has identified that individuals with Cannabis use disorder (CUD) show impairments in emotion processing circuitry. However, whether the functional networks involving these regions are also altered in CUD remains poorly understood. AIMS Investigate changes in resting-state functional connectivity (rsFC) in regions related to emotional processing in CUD. METHODS Sixty-two participants completed resting-state fMRI, including 21 with CUD, 20 with histories of illicit substance use but no current CUD diagnosis, and 21 with no history of illicit substance use. Whole-brain seed-based connectivity analyses were performed and one-way analyses of covariance (ANCOVAs) were conducted to detect group differences in the bilateral amygdalae, hippocampi, and the anterior and posterior cingulate cortices. RESULTS The CUD group exhibited significant reductions in rsFC between the amygdala and the cuneus, paracentral lobule, and supplementary motor area, and between the cingulate cortices and the occipital and temporal lobes. There were no significant group differences in hippocampal functional connectivity. In addition, CUD symptom counts based on the Structured Clinical Interview for DSM-5 (SCID) and the Cannabis Use Disorders Identification Test (CUDIT) significantly correlated with multiple connectivity metrics. CONCLUSION These data expand on emerging literature indicating that CUD is associated with dysfunction in the neural circuits underlying emotion processing. Dysfunction in emotion processing circuits may play a role in the behavioral impairments seen in emotion processing tasks in individuals with CUD, and the severity of CUD symptoms appears to be directly related to the degree of dysfunction in these circuits.
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Affiliation(s)
- Joseph Aloi
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Marie C. McCusker
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Brandon J. Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Jacob A. Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Michaela R. Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
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Abstract
PURPOSE Alcohol and cannabis are the most commonly used substances during adolescence and are typically initiated during this sensitive neurodevelopmental period. The aim of this review is to provide a comprehensive overview of the most recent literature focused on understanding how these substances affect the developing brain. SEARCH METHODS Articles included in this review were identified by entering 30 search terms focused on substance use, adolescence, and neurodevelopment into MEDLINE, Embase, PsycINFO, ProQuest Central, and Web of Science. Studies were eligible for inclusion if they longitudinally examined the effect of adolescent alcohol and/or cannabis use on structural or functional outcomes in 50 or more participants. SEARCH RESULTS More than 700 articles were captured by the search, and 43 longitudinal studies met inclusion criteria, including 18 studies focused on alcohol use, 13 on cannabis use, and 12 on alcohol and cannabis co-use. DISCUSSION AND CONCLUSIONS Existing studies suggest heavy alcohol and cannabis use during adolescence are related to small to moderate disruptions in brain structure and function, as well as neurocognitive impairment. The effects of alcohol use include widespread decreases in gray matter volume and cortical thickness across time; slowed white matter growth and poorer integrity; disrupted network efficiency; and poorer impulse and attentional control, learning, memory, visuospatial processing, and psychomotor speed. The severity of some effects is dependent on dose. Heavy to very heavy cannabis use is associated with decreased subcortical volume and increased frontoparietal cortical thickness, disrupted functional development, and decreased executive functioning and IQ compared to non-using controls. Overall, co-use findings suggest more pronounced effects related to alcohol use than to cannabis use. Several limitations exist in the literature. Sample sizes are relatively small and demographically homogenous, with significant heterogeneity in substance use patterns and methodologies across studies. More research is needed to clarify how substance dosing and interactions between substances, as well as sociodemographic and environmental factors, affect outcomes. Larger longitudinal studies, already underway, will help clarify the relationship between brain development and substance use.
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Affiliation(s)
- Briana Lees
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Jennifer Debenham
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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17
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Yüncü Z, Cakmak Celik Z, Colak C, Thapa T, Fornito A, Bora E, Kitis O, Zorlu N. Resting state functional connectivity in adolescent synthetic cannabinoid users with and without attention-deficit/hyperactivity disorder. Hum Psychopharmacol 2021; 36:e2781. [PMID: 33675677 DOI: 10.1002/hup.2781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Synthetic cannabinoids (SCs) have become increasingly popular in recent years, especially among adolescents. The first aim of the current study was to examine resting-state functional connectivity (rsFC) in SC users compared to controls. Our second aim was to examine the influence of comorbid attention-deficit/hyperactivity disorder (ADHD) symptomatology on rsFC changes in SC users compared to controls. METHODS Resting-state functional magnetic resonance imaging (fMRI) analysis included 25 SC users (14 without ADHD and 11 with ADHD combined type) and 12 control subjects. RESULTS We found (i) higher rsFC between the default mode network (DMN) and salience network, dorsal attention network and cingulo-opercular network, and (ii) lower rsFC within the DMN and between the DMN and visual network in SC users compared to controls. There were no significant differences between SC users with ADHD and controls, nor were there any significant differences between SC users with and without ADHD. CONCLUSIONS We found the first evidence of abnormalities within and between resting state networks in adolescent SC users without ADHD. In contrast, SC users with ADHD showed no differences compared to controls. These results suggest that comorbidity of ADHD and substance dependence may show different rsFC alterations than substance use alone.
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Affiliation(s)
- Zeki Yüncü
- Department of Child Psychiatry, Ege University School of Medicine, Izmir, Turkey
| | | | - Ciğdem Colak
- Department of Psychiatry, Cigli Regional Training Hospital, Izmir, Turkey
| | - Tribikram Thapa
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Alex Fornito
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Emre Bora
- Department of Psychiatry, Dokuz Eylül University Medical School, Izmir, Turkey
| | - Omer Kitis
- Department of Radiodiagnostics, Ege University School of Medicine, Izmir, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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18
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Debenham J, Birrell L, Champion K, Lees B, Yücel M, Newton N. Neuropsychological and neurophysiological predictors and consequences of cannabis and illicit substance use during neurodevelopment: a systematic review of longitudinal studies. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:589-604. [PMID: 33991473 DOI: 10.1016/s2352-4642(21)00051-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022]
Abstract
Adolescence and early adulthood are crucial periods of neurodevelopment characterised by functional, structural, and cognitive maturation, which helps prepare young people for adulthood. This systematic review of longitudinal studies aims to delineate neural predictors from neural consequences of cannabis and illicit substance use, as well as investigate the potential for the developing brain (at ages 10-25 years) to recover after damage. Five databases were searched to yield a total of 38 eligible studies, with some assessing multiple outcome techniques, including 22 neuroimaging, two neurophysiological, and 22 neuropsychological findings. High-quality evidence suggested that delayed or irregular neurodevelopment in executive functioning, particularly emotional perception, might predispose young people to higher frequency substance use. There was evidence of functional, structural, and cognitive deficits proceeding substance use, with harm potentially dependent on the frequency of use and recovery potentially dependent on the duration of use. Identifying aberrant neurodevelopment in young people is crucial for preventing substance use-related harm.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia.
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, NSW, Australia
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19
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Feinstein A, Meza C, Stefan C, Staines WR. Impaired awareness: Why people with multiple sclerosis continue using cannabis despite evidence to the contrary. Brain Behav 2021; 11:e2220. [PMID: 34087949 PMCID: PMC8413765 DOI: 10.1002/brb3.2220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/07/2021] [Accepted: 05/16/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With widespread moves toward legalization of cannabis, increasing numbers of people with multiple sclerosis (pwMS) are using the drug. Emerging MS-related data show that cannabis can cause or exacerbate cognitive dysfunction. OBJECTIVE To understand why people with MS continue using cannabis despite adverse cognitive consequences. It was hypothesized that lack of awareness, a component of metacognition, could explain this decision, in part. METHOD Forty pwMS who smoked cannabis almost daily were assigned by odd-even case number selection to either a cannabis continuation (CC) or cannabis withdrawal (CW) group. Both groups were followed for 28 days. All participants completed, at baseline and day 28, the brief repeatable battery of neuropsychological tests (BRNB) in MS for measures of processing speed, memory and executive function; Modified fatigue impact scale (mFIS) for self-report indices of cognitive functioning. RESULTS No significant baseline differences between the groups on the BRNB and mFIS. At day 28, significant improvement within group was seen on all measures of the BRNB, but only in the CW group (p = .0001 for all indices). A repeat measure ANOVA did not find any significant group (CC vs. CW) × time (baseline and day 28) interactions for the self-report cognitive measures on the mFIS. Cannabis abstainers did report less ability to function away from home. All 19 participants in the CW group reverted to using cannabis on study completion despite being informed individually of their cognitive improvement. CONCLUSIONS AND RELEVANCE The inability of pwMS to accurately appraise their memory and executive function can help explain, in part, why they continue to smoke cannabis despite objective evidence of the deleterious cognitive side effects of this behavior.
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Affiliation(s)
- Anthony Feinstein
- Sunnybrook Research Institute, Division of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Cecilia Meza
- Sunnybrook Research Institute, Division of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Cristiana Stefan
- Clinical Laboratory and Diagnostic Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - William R Staines
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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20
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Kearney-Ramos T, Haney M. Repetitive transcranial magnetic stimulation as a potential treatment approach for cannabis use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110290. [PMID: 33677045 PMCID: PMC9165758 DOI: 10.1016/j.pnpbp.2021.110290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
The expanding legalization of cannabis across the United States is associated with increases in cannabis use, and accordingly, an increase in the number and severity of individuals with cannabis use disorder (CUD). The lack of FDA-approved pharmacotherapies and modest efficacy of psychotherapeutic interventions means that many of those who seek treatment for CUD relapse within the first few months. Consequently, there is a pressing need for innovative, evidence-based treatment development for CUD. Preliminary evidence suggests that repetitive transcranial magnetic stimulation (rTMS) may be a novel, non-invasive therapeutic neuromodulation tool for the treatment of a variety of substance use disorders (SUDs), including recently receiving FDA clearance (August 2020) for use as a smoking cessation aid in tobacco cigarette smokers. However, the potential of rTMS for CUD has not yet been reviewed. This paper provides a primer on therapeutic neuromodulation techniques for SUDs, with a particular focus on reviewing the current status of rTMS research in people who use cannabis. Lastly, future directions are proposed for rTMS treatment development in CUD, with suggestions for study design parameters and clinical endpoints based on current gold-standard practices for therapeutic neuromodulation research.
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Affiliation(s)
- Tonisha Kearney-Ramos
- New York State Psychiatric Institute, New York, NY, USA; Columbia University Irving Medical Center, New York, NY, USA.
| | - Margaret Haney
- New York State Psychiatric Institute, New York, New York, USA,Columbia University Irving Medical Center, New York, New York, USA
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21
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Martin AMS, Kim DJ, Newman SD, Cheng H, Hetrick WP, Mackie K, O’Donnell BF. Altered cerebellar-cortical resting-state functional connectivity in cannabis users. J Psychopharmacol 2021; 35:823-832. [PMID: 34034553 PMCID: PMC8813046 DOI: 10.1177/02698811211019291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cannabis use has been associated with abnormalities in cerebellar mediated motor and non-motor (i.e. cognition and personality) phenomena. Since the cerebellum is a region with high cannabinoid type 1 receptor density, these impairments may reflect alterations of signaling between the cerebellum and other brain regions. AIMS We hypothesized that cerebellar-cortical resting-state functional connectivity (rsFC) would be altered in cannabis users, relative to their non-using peers. It was also hypothesized that differences in rsFC would be associated with cannabis use features, such as age of initiation and lifetime use. METHODS Cerebellar-cortical and subcortical rsFCs were computed between 28 cerebellar lobules, defined by a spatially unbiased atlas template of the cerebellum, and individual voxels in the cerebral regions, in 41 regular cannabis users (20 female) and healthy non-using peers (N = 31; 18 female). We also investigated associations between rsFC and cannabis use features (e.g. lifetime cannabis use and age of initiation). RESULTS Cannabis users demonstrated hyperconnectivity between the anterior cerebellar regions (i.e. lobule I-IV) with the posterior cingulate cortex, and hypoconnectivity between the rest of the cerebellum (i.e. Crus I and II, lobule VIIb, VIIIa, VIIIb, IX, and X) and the cortex. No associations were observed between features of cannabis use and rsFC. CONCLUSIONS Cannabis use was associated with altered patterns of rsFC from the cerebellum to the cerebral cortex which may have a downstream impact on behavior and cognition.
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Affiliation(s)
- Ashley M Schnakenberg Martin
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dae-Jin Kim
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Hu Cheng
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - William P Hetrick
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ken Mackie
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brian F O’Donnell
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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22
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Manza P, Shokri-Kojori E, Volkow ND. Reduced Segregation Between Cognitive and Emotional Processes in Cannabis Dependence. Cereb Cortex 2021; 30:628-639. [PMID: 31211388 DOI: 10.1093/cercor/bhz113] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/26/2019] [Accepted: 05/06/2019] [Indexed: 01/16/2023] Open
Abstract
Addiction is characterized by an erosion of cognitive control toward drug taking that is accentuated by negative emotional states. Here we tested the hypothesis that enhanced interference on cognitive control reflects a loss of segregation between cognition and emotion in addiction. We analyzed Human Connectome Project data from 1206 young adults, including 89 with cannabis dependence (CD). Two composite factors, one for cognition and one for emotion, were derived using principal component (PC) analyses. Component scores for these PCs were significantly associated in the CD group, such that negative emotionality correlated with poor cognition. However, the corresponding component scores were uncorrelated in matched controls and nondependent recreational cannabis users (n = 87). In CD, but not controls or recreational users, functional magnetic resonance imaging activations to emotional stimuli (angry/fearful faces > shapes) correlated with activations to cognitive demand (working memory; 2-back > 0-back). Canonical correlation analyses linked individual differences in cognitive and emotional component scores with brain activations. In CD, there was substantial overlap between cognitive and emotional brain-behavior associations, but in controls, associations were more restricted to the cognitive domain. These findings support our hypothesis of impaired segregation between cognitive and emotional processes in CD that might contribute to poor cognitive control under conditions of increased emotional demand.
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Affiliation(s)
- Peter Manza
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ehsan Shokri-Kojori
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nora D Volkow
- National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, MD 20892, USA.,National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
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23
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Ritchay MM, Huggins AA, Wallace AL, Larson CL, Lisdahl KM. Resting state functional connectivity in the default mode network: Relationships between cannabis use, gender, and cognition in adolescents and young adults. Neuroimage Clin 2021; 30:102664. [PMID: 33872994 PMCID: PMC8080071 DOI: 10.1016/j.nicl.2021.102664] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cannabis is the most commonly used illicit substance in the United States, and nearly 1 in 4 young adults are current cannabis users. Chronic cannabis use is associated with changes in resting state functional connectivity (RSFC) in the default mode network (DMN) in adolescents and young adults; results are somewhat inconsistent across studies, potentially due to methodological differences. The aims of the present study were to examine potential differences in DMN RSFC between cannabis users and controls, and to examine, as an exploratory analysis, if gender moderated any findings. We further examined whether differences in RSFC related to differences in performance on selected neuropsychological measures. MATERIALS AND METHODS Seventy-seven 16-26-year-old participants underwent an MRI scan (including resting state scan), neuropsychological battery, toxicology screening, and drug use interview. Differences in DMN connectivity were examined between groups (cannabis vs. control) and with an exploratory group by gender interaction, using a left posterior cingulate cortex (PCC) seed-based analysis conducted in AFNI. RESULTS Cannabis users demonstrated weaker connectivity than controls between the left PCC and various DMN nodes, and the right Rolandic operculum/Heschl's gyrus. Cannabis users demonstrated stronger connectivity between the left PCC and the cerebellum and left supramarginal gyrus. The group by gender interaction was not significantly associated with connectivity differences. Stronger left PCC-cerebellum connectivity was associated with poorer performance on cognitive measures in cannabis users. In controls, intra-DMN connectivity was positively correlated with performance on a speeded selective/sustained attention measure. DISCUSSION Consistent with our hypotheses and other studies, cannabis users demonstrated weaker connectivity between the left PCC and DMN nodes. Chronic THC exposure may alter GABA and glutamate concentrations, which may alter brain communication. Future studies should be conducted with a larger sample size and examine gender differences and the mechanism by which these differences may arise.
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Affiliation(s)
- Megan M Ritchay
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave Garland 224, Milwaukee, 53211 WI, USA
| | - Ashley A Huggins
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave Garland 224, Milwaukee, 53211 WI, USA
| | - Alexander L Wallace
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave Garland 224, Milwaukee, 53211 WI, USA
| | - Christine L Larson
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave Garland 224, Milwaukee, 53211 WI, USA
| | - Krista M Lisdahl
- University of Wisconsin-Milwaukee, Department of Psychology, 2441 E. Hartford Ave Garland 224, Milwaukee, 53211 WI, USA.
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24
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Fear extinction learning and anandamide: an fMRI study in healthy humans. Transl Psychiatry 2021; 11:161. [PMID: 33723207 PMCID: PMC7961038 DOI: 10.1038/s41398-020-01177-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 11/23/2022] Open
Abstract
Anxiety- and trauma-related disorders are severe illnesses with high prevalence. Current treatment options leave room for improvement and the endocannabinoid system (ECS) has become a key target in psychopharmacological research. Rodent models suggest an anxiolytic effect of endocannabinoids and demonstrated that the ECS is involved in the modulation of fear learning and aversive memory consolidation. So far, one prominent target was inhibition of fatty acid amino hydrolase (FAAH), the degrading enzyme of the endocannabinoid anandamide (AEA). Research in humans remains scarce, but genetic studies have found that the single-nucleotide polymorphism (SNP) FAAH C385A (rs324420) is associated with lower catabolic performance of FAAH and increased levels of AEA. Translational research on the ECS in fear learning processes is rare, yet crucial to understand the mechanisms involved. To address this lack of research, we designed a fear conditioning, extinction learning paradigm with 51 healthy, male humans who underwent functional magnetic resonance imaging (fMRI) before analysing baseline and task-related changes of AEA, as well as the FAAH polymorphism (rs324420). The results indicate higher AEA levels in AC-heterozygotes than in CC-individuals (SNP rs324420), but no difference between the groups during extinction learning. However, neural activation of the anterior cingulate cortex and anterior insular cortex during extinction learning correlated positively with AEA baseline levels, and task-related changes in AEA were found particularly during fear extinction, with a modulatory effect on neural activation related to extinction learning. Results indicate a putative role for AEA in fear extinction learning. Pre-treatment with AEA-enhancing drugs could promote extinction learning during psychotherapeutic interventions.
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25
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Hall SA, Lalee Z, Bell RP, Towe SL, Meade CS. Synergistic effects of HIV and marijuana use on functional brain network organization. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110040. [PMID: 32687963 PMCID: PMC7685308 DOI: 10.1016/j.pnpbp.2020.110040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/23/2020] [Accepted: 07/12/2020] [Indexed: 11/25/2022]
Abstract
HIV is associated with disruptions in cognition and brain function. Marijuana use is highly prevalent in HIV but its effects on resting brain function in HIV are unknown. Brain function can be characterized by brain activity that is correlated between regions over time, called functional connectivity. Neuropsychiatric disorders are increasingly being characterized by disruptions in such connectivity. We examined the synergistic effects of HIV and marijuana use on functional whole-brain network organization during resting state. Our sample included 78 adults who differed on HIV and marijuana status (19 with co-occurring HIV and marijuana use, 20 HIV-only, 17 marijuana-only, and 22 controls). We examined differences in local and long-range brain network organization using eight graph theoretical metrics: transitivity, local efficiency, within-module degree, modularity, global efficiency, strength, betweenness, and participation coefficient. Local and long-range connectivity were similar between the co-occurring HIV and marijuana use and control groups. In contrast, the HIV-only and marijuana-only groups were both associated with disruptions in brain network organization. These results suggest that marijuana use in HIV may normalize disruptions in brain network organization observed in persons with HIV. However, future work is needed to determine whether this normalization is suggestive of a beneficial or detrimental effect of marijuana on cognitive functioning in HIV.
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Affiliation(s)
- Shana A Hall
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC 27708, USA.
| | - Zahra Lalee
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC 27708, USA
| | - Ryan P Bell
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC 27708, USA
| | - Sheri L Towe
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC 27708, USA
| | - Christina S Meade
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC 27708, USA; Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27708, USA
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26
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Ma L, Hettema JM, Cousijn J, Bjork JM, Steinberg JL, Keyser-Marcus L, Woisard K, Lu Q, Roberson-Nay R, Abbate A, Moeller FG. Resting-State Directional Connectivity and Anxiety and Depression Symptoms in Adult Cannabis Users. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:545-555. [PMID: 33388293 DOI: 10.1016/j.bpsc.2020.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/26/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anxiety and depression symptoms are common among cannabis users and could be a risk factor for cannabis use (CU) disorder. Thus, it is critical to understand the neuronal circuits underlying the associations between CU and these symptoms. Alterations in resting-state functional connectivity within and/or between the default mode network and salience network have been reported in CU, anxiety, and depressive disorders and thus could be a mechanism underlying the associations between CU disorder and anxiety/depression symptoms. METHODS Using resting-state functional magnetic resonance imaging, effective connectivities (ECs) among 9 major nodes from the default mode network and salience network were measured using dynamic causal modeling in 2 datasets: the Human Connectome Project (28 CU participants and 28 matched non-drug-using control participants) and a local CU study (21 CU participants and 21 matched non-drug-using control participants) in separate and parallel analyses. RESULTS Relative to the control participants, right amygdala to left amygdala, anterior cingulate cortex to left amygdala, and medial prefrontal cortex to right insula ECs were greater, and left insula to left amygdala EC was smaller in the CU group. Each of these ECs showed a reliable linear relationship with at least one of the anxiety/depression measures. Most findings on the right amygdala to left amygdala EC were common to both datasets. CONCLUSIONS Right amygdala to left amygdala and anterior cingulate cortex to left amygdala ECs may be related to the close associations between CU and anxiety/depression symptoms. The findings on the medial prefrontal cortex to right insula and left insula to left amygdala ECs may reflect a compensatory mechanism.
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Affiliation(s)
- Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Radiology, Virginia Commonwealth University, Richmond, Virginia.
| | - John M Hettema
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Janna Cousijn
- Neuroscience of Addiction lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Lori Keyser-Marcus
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Kyle Woisard
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - QiQi Lu
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, Virginia
| | - Roxann Roberson-Nay
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Antonio Abbate
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia; Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia; Department of Neurology, Virginia Commonwealth University, Richmond, Virginia
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Navarri X, Afzali MH, Lavoie J, Sinha R, Stein DJ, Momenan R, Veltman DJ, Korucuoglu O, Sjoerds Z, Holst RJ, Hester R, Orr C, Cousijn J, Yucel M, Lorenzetti V, Wiers R, Jahanshad N, Glahn DC, Thompson PM, Mackey S, Conrod PJ. How do substance use disorders compare to other psychiatric conditions on structural brain abnormalities? A cross‐disorder meta‐analytic comparison using the
ENIGMA
consortium findings. Hum Brain Mapp 2020; 43:399-413. [PMID: 32643841 PMCID: PMC8675406 DOI: 10.1002/hbm.25114] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/19/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Xavier Navarri
- Department of PsychiatryUniversité de Montreal, CHU Ste Justine Hospital, CHU Ste‐Justine Montreal Canada
| | - Mohammad H. Afzali
- Department of PsychiatryUniversité de Montreal, CHU Ste Justine Hospital, CHU Ste‐Justine Montreal Canada
| | - Jacob Lavoie
- Department of PsychiatryUniversité de Montreal, CHU Ste Justine Hospital, CHU Ste‐Justine Montreal Canada
| | - Rajita Sinha
- Department of PsychiatryYale University School of Medicine New Haven Connecticut USA
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience InstituteUniversity of Cape Town Cape Town South Africa
| | - Reza Momenan
- National Institute of Alcohol Abuse and Alcoholism (NIAAA) Bethesda Maryland USA
| | - Dick J Veltman
- Department of PsychiatryAmsterdam UMC location VUMC Amsterdam The Netherlands
| | - Ozlem Korucuoglu
- Addiction, Development and Psychopathology (ADAPT) Lab, Department of PsychologyUniversity of Amsterdam Amsterdam The Netherlands
| | - Zsuzsika Sjoerds
- Cognitive Psychology Unit & Leiden Institute for Brain & CognitionInstitute of Psychology, Leiden University Leiden The Netherlands
| | - Ruth J. Holst
- Amsterdam Institute for Addiction Research, Department of PsychiatryAmsterdam UMC, Location AMC, University of Amsterdam Amsterdam The Netherlands
| | - Rob Hester
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne Australia
| | - Catherine Orr
- Department of PsychiatryUniversity of Vermont Burlington Vermont USA
- Department of PsychologyUniversity of Vermont Burlington Vermont USA
| | - Janna Cousijn
- Department of PsychologyUniversity of Amsterdam Amsterdam The Netherlands
| | - Murat Yucel
- Monash Institute of Cognitive and Clinical Neurosciences, and School of Psychological Sciences, Monash University Monash Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Research HubMonash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University Melbourne Australia
| | - Reinout Wiers
- Brain Research Institute, University of California Los Angeles California USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Infomatics, Keck School of MedicineUniversity of Southern California Marina del Rey California USA
| | - David C. Glahn
- Department of PsychiatryYale University School of Medicine New Haven Connecticut USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Infomatics, Keck School of MedicineUniversity of Southern California Marina del Rey California USA
| | - Scott Mackey
- Department of PsychiatryUniversity of Vermont Burlington Vermont USA
- Department of PsychologyUniversity of Vermont Burlington Vermont USA
| | - Patricia J. Conrod
- Department of PsychiatryUniversité de Montreal, CHU Ste Justine Hospital, CHU Ste‐Justine Montreal Canada
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Sami MB, McCutcheon RA, Ettinger U, Williams S, Lythgoe D, McGuire P, Bhattacharyya S. Cannabis Use Linked to Altered Functional Connectivity of the Visual Attentional Connectivity in Patients With Psychosis and Controls. ACTA ACUST UNITED AC 2020. [DOI: 10.1093/schizbullopen/sgaa018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Both chronic cannabis use and psychotic disorders are associated with abnormalities in visual attentional processing. Using functional magnetic resonance imaging (fMRI), we sought to determine whether there would be a difference in functional connectivity in patients and controls with and without a history of cannabis use in the visual and dorsal attention networks.
Methods
Resting-state fMRI data were acquired in patients with early psychosis with (EPC = 29) and without (EPNC = 25); and controls with (HCC = 16) and without (HCNC = 22) cannabis use.
Results
There was a patient effect in both Visual-Dorsal Attention Internetwork (F(1,87) = 5.326, P = .023) and the Visual Network (F(1,87) = 4.044, P = .047) and a cannabis effect in the Dorsal Attention Network (F(1,87) = 4.773, P = .032). These effects were specific to the networks examined with no evidence for significant patient or cannabis effects in other canonical networks. Patients with a history of cannabis use showed increased connectivity in the Dorsal Attention Network (134%, P = .019) and Visual Dorsal Attention Internetwork (285%, P = .036) compared to non-using controls. In the EPC group connectivity of the Visual Network (ρ = 0.379, P = .042) and Visual-Dorsal Attention Internetwork (ρ = 0.421, P = .023) correlated with visual hallucinations which were significantly different from EPNC (P = .011). Dorsal attention network strength correlated with severity of dependence for cannabis (ρ = 0.215, P = .04).
Conclusion
We demonstrate specific cannabis and patient effects in networks associated with visual attentional processing. There is a differential association with hallucinatory symptoms in patients with and without a history of cannabis use. This may indicate that dysconnectivity in these networks serves different roles in the context of cannabis use.
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Affiliation(s)
- Musa Basseer Sami
- Institute of Psychiatry, Psychology and Neurosciences King’s College London, London, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neurosciences King’s College London, London, UK
| | | | - Steve Williams
- Centre for Neuroimaging Sciences, King’s College London, London, UK
| | - Dave Lythgoe
- Centre for Neuroimaging Sciences, King’s College London, London, UK
| | - Philip McGuire
- Institute of Psychiatry, Psychology and Neurosciences King’s College London, London, UK
| | - Sagnik Bhattacharyya
- Institute of Psychiatry, Psychology and Neurosciences King’s College London, London, UK
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29
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Deconstructing the neurobiology of cannabis use disorder. Nat Neurosci 2020; 23:600-610. [PMID: 32251385 DOI: 10.1038/s41593-020-0611-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/13/2020] [Indexed: 12/20/2022]
Abstract
There have been dramatic changes worldwide in the attitudes toward and consumption of recreational and medical cannabis. Cannabinoid receptors, which mediate the actions of cannabis, are abundantly expressed in brain regions known to mediate neural processes underlying reward, cognition, emotional regulation and stress responsivity relevant to addiction vulnerability. Despite debates regarding potential pathological consequences of cannabis use, cannabis use disorder is a clinical diagnosis with high prevalence in the general population and that often has its genesis in adolescence and in vulnerable individuals associated with psychiatric comorbidity, genetic and environmental factors. Integrated information from human and animal studies is beginning to expand insights regarding neurobiological systems associated with cannabis use disorder, which often share common neural characteristics with other substance use disorders, that could inform prevention and treatment strategies.
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30
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Altered coupling of default-mode, executive-control and salience networks in Internet gaming disorder. Eur Psychiatry 2020; 45:114-120. [DOI: 10.1016/j.eurpsy.2017.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 01/01/2023] Open
Abstract
AbstractBackground:Recently, a triple-network model suggested the abnormal interactions between the executive-control network (ECN), default-mode network (DMN) and salience network (SN) are important characteristics of addiction, in which the SN plays a critical role in allocating attentional resources toward the ECN and DMN. Although increasing studies have reported dysfunctions in these brain networks in Internet gaming disorder (IGD), interactions between these networks, particularly in the context of the triple-network model, have not been investigated in IGD. Thus, we aimed to assess alterations in the inter-network interactions of these large-scale networks in IGD, and to associate the alterations with IGD-related behaviors.Methods:DMN, ECN and SN were identified using group-level independent component analysis (gICA) in 39 individuals with IGD and 34 age and gender matched healthy controls (HCs). Then alterations in the SN-ECN and SN-DMN connectivity, as well as in the modulation of ECN versus DMN by SN, using a resource allocation index (RAI) developed and validated previously in nicotine addiction, were assessed. Further, associations between these altered network coupling and clinical assessments were also examined.Results:Compared with HCs, IGD had significantly increased SN-DMN connectivity and decreased RAI in right hemisphere (rRAI), and the rRAI in IGD was negatively associated with their scores of craving.Conclusions:These findings suggest that the deficient modulation of ECN versus DMN by SN might provide a mechanistic framework to better understand the neural basis of IGD and might provide novel evidence for the triple-network model in IGD.
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Moeller SJ, Hanley AW, Garland EL. Behavioral preference for viewing drug v. pleasant images predicts current and future opioid misuse among chronic pain patients. Psychol Med 2020; 50:644-652. [PMID: 30982480 PMCID: PMC7413318 DOI: 10.1017/s0033291719000461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The USA is currently enduring an opioid crisis. Identifying cost-effective, easy-to-implement behavioral measures that predict treatment outcomes in opioid misusers is a crucial scientific, therapeutic, and epidemiological goal. METHODS The current study used a mixed cross-sectional and longitudinal design to test whether a behavioral choice task, previously validated in stimulant users, was associated with increased opioid misuse severity at baseline, and whether it predicted change in opioid misuse severity at follow-up. At baseline, data from 100 prescription opioid-treated chronic pain patients were analyzed; at follow-up, data were analyzed in 34 of these participants who were non-misusers at baseline. During the choice task, participants chose under probabilistic contingencies whether to view opioid-related images in comparison with affectively pleasant, unpleasant, and neutral images. Following previous procedures, we also assessed insight into choice behavior, operationalized as whether (yes/no) participants correctly self-reported the image category they chose most often. RESULTS At baseline, the higher choice for viewing opioid images in direct comparison with pleasant images was associated with opioid misuse and impaired insight into choice behavior; the combination of these produced especially elevated opioid-related choice behavior. In longitudinal analyses of individuals who were initially non-misusers, higher baseline opioid v. pleasant choice behavior predicted more opioid misuse behaviors at follow-up. CONCLUSIONS These results indicate that greater relative allocation of behavior toward opioid stimuli and away from stimuli depicting natural reinforcement is associated with concurrent opioid misuse and portends vulnerability toward future misuse. The choice task may provide important medical information to guide opioid-prescribing practices.
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Affiliation(s)
- Scott J. Moeller
- Department of Psychiatry, Stony Brook University School of Medicine
| | - Adam W. Hanley
- University of Utah Center on Mindfulness and Integrative Health Intervention Development
| | - Eric L. Garland
- University of Utah Center on Mindfulness and Integrative Health Intervention Development
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Tsurumi K, Aso T, Kawada R, Murai T, Takahashi H. A positive shift in resting-state functional connectivity between the insula and default mode network regions reflects the duration of illness in gambling disorder patients without lifetime substance abuse. Psychiatry Res Neuroimaging 2020; 295:111018. [PMID: 31770702 DOI: 10.1016/j.pscychresns.2019.111018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/07/2019] [Accepted: 11/13/2019] [Indexed: 11/22/2022]
Abstract
The insula is considered an important structure involved in addiction and in the context of dynamic activity switching between large-scale brain networks, such as the default mode network (DMN) and the central executive network. Although insular-DMN resting-state functional connectivity (rsFC), which could affect such switching, has been examined in substance addiction populations, the results have been inconsistent, partly because of the confounding neural effects of the abused substances. To investigate this subject, using MRI, we examined insular-DMN rsFC in gambling disorder (GD) patients without a history of substance use. We examined rsFC between insular seeds and DMN regions of interest during rest in 23 GD patients and 27 age-, sex-, handedness-, and high education rate-matched healthy control (HC) subjects. We found a positive shift in insular-DMN rsFC in GD patients compared with HC subjects. Furthermore, the connectivity strength between insular seed regions and DMN regions was positively correlated with illness duration in GD patients. This alteration might affect switching between large-scale brain networks, potentially leading to a preoccupation with gambling as well as various types of cognitive impairments. Our results could clarify the controversial findings regarding substance addiction and enhance the system-level understanding of addiction.
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Affiliation(s)
- Kosuke Tsurumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahararacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, 6-7-3, Minatojimaminamimachi, Chuo-ku, Kobe-city, Hyogo 650-0047, Japan
| | - Ryosaku Kawada
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahararacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahararacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahararacho, Sakyo-ku, Kyoto 606-8507, Japan; Medical Institute of Developmental Disabilities Research, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo 157-8577, Japan; Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
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Dellazizzo L, Potvin S, Athanassiou M, Dumais A. Violence and Cannabis Use: A Focused Review of a Forgotten Aspect in the Era of Liberalizing Cannabis. Front Psychiatry 2020; 11:567887. [PMID: 33192691 PMCID: PMC7525024 DOI: 10.3389/fpsyt.2020.567887] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023] Open
Abstract
There has been a shift surrounding societal and legal perspectives on cannabis reflecting changing public attitudes towards the perceived safety and social acceptability of cannabis use. With cannabis liberalization internationally, the focus of most cannabis-related harms has been on effects with users themselves. Harm-to-others including injuries from violence have nevertheless been unfortunately largely overlooked. While studies remain heterogeneous, there is meta-analytical evidence pointing towards an association. The aims of this focused review are two-fold: (I) review the evidence from meta-analyses on the association between cannabis and violence; and (II) provide an overview of possible mechanisms relating cannabis use to violence. First, evidence from meta-analytical studies in youths, intimate partners, and individuals with severe mental disorders have shown that there is a global moderate association between cannabis use and violence, which is stronger in the latter more at-risk population. Preliminary data has even highlighted a potential dose-response relationship with larger effects in more frequent users. Although of importance, this subject has remained essentially forgotten as a public health concern. While literature remains inconclusive, data has suggested potential increases in cannabis use following liberalization policies. This may increase violent outcomes if the effect is directly related to the use of cannabis by means of its psychophysiological modifications. However, for the moment, the mechanisms associating cannabis use and violence remain to be clearly resolved. Considering the recency of policy changes on cannabis, further methodologically sound research using longitudinal designs should examine the effects that cannabis use may have on different forms of violence and the trends that emerge, while evaluating the effects of possible confounding factors (e.g. other substance use). In addition, as evidence-based research from meta-analyses have shown that cannabis use is associated with violence, measures must be taken to mitigate the risks.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Maria Athanassiou
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
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Shollenbarger S, Thomas AM, Wade NE, Gruber SA, Tapert SF, Filbey FM, Lisdahl KM. Intrinsic Frontolimbic Connectivity and Mood Symptoms in Young Adult Cannabis Users. Front Public Health 2019; 7:311. [PMID: 31737591 PMCID: PMC6838025 DOI: 10.3389/fpubh.2019.00311] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/14/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: The endocannbinoid system and cannabis exposure has been implicated in emotional processing. The current study examined whether regular cannabis users demonstrated abnormal intrinsic (a.k.a. resting state) frontolimbic connectivity compared to non-users. A secondary aim examined the relationship between cannabis group connectivity differences and self-reported mood and affect symptoms. Method: Participants included 79 cannabis-using and 80 non-using control emerging adults (ages of 18–30), balanced for gender, reading ability, and age. Standard multiple regressions were used to predict if cannabis group status was associated with frontolimbic connectivity after controlling for site, past month alcohol and nicotine use, and days of abstinence from cannabis. Results: After controlling for research site, past month alcohol and nicotine use, and days of abstinence from cannabis, cannabis users demonstrated significantly greater connectivity between left rACC and the following: right rACC (p = 0.001; corrected p = 0.05; f2 = 0.55), left amygdala (p = 0.03; corrected p = 0.47; f2 = 0.17), and left insula (p = 0.03; corrected p = 0.47; f2 = 0.16). Among cannabis users, greater bilateral rACC connectivity was significantly associated with greater subthreshold depressive symptoms (p = 0.02). Conclusions: Cannabis using young adults demonstrated greater connectivity within frontolimbic regions compared to controls. In cannabis users, greater bilateral rACC intrinsic connectivity was associated with greater levels of subthreshold depression symptoms. Current findings suggest that regular cannabis use during adolescence is associated with abnormal frontolimbic connectivity, especially in cognitive control and emotion regulation regions.
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Affiliation(s)
- Skyler Shollenbarger
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Alicia M Thomas
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Natasha E Wade
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Staci A Gruber
- Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Francesca M Filbey
- Bert Moore Chair in BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, United States
| | - Krista M Lisdahl
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage 2019; 200:313-331. [DOI: 10.1016/j.neuroimage.2019.06.036] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
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Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine. Sci Rep 2019; 9:12912. [PMID: 31501482 PMCID: PMC6733873 DOI: 10.1038/s41598-019-49360-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/30/2022] Open
Abstract
Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.
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Ma L, Del Buono MG, Moeller FG. Cannabis Use as a Risk Factor for Takotsubo (Stress) Cardiomyopathy: Exploring the Evidence from Brain-Heart Link. Curr Cardiol Rep 2019; 21:121. [DOI: 10.1007/s11886-019-1210-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Oriolo G, Blanco-Hinojo L, Navines R, Mariño Z, Martín-Hernández D, Cavero M, Gimenez D, Caso J, Capuron L, Forns X, Pujol J, Sola R, Martin-Santos R. Association of chronic inflammation and perceived stress with abnormal functional connectivity in brain areas involved with interoception in hepatitis C patients. Brain Behav Immun 2019; 80:204-218. [PMID: 30872094 DOI: 10.1016/j.bbi.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/06/2019] [Accepted: 03/09/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Sickness behavioral changes elicited by inflammation may become prolonged and dysfunctional in patients with chronic disease, such as chronic hepatitis C (CHC). Neuroimaging studies show that the basal ganglia and insula are sensitive to systemic inflammation. AIM To elucidate the clinical and neurobiological aspects of prolonged illnesses in patients with CHC. METHODS Thirty-five CHC patients not treated with interferon-α or other antiviral therapy, and 30 control subjects matched for age and sex, were evaluated for perceived stress (perceived stress scale; PSS), depression (PHQ-9), fatigue and irritability through a visual analog scale (VAS), as well as serum levels of interleukin-6 (IL-6), prostaglandin E2 (PGE2) and oxidative stress markers. Functional MRI was performed, measuring resting-state functional connectivity using a region-of-interest (seed)-based approach focusing on the bilateral insula, subgenual anterior cingulate cortex and bilateral putamen. Between-group differences in functional connectivity patterns were assessed with two-sample t-tests, while the associations between symptoms, inflammatory markers and functional connectivity patterns were analyzed with multiple regression analyses. RESULTS CHC patients had higher PSS, PHQ-9 and VAS scores for fatigue and irritability, as well as increased IL-6 levels, PGE2 concentrations and antioxidant system activation compared to controls. PSS scores positively correlated with functional connectivity between the right anterior insula and right putamen, whereas PHQ-9 scores correlated with functional connectivity between most of the seeds and the right anterior insula. PGE2 (positively) and IL-6 (negatively) correlated with functional connectivity between the right anterior insula and right caudate nucleus and between the right ventral putamen and right putamen/globus pallidus. PGE2 and PSS scores accounted for 46% of the variance in functional connectivity between the anterior insula and putamen. CONCLUSIONS CHC patients exhibited increased perceived stress and depressive symptoms, which were associated with changes in inflammatory marker levels and in functional connectivity between the insula and putamen, areas involved in interoceptive integration, emotional awareness, and orientation of motivational state.
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Affiliation(s)
- Giovanni Oriolo
- Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Medicine, Faculty of Medicine, and Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, CIBERSAM, G21, Barcelona, Spain
| | - Ricard Navines
- Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Medicine, Faculty of Medicine, and Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain
| | - Zoe Mariño
- Liver Unit, Hospital Clinic, IDIBAPS, Centro Investigacion Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - David Martín-Hernández
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid, CIBERSAM, Imas12, IUINQ, Madrid, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Medicine, Faculty of Medicine, and Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain
| | - Dolors Gimenez
- Liver Section, Hospital del Mar, Parc de Salut Mar, Grup de Recerca Hepatológica, FIMIM, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Javier Caso
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid, CIBERSAM, Imas12, IUINQ, Madrid, Spain
| | - Lucile Capuron
- INRA, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, F-33076 Bordeaux, France; University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, F-33076 Bordeaux, France
| | - Xavier Forns
- Liver Unit, Hospital Clinic, IDIBAPS, Centro Investigacion Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, CIBERSAM, G21, Barcelona, Spain
| | - Ricard Sola
- Liver Section, Hospital del Mar, Parc de Salut Mar, Grup de Recerca Hepatológica, FIMIM, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Medicine, Faculty of Medicine, and Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain.
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Burggren AC, Shirazi A, Ginder N, London ED. Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:563-579. [PMID: 31365275 PMCID: PMC7027431 DOI: 10.1080/00952990.2019.1634086] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Background: Cannabis is the most widely used illicit substance worldwide, and legalization for recreational and medical purposes has substantially increased its availability and use in the United States.Objectives: Decades of research have suggested that recreational cannabis use confers risk for cognitive impairment across various domains, and structural and functional differences in the brain have been linked to early and heavy cannabis use.Methods: With substantial evidence for the role of the endocannabinoid system in neural development and understanding that brain development continues into early adulthood, the rising use of cannabis in adolescents and young adults raises major concerns. Yet some formulations of cannabinoid compounds are FDA-approved for medical uses, including applications in children.Results: Potential effects on the trajectory of brain morphology and cognition, therefore, should be considered. The goal of this review is to update and consolidate relevant findings in order to inform attitudes and public policy regarding the recreational and medical use of cannabis and cannabinoid compounds.Conclusions: The findings point to considerations for age limits and guidelines for use.
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Affiliation(s)
- Alison C Burggren
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Anaheed Shirazi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
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Zaytseva Y, Horáček J, Hlinka J, Fajnerová I, Androvičová R, Tintěra J, Salvi V, Balíková M, Hložek T, Španiel F, Páleníček T. Cannabis-induced altered states of consciousness are associated with specific dynamic brain connectivity states. J Psychopharmacol 2019; 33:811-821. [PMID: 31154891 DOI: 10.1177/0269881119849814] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cannabis, and specifically one of its active compounds delta-9-tetrahydrocannabinol in recreational doses, has a variety of effects on cognitive processes. Most studies employ resting state functional magnetic resonance imaging techniques to assess the stationary effects of cannabis and to-date one report addressed the impact of delta-9-tetrahydrocannabinol on the dynamics of whole-brain functional connectivity. METHODS Using a repeated-measures, within-subjects design, 19 healthy occasional cannabis users (smoking cannabis ⩽2 per week) underwent resting state functional magnetic resonance imaging scans. Each subject underwent two scans: in the intoxicated condition, shortly after smoking a cannabis cigarette, and in the non-intoxicated condition, with the subject being free from cannabinoids for at least one week before. All sessions were randomized and performed in a four-week interval. Data were analysed employing a standard independent component analysis approach with subsequent tracking of the functional connectivity dynamics, which allowed six connectivity clusters (states) to be individuated. RESULTS Using standard independent component analysis in resting state functional connectivity, a group effect was found in the precuneus connectivity. With a dynamic independent component analysis approach, we identified one transient connectivity state, characterized by high connectivity within and between auditory and somato-motor cortices and anti-correlation with subcortical structures and the cerebellum that was only found during the intoxicated condition. Behavioural measures of the subjective experiences of changed perceptions and tetrahydrocannabinol plasma levels during intoxication were associated with this state. CONCLUSIONS With the help of the dynamic connectivity approach we could elucidate neural correlates of the transitory perceptual changes induced by delta-9-tetrahydrocannabinol in cannabis users, and possibly identify a biomarker of cannabis intoxication.
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Affiliation(s)
- Yuliya Zaytseva
- 1 National Institute of Mental Health, Klecany, Czech Republic.,3 Human Science Centre, Ludwig-Maximilian University, Munich, Germany
| | - Jiří Horáček
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jaroslav Hlinka
- 1 National Institute of Mental Health, Klecany, Czech Republic.,4 Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic
| | - Iveta Fajnerová
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Renata Androvičová
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | | | - Virginio Salvi
- 5 Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marie Balíková
- 6 Institute of Forensic Medicine and Toxicology, Charles University in Prague, Czech Republic
| | - Tomáš Hložek
- 6 Institute of Forensic Medicine and Toxicology, Charles University in Prague, Czech Republic
| | - Filip Španiel
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Tomáš Páleníček
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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O'Connor E, Zeffiro T. Is treated HIV infection still toxic to the brain? PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:259-284. [PMID: 31481166 DOI: 10.1016/bs.pmbts.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Clinically apparent HIV infection, accompanied by CNS opportunistic infections and HIV encephalopathy, was often associated with profound structural and functional brain effects prior to the introduction of anti-retroviral therapy (ART). With treatment, HIV structural and functional brain effects are smaller and have not been as easily detected. With near complete elimination of CNS opportunistic infections, the HIV neuroimaging research community now grapples with the problem of detecting subtler structural and functional changes against a background of persisting confounds, such as comorbidities and clinical features common in the HIV infected population. This situation also raises the question of whether imaging measure changes that are reported as HIV brain effects are purely related to viral infection, rather than originating from confounding effects that might include age, substance use, hepatitis C coinfection, cerebrovascular risk factors, ART, premorbid cognitive skills and illness duration. In addition to cohort characteristics, variation in image acquisition and analysis techniques may also contribute to study outcome heterogeneity. We review the potential effects of these confounds on detection of HIV infection effects and discuss strategies to avoid or mitigate the effects of these confounds. We then present a systematic approach to measurement, design and analysis in HIV neuroimaging studies, combining both experimental and statistical control techniques to determine if HIV infection effects persist, fluctuate or worsen in groups achieving viral suppression from ART.
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Affiliation(s)
- Erin O'Connor
- University of Maryland School of Medicine, Baltimore, MD, United States.
| | - Thomas Zeffiro
- University of Maryland School of Medicine, Baltimore, MD, United States.
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Andrade AK, Renda B, Murray JE. Cannabinoids, interoception, and anxiety. Pharmacol Biochem Behav 2019; 180:60-73. [DOI: 10.1016/j.pbb.2019.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/14/2019] [Accepted: 03/22/2019] [Indexed: 12/16/2022]
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Wilcox CE, Abbott CC, Calhoun VD. Alterations in resting-state functional connectivity in substance use disorders and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:79-93. [PMID: 29953936 PMCID: PMC6309756 DOI: 10.1016/j.pnpbp.2018.06.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 02/06/2023]
Abstract
Substance use disorders (SUD) are diseases of the brain, characterized by aberrant functioning in the neural circuitry of the brain. Resting state functional connectivity (rsFC) can illuminate these functional changes by measuring the temporal coherence of low-frequency fluctuations of the blood oxygenation level-dependent magnetic resonance imaging signal in contiguous or non-contiguous regions of the brain. Because this data is easy to obtain and analyze, and therefore fairly inexpensive, it holds promise for defining biological treatment targets in SUD, which could help maximize the efficacy of existing clinical interventions and develop new ones. In an effort to identify the most likely "treatment targets" obtainable with rsFC we summarize existing research in SUD focused on 1) the relationships between rsFC and functionality within important psychological domains which are believed to underlie relapse vulnerability 2) changes in rsFC from satiety to deprived or abstinent states 3) baseline rsFC correlates of treatment outcome and 4) changes in rsFC induced by treatment interventions which improve clinical outcomes and reduce relapse risk. Converging evidence indicates that likely "treatment target" candidates, emerging consistently in all four sections, are reduced connectivity within executive control network (ECN) and between ECN and salience network (SN). Other potential treatment targets also show promise, but the literature is sparse and more research is needed. Future research directions include data-driven prediction analyses and rsFC analyses with longitudinal datasets that incorporate time since last use into analysis to account for drug withdrawal. Once the most reliable biological markers are identified, they can be used for treatment matching, during preliminary testing of new pharmacological compounds to establish clinical potential ("target engagement") prior to carrying out costly clinical trials, and for generating hypotheses for medication repurposing.
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Zehra A, Burns J, Liu CK, Manza P, Wiers CE, Volkow ND, Wang GJ. Cannabis Addiction and the Brain: a Review. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2019; 17:169-182. [PMID: 32021587 DOI: 10.1176/appi.focus.17204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
(©Zehra A, Liuck, Manza P, Wiers CE, Volkow ND Wergh J, 2018. Reprinted with permission from Journal of Neuroimmune Pharmacology (2018) 13:438-452).
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Zehra A, Burns J, Liu CK, Manza P, Wiers CE, Volkow ND, Wang GJ. Cannabis Addiction and the Brain: a Review. J Neuroimmune Pharmacol 2018; 13:438-452. [PMID: 29556883 PMCID: PMC6223748 DOI: 10.1007/s11481-018-9782-9] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/07/2018] [Indexed: 02/07/2023]
Abstract
Cannabis is the most commonly used substance of abuse in the United States after alcohol and tobacco. With a recent increase in the rates of cannabis use disorder (CUD) and a decrease in the perceived risk of cannabis use, it is imperative to assess the addictive potential of cannabis. Here we evaluate cannabis use through the neurobiological model of addiction proposed by Koob and Volkow. The model proposes that repeated substance abuse drives neurobiological changes in the brain that can be separated into three distinct stages, each of which perpetuates the cycle of addiction. Here we review previous research on the acute and long-term effects of cannabis use on the brain and behavior, and find that the three-stage framework of addiction applies to CUD in a manner similar to other drugs of abuse, albeit with some slight differences. These findings highlight the urgent need to conduct research that elucidates specific neurobiological changes associated with CUD in humans.
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Affiliation(s)
- Amna Zehra
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
| | - Jamie Burns
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
| | - Christopher Kure Liu
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
| | - Corinde E Wiers
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive 31, Room B2L124, Bethesda, MD, 20892, USA.
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46
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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Mouro FM, Ribeiro JA, Sebastião AM, Dawson N. Chronic, intermittent treatment with a cannabinoid receptor agonist impairs recognition memory and brain network functional connectivity. J Neurochem 2018; 147:71-83. [PMID: 29989183 PMCID: PMC6220860 DOI: 10.1111/jnc.14549] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/15/2018] [Accepted: 06/29/2018] [Indexed: 12/11/2022]
Abstract
Elucidating how cannabinoids affect brain function is instrumental for the development of therapeutic tools aiming to mitigate 'on target' side effects of cannabinoid-based therapies. A single treatment with the cannabinoid receptor agonist, WIN 55,212-2, disrupts recognition memory in mice. Here, we evaluate how prolonged, intermittent (30 days) exposure to WIN 55,212-2 (1 mg/kg) alters recognition memory and impacts on brain metabolism and functional connectivity. We show that chronic, intermittent treatment with WIN 55,212-2 disrupts recognition memory (Novel Object Recognition Test) without affecting locomotion and anxiety-like behaviour (Open Field and Elevated Plus Maze). Through 14 C-2-deoxyglucose functional brain imaging we show that chronic, intermittent WIN 55,212-2 exposure induces hypometabolism in the hippocampal dorsal subiculum and in the mediodorsal nucleus of the thalamus, two brain regions directly involved in recognition memory. In addition, WIN 55,212-2 exposure induces hypometabolism in the habenula with a contrasting hypermetabolism in the globus pallidus. Through the application of the Partial Least Squares Regression (PLSR) algorithm to the brain imaging data, we observed that prolonged WIN 55,212-2 administration alters functional connectivity in brain networks that underlie recognition memory, including that between the hippocampus and prefrontal cortex, the thalamus and prefrontal cortex, and between the hippocampus and the perirhinal cortex. In addition, our results support disturbed lateral habenula and serotonin system functional connectivity following WIN 55,212-2 exposure. Overall, this study provides new insight into the functional mechanisms underlying the impact of chronic cannabinoid exposure on memory and highlights the serotonin system as a particularly vulnerable target.
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Affiliation(s)
- Francisco M. Mouro
- Faculdade de MedicinaInstituto de Farmacologia e NeurociênciasUniversidade de LisboaLisboaPortugal
- Faculdade de MedicinaInstituto de Medicina MolecularUniversidade de LisboaLisboaPortugal
| | - Joaquim A. Ribeiro
- Faculdade de MedicinaInstituto de Farmacologia e NeurociênciasUniversidade de LisboaLisboaPortugal
- Faculdade de MedicinaInstituto de Medicina MolecularUniversidade de LisboaLisboaPortugal
| | - Ana M. Sebastião
- Faculdade de MedicinaInstituto de Farmacologia e NeurociênciasUniversidade de LisboaLisboaPortugal
- Faculdade de MedicinaInstituto de Medicina MolecularUniversidade de LisboaLisboaPortugal
| | - Neil Dawson
- Division of Biomedical and Life SciencesUniversity of LancasterLancashireUK
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Kim DJ, Schnakenberg Martin AM, Shin YW, Jo HJ, Cheng H, Newman SD, Sporns O, Hetrick WP, Calkins E, O'Donnell BF. Aberrant structural-functional coupling in adult cannabis users. Hum Brain Mapp 2018; 40:252-261. [PMID: 30203892 DOI: 10.1002/hbm.24369] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/09/2018] [Accepted: 08/11/2018] [Indexed: 12/13/2022] Open
Abstract
Cellular studies indicate that endocannabinoid type-1 retrograde signaling plays a major role in synaptic plasticity. Disruption of these processes by delta-9-tetrahydrocannabinol (THC) could produce alterations either in structural and functional brain connectivity or in their association in cannabis (CB) users. Graph theoretic structural and functional networks were generated with diffusion tensor imaging and resting-state functional imaging in 37 current CB users and 31 healthy non-users. The primary outcome measures were coupling between structural and functional connectivity, global network characteristics, association between the coupling and network properties, and measures of rich-club organization. Structural-functional (SC-FC) coupling was globally preserved showing a positive association in current CB users. However, the users had disrupted associations between SC-FC coupling and network topological characteristics, most perturbed for shorter connections implying region-specific disruption by CB use. Rich-club analysis revealed impaired SC-FC coupling in the hippocampus and caudate of users. This study provides evidence of the abnormal SC-FC association in CB users. The effect was predominant in shorter connections of the brain network, suggesting that the impact of CB use or predispositional factors may be most apparent in local interconnections. Notably, the hippocampus and caudate specifically showed aberrant structural and functional coupling. These structures have high CB1 receptor density and may also be associated with changes in learning and habit formation that occur with chronic cannabis use.
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Affiliation(s)
- Dae-Jin Kim
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | | | - Yong-Wook Shin
- Department of Psychiatry, Ulsan University School of Medicine, ASAN Medical Center, Seoul, South Korea
| | - Hang Joon Jo
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Hu Cheng
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.,Imaging Research Facility, Indiana University, Bloomington, Indiana
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.,Imaging Research Facility, Indiana University, Bloomington, Indiana
| | - Olaf Sporns
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.,Indiana University Network Science Institute, Indiana University, Bloomington, Indiana
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Eli Calkins
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - Brian F O'Donnell
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
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Filbey FM, Gohel S, Prashad S, Biswal BB. Differential associations of combined vs. isolated cannabis and nicotine on brain resting state networks. Brain Struct Funct 2018; 223:3317-3326. [PMID: 29882015 PMCID: PMC6286234 DOI: 10.1007/s00429-018-1690-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/26/2018] [Indexed: 01/30/2023]
Abstract
Concomitant cannabis and nicotine use is more prevalent than cannabis use alone; however, to date, most of the literature has focused on associations of isolated cannabis and nicotine use limiting the generalizability of existing research. To determine differential associations of concomitant use of cannabis and nicotine, isolated cannabis use and isolated nicotine use on brain network connectivity, we examined systems-level neural functioning via independent components analysis (ICA) on resting state networks (RSNs) in cannabis users (CAN, n = 53), nicotine users (NIC, n = 28), concomitant nicotine and cannabis users (NIC + CAN, n = 26), and non-users (CTRL, n = 30). Our results indicated that the CTRL group and NIC + CAN users had the greatest functional connectivity relative to CAN users and NIC users in 12 RSNs: anterior default mode network (DMN), posterior DMN, left frontal parietal network, lingual gyrus, salience network, right frontal parietal network, higher visual network, insular cortex, cuneus/precuneus, posterior cingulate gyrus/middle temporal gyrus, dorsal attention network, and basal ganglia network. Post hoc tests showed no significant differences between (1) CTRL and NIC + CAN and (2) NIC and CAN users. These findings of differential associations of isolated vs. combined nicotine and cannabis use demonstrate an interaction between cannabis and nicotine use on RSNs. These unique and combined mechanisms through which cannabis and nicotine influence cortical network functional connectivity are important to consider when evaluating the neurobiological pathways associated with cannabis and nicotine use.
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Affiliation(s)
- Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
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50
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Scott JC, Slomiak ST, Jones JD, Rosen AFG, Moore TM, Gur RC. Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis. JAMA Psychiatry 2018; 75:585-595. [PMID: 29710074 PMCID: PMC6137521 DOI: 10.1001/jamapsychiatry.2018.0335] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Substantial shifts in perception and policy regarding cannabis have recently occurred, with use of cannabis increasing while its perceived harm decreases. One possible risk of increased cannabis use is poorer cognitive functioning, especially in youth. OBJECTIVE To provide the first quantitative synthesis of the literature examining cannabis and cognitive functioning in adolescents and young adults (with a mean age of 26 years and younger). DATA SOURCES PubMed, PsycInfo, Academic Search Premier, Scopus, and bibliographies of relevant reviews were searched for peer-reviewed, English-language studies from the date the databases began through May 2017. STUDY SELECTION Consensus criteria were used to determine study inclusion through abstract and manuscript review. DATA EXTRACTION AND SYNTHESIS This study followed Meta-analysis of Observational Studies in Epidemiology guidelines. Effect size estimates were calculated using multivariate mixed-effects models for cognitive functioning outcomes classified into 10 domains. MAIN OUTCOMES AND MEASURES Results from neurocognitive tests administered in cross-sectional studies were primary outcomes, and we examined the influence of a priori explanatory variables on variability in effect size. RESULTS Sixty-nine studies of 2152 cannabis users (mean [SD] age, 20.6 [2.8] years; 1472 [68.4%] male) and 6575 comparison participants with minimal cannabis exposure were included (mean [SD] age, 20.8 [3.4]; 3669 [55.8%] male). Results indicated a small overall effect size (presented as mean d) for reduced cognitive functioning associated with frequent or heavy cannabis use (d, -0.25; 95% CI, -0.32 to -0.17; P < .001). The magnitude of effect sizes did not vary by sample age or age at cannabis use onset. However, studies requiring an abstinence period longer than 72 hours (15 studies; n = 928) had an overall effect size (d, -0.08; 95% CI, -0.22 to 0.07) that was not significantly different from 0 and smaller than studies with less stringent abstinence criteria (54 studies; n = 7799; d, -0.30; 95% CI, -0.37 to -0.22; P = .01). CONCLUSIONS AND RELEVANCE Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with cannabis use. Although other outcomes (eg, psychosis) were not examined in the included studies, results indicate that previous studies of cannabis in youth may have overstated the magnitude and persistence of cognitive deficits associated with use. Reported deficits may reflect residual effects from acute use or withdrawal. Future studies should examine individual differences in susceptibility to cannabis-associated cognitive dysfunction.
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Affiliation(s)
- J. Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania
| | - Samantha T. Slomiak
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jason D. Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Adon F. G. Rosen
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Veterans Integrated Service Network 4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania
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