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Bang M, Heo Y, Choi TK, Lee SH. Positive Effects of Uric Acid on White Matter Microstructures and Treatment Response in Patients With Schizophrenia. Schizophr Bull 2024:sbae008. [PMID: 38300803 DOI: 10.1093/schbul/sbae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS Schizophrenia involves microstructural changes in white matter (WM) tracts. Oxidative stress is a key factor causing WM damage by hindering oligodendrocyte development and myelin maturation. Uric acid (UA), an endogenous antioxidant, may protect against oxidative stress. We investigated the effect of UA on WM connectivity in antipsychotic-naive or -free patients with early- or chronic-stage schizophrenia. STUDY DESIGN A total of 192 patients with schizophrenia (122 recent-onset [ROS] and 70 chronic [CS]) and 107 healthy controls (HCs) participated in this study. Diffusion tensor imaging data and serum UA levels at baseline were obtained. STUDY RESULTS Fractional anisotropy was lower in the widespread WM regions across the whole brain, and diffusivity measures were higher in both schizophrenia groups than in HCs. The CS group showed lower diffusivity in some WM tracts than the ROS or HC groups. The linear relationship of serum UA levels with axial and mean diffusivity in the right frontal region was significantly different between schizophrenia stages, which was driven by a negative association in the CS group. WM diffusivity associated with serum UA levels correlated with 8-week treatment responses only in patients with CS, suggesting UA to be protective against long-term schizophrenia. CONCLUSIONS UA may protect against the WM damage associated with the progression of schizophrenia by reducing oxidative stress and supporting WM repair against oxidative damage. These results provide insights into the positive role of UA and may facilitate the development of novel disease-modifying therapies.
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Affiliation(s)
- Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Yul Heo
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Honarvar F, Arfaie S, Edalati H, Ghasroddashti A, Solgi A, Mashayekhi MS, Mofatteh M, Ren LY, Kwan ATH, Keramatian K. Neuroanatomical predictors of problematic alcohol consumption in adolescents: a systematic review of longitudinal studies. Alcohol Alcohol 2023; 58:455-471. [PMID: 37553844 DOI: 10.1093/alcalc/agad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 08/10/2023] Open
Abstract
AIMS This study aimed to systematically review the literature on neuroanatomical predictors of future problematic drinking in adolescents. METHODS Using PRISMA guidelines, a systematic review was conducted to evaluate neuroanatomical predictors of problematic alcohol consumption in adolescents. EMBASE, MEDLINE, and PsycINFO databases were searched from inception to 6 January 2023. Studies were included if they were original, had a prospective design, had a sample size of at least 12, had a follow-up period of at least 1 year, had at least one structural neuroimaging scan before 18 with no prior alcohol use, and had alcohol use as the primary outcome. Studies were excluded if they had animals only and were not in English. Risk of bias was conducted using the CASP tool. RESULTS Out of 1412 studies identified, 19 studies met the criteria, consisting of 11 gray matter (n = 4040), 5 white matter (n = 319), and 3 assessing both (n = 3608). Neuroanatomical predictors of future problematic drinking in adolescents were reported to be distributed across various brain regions such as the orbitofrontal cortex and paralimbic regions. However, the findings were largely heterogeneous. CONCLUSIONS This is the first systematic review to map out the existing literature on neuroanatomical predictors of problematic drinking in adolescents. Future research should focus on the aforementioned regions to determine their role in predicting future problematic drinking with more certainty.
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Affiliation(s)
- Faraz Honarvar
- School of Medicine, Queen's University, 80 Barrie Street, Kingston, Ontario K7L 3N6, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Irving Ludmer Building1033 Pine Avenue West, room 310, Montréal, Québec H3A 1A1, Canada
- Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montréal, Québec H3G 2M1, Canada
- Department of Molecular and Cell Biology, University of California Berkeley, Weill Hall, #3200, Berkeley, CA 94720, United States
| | - Hanie Edalati
- Institut national de psychiatrie légale Philippe-Pinel, Université de Montréal, 10905 Boulevard Henri-Bourassa E, Montreal, Québec, H1C 1H1, Canada
- Centre for Research on Children and Families, McGill University, Room 155, Suite 100, Tour Est550 Sherbrooke Ouest, Montreal, Québec H3A 1B9, Canada
| | - Arashk Ghasroddashti
- School of Medicine, Queen's University, 80 Barrie Street, Kingston, Ontario K7L 3N6, Canada
| | - Arad Solgi
- School of Kinesiology & Health Science, York University, Norman Bethune CollegeRoom 3414700 Keele St, Toronto, Ontario M3J 1P3, Canada
| | | | - Mohammad Mofatteh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, United Kingdom
| | - Lily Yuxi Ren
- Lane Medical Library and Knowledge Management Center, Stanford Medicine, Stanford University, 300 Pasteur Dr, Stanford, CA 94305, United States
| | - Angela T H Kwan
- Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario K1H 8M5, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, British Columbia V6T 2A1, Canada
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Bilaus B, Turchinski NR, Ahdoot HL, Gavish RE, Shany O, Maayan R, Rosca P, Weizman A, Delayahu Y, Yadid G, Admon R. The Effect of Dehydroepiandrosterone Administration during Rehabilitation on White Matter Integrity Among Individuals With Polysubstance Use Disorder. J Addict Med 2023; 17:551-556. [PMID: 37788608 DOI: 10.1097/adm.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Individuals with polysubstance use disorder (pSUD) exhibit vulnerability to relapse even after prolonged abstinence, with rehabilitation efforts achieving limited success. Previous studies highlighted dehydroepiandrosterone (DHEA) as a putative therapeutic agent that may aid rehabilitation, potentially by impacting white matter (WM) properties. The current study tested, for the first time, the effect of DHEA administration during rehabilitation on WM integrity among pSUD individuals, while assessing its putative association with long-term relapse rates. METHODS Immediately after admission to rehabilitation, 30 pSUD individuals were assigned to receive either placebo or DHEA (100 mg) daily for 3 months, via a randomized double-blind counterbalanced design. Participants also provided blood samples to assess circulating DHEA levels at treatment initiation and completed a diffusion tensor imaging (DTI) scan approximately 1 month after treatment initiation. Clinical status was evaluated 16 months after treatment initiation. Thirty matched healthy controls also underwent a DTI scan without any intervention. RESULTS DHEA administration was not associated with reduced relapse rates compared with placebo. Nevertheless, exploratory analysis revealed that DHEA was associated with successful rehabilitation among pSUD individuals with low circulating DHEA levels at treatment initiation. White matter integrity in the splenium corpus callosum (CC) was reduced in pSUD individuals compared with healthy controls, yet pSUD individuals receiving DHEA exhibited recovery of splenium CC WM integrity. CONCLUSIONS DHEA administration during rehabilitation may restore WM integrity in the CC among pSUD individuals. Although DHEA was not associated with reduced relapse rates in here, its therapeutic efficacy may depend on circulating DHEA levels at treatment initiation.
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Affiliation(s)
- Ben Bilaus
- From the School of Psychological Sciences, University of Haifa, Haifa, Israel (BB, RA); Sagol Department of Neurobiology, University of Haifa, Haifa, Israel (NRT); Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel (HLA, REG, GY); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (OS); Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (OS); The Laboratory of Molecular Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel (RM, AW); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (RM, AW, YD); Department for the Treatment of Substance Abuse and Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel (PR); Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel (PR); Research Unit, Geha Mental Health Center, Petah Tikva, Israel (AW); The Dual Diagnosis Ward, Abarbanel Mental Health Center, Bat Yam, Israel (YD); The Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel (RA)
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Robinson EA, Gleeson J, Arun AH, Clemente A, Gaillard A, Rossetti MG, Brambilla P, Bellani M, Crisanti C, Curran HV, Lorenzetti V. Measuring white matter microstructure in 1,457 cannabis users and 1,441 controls: A systematic review of diffusion-weighted MRI studies. FRONTIERS IN NEUROIMAGING 2023; 2:1129587. [PMID: 37554654 PMCID: PMC10406316 DOI: 10.3389/fnimg.2023.1129587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/09/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Cannabis is the most widely used regulated substance by youth and adults. Cannabis use has been associated with psychosocial problems, which have been partly ascribed to neurobiological changes. Emerging evidence to date from diffusion-MRI studies shows that cannabis users compared to controls show poorer integrity of white matter fibre tracts, which structurally connect distinct brain regions to facilitate neural communication. However, the most recent evidence from diffusion-MRI studies thus far has yet to be integrated. Therefore, it is unclear if white matter differences in cannabis users are evident consistently in selected locations, in specific diffusion-MRI metrics, and whether these differences in metrics are associated with cannabis exposure levels. METHODS We systematically reviewed the results from diffusion-MRI imaging studies that compared white matter differences between cannabis users and controls. We also examined the associations between cannabis exposure and other behavioral variables due to changes in white matter. Our review was pre-registered in PROSPERO (ID: 258250; https://www.crd.york.ac.uk/prospero/). RESULTS We identified 30 diffusion-MRI studies including 1,457 cannabis users and 1,441 controls aged 16-to-45 years. All but 6 studies reported group differences in white matter integrity. The most consistent differences between cannabis users and controls were lower fractional anisotropy within the arcuate/superior longitudinal fasciculus (7 studies), and lower fractional anisotropy of the corpus callosum (6 studies) as well as higher mean diffusivity and trace (4 studies). Differences in fractional anisotropy were associated with cannabis use onset (4 studies), especially in the corpus callosum (3 studies). DISCUSSION The mechanisms underscoring white matter differences are unclear, and they may include effects of cannabis use onset during youth, neurotoxic effects or neuro adaptations from regular exposure to tetrahydrocannabinol (THC), which exerts its effects by binding to brain receptors, or a neurobiological vulnerability predating the onset of cannabis use. Future multimodal neuroimaging studies, including recently developed advanced diffusion-MRI metrics, can be used to track cannabis users over time and to define with precision when and which region of the brain the white matter changes commence in youth cannabis users, and whether cessation of use recovers white matter differences. SYSTEMATIC REVIEW REGISTRATION www.crd.york.ac.uk/prospero/, identifier: 258250.
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Affiliation(s)
- Emily Anne Robinson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - John Gleeson
- Digital Innovation in Mental Health and Well-Being Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Arush Honnedevasthana Arun
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Adam Clemente
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Alexandra Gaillard
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Crisanti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - H. Valerie Curran
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Jansen JM, Zijlmans J, Popma A, Marhe R. White matter integrity in delinquent emerging adults and non-delinquent controls, and its relationship with aggression, psychopathic traits, and cannabis use. Front Behav Neurosci 2022; 16:895798. [PMID: 35967894 PMCID: PMC9365978 DOI: 10.3389/fnbeh.2022.895798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background Atypical white matter integrity may be one of the biological factors related to delinquency. In adults, decreased white matter integrity has been related to antisocial behavior, but findings from research in adolescent and young adult populations are either mixed or lacking. Here we investigated this association within a naturalistic sample of delinquent young adults (age 18–27). Methods In a sample of 95 young adult, delinquent men and 22 age and gender matched controls, we assessed white matter integrity through fractional anisotropy and mean diffusivity measures. We compared white matter integrity between the groups, and within the delinquent group assessed the association between white matter integrity and aggression, psychopathic traits, and cannabis use. Results We found no differences in fractional anisotropy or mean diffusivity between delinquent young adults and non-delinquent controls. Additionally, within the group of delinquent young adults, we found no associations between white matter integrity and aggression, psychopathic traits, or cannabis use. Conclusion Our null findings suggest that white matter integrity differences may be unrelated to antisocial behavior in emerging adults, and/or that white matter differences between delinquent populations and controls may only arise later in life.
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Affiliation(s)
- Jochem M. Jansen
- Faculty of Law, Institute for Criminal Law and Criminology, Leiden University, Leiden, Netherlands
- *Correspondence: Jochem M. Jansen
| | - Josjan Zijlmans
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Reshmi Marhe
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
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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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7
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Urbanik A, Kozub J, Karcz P, Ostrogórska M. Changes in the brain directly following alcohol consumption-a study of healthy male individuals, with the use of proton magnetic resonance spectroscopy (1HMRS) and diffusion (DWI). Alcohol Alcohol 2021; 56:415-424. [PMID: 33179046 DOI: 10.1093/alcalc/agaa119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/04/2020] [Accepted: 10/12/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS To use proton magnetic resonance spectroscopy (1HMRS) and diffusion weighted imaging (DWI) to identify ethanol in the brain directly after consumption, and examine changes in brain metabolite levels and brain microstructure relative to the duration of time following exposure to alcohol. METHODS The study involved 44 male volunteers (18-55 years). All brain changes were assessed in the frontal lobes, occipital lobes, basal ganglia and cerebellum, however the detailed analyses focused on the frontal lobes. All participants were examined four times, i.e. before and 0.5-hour, 1 hour and 2 hours after consumption of 150 mL pure vodka (60 g of ethanol). RESULTS The highest ethanol levels were identified between 0.5 and 1 hour following alcohol intake. There were significant increases in the concentrations of lipids and lactates approximately one hour after alcohol consumption, and the concentration levels were found to normalise during the following two hours. Some statistically insignificant trends of changes were found for tCr, tCho, mI, GABA, Glc, Glx and tNAA. For the DWI and ADC (Apparent Diffusion Coefficient of water) values, the findings showed statistically insignificant decrease and increase, followed by a tendency towards normalisation. Similar associations in changes of metabolite concentrations and DWI and ADC values were found in the other locations investigated in the study. CONCLUSION A single dose of alcohol as used in this experiment produces increases in lipids and lactates in brain tissues that appear reversible.
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Affiliation(s)
- Andrzej Urbanik
- Department of Radiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Justyna Kozub
- Department of Radiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Paulina Karcz
- Department of Electroradiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Monika Ostrogórska
- Department of Radiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
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Debenham J, Newton N, Birrell L, Yücel M, Lees B, Champion K. Cannabis and Illicit Drug Use During Neurodevelopment and the Associated Structural, Functional and Cognitive Outcomes: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e18349. [PMID: 32716005 PMCID: PMC7418018 DOI: 10.2196/18349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/16/2023] Open
Abstract
Background High rates of cannabis and illicit drug use are experienced by young people during the final stages of neurodevelopment (aged 15-24 years), a period characterized by high neuroplasticity. Frequent drug use during this time may interfere with neurophysiological and neuropsychological development pathways, potentially leading to ongoing unfavorable neuroadaptations. The dose-response relationship between illicit drug use, exposure, and individual neurodevelopmental variation is unknown but salient with global shifts in the legal landscape and increasingly liberal attitudes and perceptions of the harm caused by cannabis and illicit drugs. Objective This systematic review aims to synthesize longitudinal studies that investigate the effects of illicit drug use on structural, functional, and cognitive brain domains in individuals under the neural age of adulthood (25 years). This protocol outlines prospective methods that will facilitate an exhaustive review of the literature exploring pre- and post-drug use brain abnormalities arising during neurodevelopment. Methods Five electronic databases (Medline, Embase, PsycINFO, ProQuest Central, and Web of Science) will be systematically searched between 1990 and 2019. The search terms will be a combination of MeSH (Medical Subject Headings), with keywords adapted to each database. Study reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and if relevant, study quality will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Eligible studies are those that sampled youth exposed to cannabis or illicit drugs and employed neurophysiological or neuropsychological assessment techniques. Studies will be excluded if participants had been clinically diagnosed with any psychiatric, neurological, or pharmacological condition. Results This is an ongoing review. As of February 2020, papers are in full-text screening, with results predicted to be complete by July 2020. Conclusions Integrating data collected on the three brain domains will enable an assessment of the links between structural, functional, and cognitive brain health across individuals and may support the early detection and prevention of neurodevelopmental harm. Trial Registration PROSPERO CRD42020151442; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=151442 International Registered Report Identifier (IRRID) PRR1-10.2196/18349
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Briana Lees
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research into Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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van den Heuvel MP, Scholtens LH, de Lange SC, Pijnenburg R, Cahn W, van Haren NEM, Sommer IE, Bozzali M, Koch K, Boks MP, Repple J, Pievani M, Li L, Preuss TM, Rilling JK. Evolutionary modifications in human brain connectivity associated with schizophrenia. Brain 2020; 142:3991-4002. [PMID: 31724729 PMCID: PMC6906591 DOI: 10.1093/brain/awz330] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/13/2019] [Accepted: 09/05/2019] [Indexed: 12/21/2022] Open
Abstract
The genetic basis and human-specific character of schizophrenia has led to the hypothesis that human brain evolution may have played a role in the development of the disorder. We examined schizophrenia-related changes in brain connectivity in the context of evolutionary changes in human brain wiring by comparing in vivo neuroimaging data from humans and chimpanzees, one of our closest living evolutionary relatives and a species with which we share a very recent common ancestor. We contrasted the connectome layout between the chimpanzee and human brain and compared differences with the pattern of schizophrenia-related changes in brain connectivity as observed in patients. We show evidence of evolutionary modifications of human brain connectivity to significantly overlap with the cortical pattern of schizophrenia-related dysconnectivity (P < 0.001, permutation testing). We validated these effects in three additional, independent schizophrenia datasets. We further assessed the specificity of effects by examining brain dysconnectivity patterns in seven other psychiatric and neurological brain disorders (including, among others, major depressive disorder and obsessive-compulsive disorder, arguably characterized by behavioural symptoms that are less specific to humans), which showed no such associations with modifications of human brain connectivity. Comparisons of brain connectivity across humans, chimpanzee and macaques further suggest that features of connectivity that evolved in the human lineage showed the strongest association to the disorder, that is, brain circuits potentially related to human evolutionary specializations. Taken together, our findings suggest that human-specific features of connectome organization may be enriched for changes in brain connectivity related to schizophrenia. Modifications in human brain connectivity in service of higher order brain functions may have potentially also rendered the brain vulnerable to brain dysfunction.
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Affiliation(s)
- Martijn P van den Heuvel
- Connectome Lab, Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Lianne H Scholtens
- Connectome Lab, Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Siemon C de Lange
- Connectome Lab, Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Rory Pijnenburg
- Connectome Lab, Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht University, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Iris E Sommer
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht University, The Netherlands.,Department of Neuroscience and Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Marco Bozzali
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex, UK.,Neuroimaging Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Kathrin Koch
- Department of Neuroradiology and TUM-Neuroimaging Center (TUM-NIC), School of Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany
| | - Marco P Boks
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Jonathan Repple
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - Michela Pievani
- Lab Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Longchuan Li
- Marcus Autism Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Todd M Preuss
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.,Center for Translational Social Neuroscience, Emory University, Atlanta, GA, USA.,Center for Behavioral Neuroscience, Atlanta, GA, USA
| | - James K Rilling
- Center for Translational Social Neuroscience, Emory University, Atlanta, GA, USA.,Center for Behavioral Neuroscience, Atlanta, GA, USA.,Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA 30322, USA.,Department of Psychiatry and Behavioral Sciences, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.,Division of Developmental and Cognitive Neuroscience, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
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10
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Hiebler-Ragger M, Unterrainer HF. The Role of Attachment in Poly-Drug Use Disorder: An Overview of the Literature, Recent Findings and Clinical Implications. Front Psychiatry 2019; 10:579. [PMID: 31507461 PMCID: PMC6720034 DOI: 10.3389/fpsyt.2019.00579] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Substance use disorders (SUDs) represent a worldwide epidemic with extensive costs to the individual and to society. Occasionally described as an attachment disorder, they have been linked to various impairments in self-regulation and social functioning. However, while there have been significant advances in the development and validation of treatment strategies for SUD in recent years, the components of these treatment approaches have yet to be fully explored. The characteristics of polydrug use disorder (PUD) especially need to be addressed in more detail, as this diagnosis is highly common in individuals seeking treatment, while simultaneously being associated with poor treatment success. Aim and Scope: This review aims at further exploring the relevance of attachment in PUD and its treatment. To this end, this review provides a concise summary of relevant theories on the development and treatment of SUD in general, including related parameters of attachment, emotion regulation, and neuroscience. Furthermore, several studies focused specifically on PUD are described in more detail. These studies explored the connections between attachment, personality structure, primary and higher emotions (including spirituality), as well as structural and functional neural parameters in inpatients with PUD as well as in healthy controls. Most notably, the described studies highlight that insecure attachment and impairments in personality structure are present in inpatients with PUD. In addition, these characteristics are paralleled by extensive impairments in white matter integrity, especially in tracts connected to facets of emotion regulation. Conclusions: Based on our findings, we emphasize conceptualization of PUD as an Attachment Disorder, on a behavioral as well as on a neural level. Furthermore, we point out the importance of an integrated bio-psycho-social approach in this research area. Consequently, future studies might more closely focus on the influence of attachment-based interventions on emotion regulation abilities as well as a potentially related neuroplasticity. Neuroplastic changes, which are still rather unexplored, might represent important parameters for the assessment of treatment outcomes especially in long-term SUD treatment.
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Affiliation(s)
- Michaela Hiebler-Ragger
- Department for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
- Center for Integrative Addiction Research (CIAR), Gruener Kreis Society, Vienna, Austria
| | - Human-Friedrich Unterrainer
- Department for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
- Center for Integrative Addiction Research (CIAR), Gruener Kreis Society, Vienna, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
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11
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Jacobus J, Courtney KE, Hodgdon EA, Baca R. Cannabis and the developing brain: What does the evidence say? Birth Defects Res 2019; 111:1302-1307. [PMID: 31385460 DOI: 10.1002/bdr2.1572] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
Cannabis use during adolescence has been linked to deleterious effects on brain integrity. This article summarizes findings from two prospective investigations (3 and 6 years, on average) on adolescent cannabis use from our laboratory that utilize structural neuroimaging and neurocognitive assessment approaches. Across most studies, findings suggest recency, frequency, and age of onset of cannabis use are likely key variables in predicting poorer neural health outcomes. There is some evidence that preexisting differences in brain architecture may also contribute to vulnerability and outcome differences. Ongoing large-scale prospective studies of youth will be able to disentangle how both cannabis use as well as pre and postexposure differences play a role in divergent outcomes among youth who use cannabis.
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Affiliation(s)
- Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, California
| | - Kelly E Courtney
- Department of Psychiatry, University of California, San Diego, California
| | | | - Rachel Baca
- Department of Psychiatry, University of California, San Diego, California
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12
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Sex Differences in the Effect of Alcohol Drinking on Myelinated Axons in the Anterior Cingulate Cortex of Adolescent Rats. Brain Sci 2019; 9:brainsci9070167. [PMID: 31315270 PMCID: PMC6680938 DOI: 10.3390/brainsci9070167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 12/29/2022] Open
Abstract
Cognitive deficits associated with teenage drinking may be due to disrupted myelination of prefrontal circuits. To better understand how alcohol affects myelination, male and female Wistar rats (n = 7-9/sex/treatment) underwent two weeks of intermittent operant self-administration of sweetened alcohol or sweetened water early in adolescence (postnatal days 28-42) and we tested for macro- and microstructural changes to myelin. We previously reported data from the males of this study showing that alcohol drinking reduced myelinated fiber density in layers II-V of the anterior cingulate division of the medial prefrontal cortex (Cg1); herein, we show that myelinated fiber density was not significantly altered by alcohol in females. Alcohol drinking patterns were similar in both sexes, but males were in a pre-pubertal state for a larger proportion of the alcohol exposure period, which may have contributed to the differential effects on myelinated fiber density. To gain more insight into how alcohol impacts myelinated axons, brain sections from a subset of these animals (n = 6/sex/treatment) were used for microstructural analyses of the nodes of Ranvier. Confocal analysis of nodal domains, flanked by immunofluorescent-labeled contactin-associated protein (Caspr) clusters, indicated that alcohol drinking reduced nodal length-to-width ratios in layers II/III of the Cg1 in both sexes. Despite sex differences in the underlying cause (larger diameter axons after alcohol in males vs. shorter nodal lengths after alcohol in females), reduced nodal ratios could have important implications for the speed and integrity of neural transmission along these axons in both males and females. Alcohol-induced changes to myelinated axonal populations in the Cg1 may contribute to long-lasting changes in prefrontal function associated with early onset drinking.
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13
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Dotterer HL, Waller R, Shaw DS, Plass J, Brang D, Forbes EE, Hyde LW. Antisocial behavior with callous-unemotional traits is associated with widespread disruptions to white matter structural connectivity among low-income, urban males. Neuroimage Clin 2019; 23:101836. [PMID: 31077985 PMCID: PMC6514428 DOI: 10.1016/j.nicl.2019.101836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 12/28/2022]
Abstract
Antisocial behavior (AB), including violence, criminality, and substance abuse, is often linked to deficits in emotion processing, reward-related learning, and inhibitory control, as well as their associated neural networks. To better understand these deficits, the structural connections between brain regions implicated in AB can be examined using diffusion tensor imaging (DTI), which assesses white matter microstructure. Prior studies have identified differences in white matter microstructure of the uncinate fasciculus (UF), primarily within offender samples. However, few studies have looked beyond the UF or determined whether these relationships are present dimensionally across the range of AB and callous-unemotional (CU) traits. In the current study, we examined associations between AB and white matter microstructure from major fiber tracts, including the UF. Further, we explored whether these associations were specific to individuals high on CU traits. Within a relatively large community sample of young adult men from low-income, urban families (N = 178), we found no direct relations between dimensional, self-report measures of either AB or CU traits and white matter microstructure. However, we found significant associations between AB and white matter microstructure of several tracts only for those with high co-occurring levels of CU traits. In general, these associations did not differ according to race, socioeconomic status, or comorbid psychiatric symptoms. The current results suggest a unique neural profile of severe AB in combination with CU traits, characterized by widespread differences in white matter microstructure, which differs from either AB or CU traits in isolation and is not specific to hypothesized tracts (i.e., the UF).
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Affiliation(s)
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, USA
| | - John Plass
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - David Brang
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Erika E Forbes
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, USA; Department of Pediatrics, University of Pittsburgh, Pittsburgh, USA
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, USA; Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, USA.
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14
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Domen P, Michielse S, Peeters S, Viechtbauer W, van Os J, Marcelis M. Childhood trauma- and cannabis-associated microstructural white matter changes in patients with psychotic disorder: a longitudinal family-based diffusion imaging study. Psychol Med 2019; 49:628-638. [PMID: 29807550 DOI: 10.1017/s0033291718001320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Decreased white matter (WM) integrity in patients with psychotic disorder has been a consistent finding in diffusion tensor imaging (DTI) studies. However, the contribution of environmental risk factors to these WM alterations is rarely investigated. The current study examines whether individuals with (increased risk for) psychotic disorder will show increased WM integrity change over time with increasing levels of childhood trauma and cannabis exposure. METHODS DTI scans were obtained from 85 patients with a psychotic disorder, 93 non-psychotic siblings and 80 healthy controls, of which 60% were rescanned 3 years later. In a whole-brain voxel-based analysis, associations between change in fractional anisotropy (ΔFA) and environmental exposures as well as interactions between group and environmental exposure in the model of FA and ΔFA were investigated. Analyses were adjusted for a priori hypothesized confounding variables: age, sex, and level of education. RESULTS At baseline, no significant associations were found between FA and both environmental risk factors. At follow-up as well as over a 3-year interval, significant interactions between group and, respectively, cannabis exposure and childhood trauma exposure in the model of FA and ΔFA were found. Patients showed more FA decrease over time compared with both controls and siblings when exposed to higher levels of cannabis or childhood trauma. CONCLUSIONS Higher levels of cannabis or childhood trauma may compromise connectivity over the course of the illness in patients, but not in individuals at low or higher than average genetic risk for psychotic disorder, suggesting interactions between the environment and illness-related factors.
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Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
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15
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Hinton KE, Lahey BB, Villalta-Gil V, Meyer FAC, Burgess LL, Chodes LK, Applegate B, Van Hulle CA, Landman BA, Zald DH. White matter microstructure correlates of general and specific second-order factors of psychopathology. Neuroimage Clin 2019; 22:101705. [PMID: 30753960 PMCID: PMC6369105 DOI: 10.1016/j.nicl.2019.101705] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Increasing data indicate that prevalent forms of psychopathology can be organized into second-order dimensions based on their correlations, including a general factor of psychopathology that explains the common variance among all disorders and specific second-order externalizing and internalizing factors. Nevertheless, most existing studies on the neural correlates of psychopathology employ case-control designs that treat diagnoses as independent categories, ignoring the highly correlated nature of psychopathology. Thus, for instance, although perturbations in white matter microstructure have been identified across a range of mental disorders, nearly all such studies used case-control designs, leaving it unclear whether observed relations reflect disorder-specific characteristics or transdiagnostic associations. Using a representative sample of 410 young adult twins oversampled for psychopathology risk, we tested the hypothesis that some previously observed relations between white matter microstructure properties in major tracts and specific disorders are related to second-order factors of psychopathology. We examined fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). White matter correlates of all second-order factors were identified after controlling for multiple statistical tests, including the general factor (FA in the body of the corpus callosum), specific internalizing (AD in the fornix), and specific externalizing (AD in the splenium of the corpus callosum, sagittal stratum, anterior corona radiata, and internal capsule). These findings suggest that some features of white matter within specific tracts may be transdiagnostically associated multiple forms of psychopathology through second-order factors of psychopathology rather with than individual mental disorders.
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Affiliation(s)
- Kendra E Hinton
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States.
| | - Benjamin B Lahey
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States
| | - Victoria Villalta-Gil
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Francisco A C Meyer
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Leah L Burgess
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Laura K Chodes
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Brooks Applegate
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, MI, United States
| | - Carol A Van Hulle
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Bennett A Landman
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - David H Zald
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States
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16
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Huang AS, Mitchell JA, Haber SN, Alia-Klein N, Goldstein RZ. The thalamus in drug addiction: from rodents to humans. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0028. [PMID: 29352027 DOI: 10.1098/rstb.2017.0028] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 02/07/2023] Open
Abstract
Impairments in response inhibition and salience attribution (iRISA) have been proposed to underlie the clinical symptoms of drug addiction as mediated by cortico-striatal-thalamo-cortical networks. The bulk of evidence supporting the iRISA model comes from neuroimaging research that has focused on cortical and striatal influences with less emphasis on the role of the thalamus. Here, we highlight the importance of the thalamus in drug addiction, focusing on animal literature findings on thalamic nuclei in the context of drug-seeking, structural and functional changes of the thalamus as measured by imaging studies in human drug addiction, particularly during drug cue and non-drug reward processing, and response inhibition tasks. Findings from the animal literature suggest that the paraventricular nucleus of the thalamus, the lateral habenula and the mediodorsal nucleus may be involved in the reinstatement, extinction and expression of drug-seeking behaviours. In support of the iRISA model, the human addiction imaging literature demonstrates enhanced thalamus activation when reacting to drug cues and reduced thalamus activation during response inhibition. This pattern of response was further associated with the severity of, and relapse in, drug addiction. Future animal studies could widen their field of focus by investigating the specific role(s) of different thalamic nuclei in different phases of the addiction cycle. Similarly, future human imaging studies should aim to specifically delineate the structure and function of different thalamic nuclei, for example, through the application of advanced imaging protocols at higher magnetic fields (7 Tesla).This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Anna S Huang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Suzanne N Haber
- Department of Pharmacology and Physiology, School of Medicine, University of Rochester, Rochester, NY, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA .,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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Shlosberg D, Amit BH, Zalsman G, Krivoy A, Mell H, Lev-Ran S, Shoval G. Cognitive Impairments in Abstinent Male Residents of a Therapeutic Community for Substance-Use Disorders: A Five-Year Retrospective Study. Subst Use Misuse 2019; 54:538-548. [PMID: 30729882 DOI: 10.1080/10826084.2018.1517800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Prior studies of residual cognitive deficits in abstinent substance-use disorder (SUD) patients, exhibited conflicting reports and a substantial patient selection bias. The aim of this study was to test the cognitive function of a sample of chronic abstinent SUD patients in a therapeutic-community. METHODS The IntegNeuroTM cognitive test battery was used for a retrospective cross-sectional study of cognitive functioning of an unselected sample (n = 105) of abstinent male residents of a therapeutic-community. The results were compared to a large age-, gender-, and education-matched normative cohort. RESULTS A significant negative deviance from the normal cohorts' mean was present in most of the cognitive test results and in all the cognitive domains that were tested. The most substantial deficit was found in the executive function domain (d = 1.02, 95%CI (±0.11)). Correct identification of facial emotions was significantly lower selectively in expressions of disgust and sadness. Substance-use starting at an early age (12.4 ± 0.8 years) was associated with lower performance in tests of sustained attention and impulsivity as well as with varied ability to identify correctly "negative" emotions in the emotion identification domain. CONCLUSIONS This 5-year retrospective study demonstrates substantial cognitive impairments in an unselected sample of abstinent SUD patients. Impairment in multiple cognitive domains may lower the probability for remission and successful social integration. Early-age substance initiation may be associated with larger impairments in cognitive performance.
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Affiliation(s)
- Dan Shlosberg
- a Child and Adolescent Division, Geha Mental Health Center , Petah Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Ben H Amit
- a Child and Adolescent Division, Geha Mental Health Center , Petah Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Gil Zalsman
- a Child and Adolescent Division, Geha Mental Health Center , Petah Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.,c Division of Molecular Imaging and Neuropathology, Department of Psychiatry , Columbia University , New York , New York , USA
| | - Amir Krivoy
- a Child and Adolescent Division, Geha Mental Health Center , Petah Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Haim Mell
- d Therapy and Rehabilitation Unit, Israel Anti-Drug Authority , Jerusalem , Israel
| | - Shaul Lev-Ran
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.,e Outpatient Addiction Clinic, Lev Hasharon Medical Center , Israel
| | - Gal Shoval
- a Child and Adolescent Division, Geha Mental Health Center , Petah Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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18
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Unterrainer HF, Hiebler-Ragger M, Koschutnig K, Fuchshuber J, Ragger K, Perchtold CM, Papousek I, Weiss EM, Fink A. Brain Structure Alterations in Poly-Drug Use: Reduced Cortical Thickness and White Matter Impairments in Regions Associated With Affective, Cognitive, and Motor Functions. Front Psychiatry 2019; 10:667. [PMID: 31616326 PMCID: PMC6763614 DOI: 10.3389/fpsyt.2019.00667] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/19/2019] [Indexed: 12/21/2022] Open
Abstract
Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.
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Affiliation(s)
- Human F Unterrainer
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria.,Institute for Religious Studies, University of Vienna, Vienna, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Klemens Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Ilona Papousek
- Institute of Psychology, University of Graz, Graz, Austria
| | | | - Andreas Fink
- Institute of Psychology, University of Graz, Graz, Austria
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19
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Graham VE, Clough AR. Cannabis Use Among Remote Indigenous Australians: Opportunities to Support Change Identified in Two Waves of Sampling. Front Public Health 2018; 6:310. [PMID: 30450354 PMCID: PMC6225832 DOI: 10.3389/fpubh.2018.00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Cannabis harms among Indigenous populations in Australia, New Zealand, Canada and the United States may be magnified by poorer health and heavy use. However, little direct evidence is available to evaluate cannabis' impacts. In communities in remote northern Queensland (Australia) where cannabis has become endemic, opportunities to support change were investigated. Methods: Opportunistically recruited participants (aged 15-49 years) discussed their cannabis use history in interviews in two waves of population sampling in Cape York (Queensland). Wave 1 included 429 people (235 males and 194 females); and wave 2 included 402 people (228 males and 174 females). Current users (used cannabis during the year before interview) described frequency of use, amount consumed, expenditure and dependence symptoms. Other substance use was recorded for 402 people at wave 2. Results: Wave 1: 69% reported lifetime use and 44% current use. Males (55%) were more likely than females (30%) to be current users (P < 0.001). Most (96%) current users described at least weekly use; nearly half (48%) were "heavy" users (≥6 cones/session at least once/week) and 77% met cannabis dependence criteria. Three communities spent up to $AUD14,200/week on cannabis, around $AUD2.0 million/year, or around 9% of community people's total income on cannabis. The majority (79%) of current users wanted to quit or reduce their cannabis use. Wave 2: no difference was observed in the proportion of lifetime (69%, |z| = 0.04, P = 0.968) or current cannabis users (39%, |z| = 1.39, P = 0.164); nor current use among males (71%, |z| = 0.91, P = 0.363) or females (62%, |z| = 0.36, P = 0.719). However, a significant reduction in current users by 15% (|z| = 2.36, P = 0.018) was observed in one community. Of 105 wave 1 current users re-assessed in 2, 29 (27%) had ceased use. These participants reported cost and family commitments as reasons to change and that social support and employment enabled abstinence. Current and lifetime cannabis use were closely associated with all other substance use, particularly tobacco and alcohol (both P > 0.001). Conclusions: High rates of heavy cannabis use in remote Australian Indigenous communities warrant action. Successful cessation among some individuals suggests that significant opportunities are available to support change even where cannabis use may be endemic.
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Affiliation(s)
- Veronica E Graham
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
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20
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Zhai ZW, Yip SW, Morie KP, Sinha R, Mayes LC, Potenza MN. Substance-use initiation moderates the effect of stress on white-matter microstructure in adolescents. Am J Addict 2018; 27:217-224. [PMID: 29569312 DOI: 10.1111/ajad.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/29/2018] [Accepted: 03/03/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND While childhood stress may contribute risk to substance-use initiation and differences in brain white-matter development, understanding of the potential impact of substance-use initiation on the relationship between experienced stress and white-matter microstructure remains limited. OBJECTIVES This study examined whether substance-use initiation moderated the effect of perceived stress on white-matter differences using measures of primary white-matter fiber anisotropy. METHODS Forty adolescents (age 14.75 ± .87 years) were assessed on the Perceived Stress Scale, and 50% were determined to have presence of substance-use initiation. White-matter microstructure was examined using primary-fiber orientations anisotropy, which may reflect white-matter integrity, modeled separately from other fiber orientations in the same voxels. Analyses were conducted on regions of interest previously associated with childhood stress and substance use. RESULTS Lower perceived stress and presence of substance-use initiation were related to greater right cingulum primary-fiber measures. Substance-use-initiation status moderated the association between perceived stress and right cingulum primary-fiber measures, such that higher perceived stress was associated with lower right cingulum primary-fiber anisotropy in adolescents without substance-use initiation, but not in those with substance-use initiation. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Findings in primary-fiber anisotropy suggest differences in right cingulum white-matter integrity is associated with substance-use initiation in higher-stress adolescents. This reflects a possible pre-existing risk factor, an impact of early substance use, or a combination thereof. Examination of potential markers associated with substance-use initiation in white-matter microstructure among stress-exposed youth warrant additional investigation as such biomarkers may inform efforts relating to tailored interventions. (Am J Addict 2018;27:217-224).
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Affiliation(s)
- Zu Wei Zhai
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Kristen P Morie
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut.,Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut
| | - Linda C Mayes
- Child Study Center, Yale School of Medicine, New Haven, Connecticut.,Departments of Epidemiology, Pediatrics, and Psychology, Yale School of Medicine, New Haven, Connecticut
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut.,Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut.,Connecticut Mental Health Center, New Haven, Connecticut
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21
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Aguilar-Ortiz S, Salgado-Pineda P, Marco-Pallarés J, Pascual JC, Vega D, Soler J, Brunel C, Martin-Blanco A, Soto A, Ribas J, Maristany T, Sarró S, Salvador R, Rodríguez-Fornells A, Pomarol-Clotet E, McKenna PJ. Abnormalities in gray matter volume in patients with borderline personality disorder and their relation to lifetime depression: A VBM study. PLoS One 2018; 13:e0191946. [PMID: 29466364 PMCID: PMC5842882 DOI: 10.1371/journal.pone.0191946] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 01/15/2018] [Indexed: 11/19/2022] Open
Abstract
Background Structural imaging studies of borderline personality disorder (BPD) have found regions of reduced cortical volume, but these have varied considerably across studies. Reduced hippocampus and amygdala volume have also been a regular finding in studies using conventional volumetric measurement. How far comorbid major depression, which is common in BPD and can also affect in brain structure, influences the findings is not clear. Methods Seventy-six women with BPD and 76 matched controls were examined using whole-brain voxel-based morphometry (VBM). The hippocampus and amygdala were also measured, using both conventional volume measurement and VBM within a mask restricted to these two subcortical structures. Lifetime history of major depression was assessed using structured psychiatric interview. Results At a threshold of p = 0.05 corrected, the BPD patients showed clusters of volume reduction in the dorsolateral prefrontal cortex bilaterally and in the pregenual/subgenual medial frontal cortex. There was no evidence of volume reductions in the hippocampus or amygdala, either on conventional volumetry or using VBM masked to these regions. Instead there was evidence of right-sided enlargement of these structures. No significant structural differences were found between patients with and without lifetime major depression. Conclusions According to this study, BPD is characterized by a restricted pattern of cortical volume reduction involving the dorsolateral frontal cortex and the medial frontal cortex, both areas of potential relevance for the clinical features of the disorder. Previous findings concerning reduced hippocampus and amygdala volume in the disorder are not supported. Brain structural findings in BPD do not appear to be explainable on the basis of history of associated lifetime major depression.
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Affiliation(s)
- Salvatore Aguilar-Ortiz
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal. PhD Programme, Doctorat de Psiquiatria. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Josep Marco-Pallarés
- Faculty of Psychology, University of Barcelona, Bellvitge Hospital, Barcelona Spain
| | - Juan C. Pascual
- CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona Spain
| | - Daniel Vega
- Servei de Psiquiatria i Salut Mental, Consorci Sanitari de l’Anoia, Igualada Spain
| | - Joaquim Soler
- CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona Spain
| | - Cristina Brunel
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - Ana Martin-Blanco
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona Spain
| | - Angel Soto
- Servei de Psiquiatria i Salut Mental, Consorci Sanitari de l’Anoia, Igualada Spain
| | - Joan Ribas
- Servei de Psiquiatria i Salut Mental, Consorci Sanitari de l’Anoia, Igualada Spain
| | | | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
| | | | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
- * E-mail:
| | - Peter J. McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Barcelona, Spain
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22
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Unterrainer HF, Hiebler M, Ragger K, Froehlich L, Koschutnig K, Schoeggl H, Kapfhammer HP, Papousek I, Weiss EM, Fink A. White matter integrity in polydrug users in relation to attachment and personality: a controlled diffusion tensor imaging study. Brain Imaging Behav 2017; 10:1096-1107. [PMID: 26542619 DOI: 10.1007/s11682-015-9475-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relationship between substance use disorders (SUD) and brain deficits has been studied extensively. However, there is still a lack of research focusing on the structural neural connectivity in long-term polydrug use disorder (PUD). Since a deficiency in white matter integrity has been reported as being related to various parameters of increased psychopathology, it might be considered an aggravating factor in the treatment of SUD. In this study we compared two groups of PUD inpatients (abstinent: n = 18, in maintenance treatment: n = 15) to healthy controls (n = 16) with respect to neural connectivity in white matter, and their relation to behavioral parameters of personality factors/organization and attachment styles. Diffusion Tensor Imaging was used to investigate white matter structure. Compared with healthy controls, the PUD patients showed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) mainly in the superior fasciculus longitudinalis and the superior corona radiata. These findings suggest diminished neural connectivity as a result of myelin pathology in PUD patients. In line with our assumptions, we observed FA in the biggest cluster as negatively correlated with anxious attachment (r = 0.36, p < 0.05), personality dysfunctioning (r = -0.41; p < 0.01) as well positively correlated with personality factors Openness (r = 0.34; p < 0.05) and Agreeableness (r = 0.28; p < 0.05). Correspondingly these findings were inversely mirrored by RD. Further research employing enhanced samples and addressing longitudinally neuronal plastic effects of SUD treatment in relation to changes in personality and attachment is recommended.
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Affiliation(s)
- H F Unterrainer
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria. .,Center for Integrative Addiction Research (Grüner Kreis Society), Vienna, Austria. .,University Clinic of Psychiatry, Medical University, Graz, Austria. .,Karl-Franzens-University Graz, Universitätsplatz 2, 8010, Graz, Austria.
| | - M Hiebler
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - K Ragger
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - L Froehlich
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - K Koschutnig
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - H Schoeggl
- University Clinic of Psychiatry, Medical University, Graz, Austria
| | - H P Kapfhammer
- University Clinic of Psychiatry, Medical University, Graz, Austria
| | - I Papousek
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - E M Weiss
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - A Fink
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
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23
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Unterrainer HF, Hiebler-Ragger M, Koschutnig K, Fuchshuber J, Tscheschner S, Url M, Wagner-Skacel J, Reininghaus EZ, Papousek I, Weiss EM, Fink A. Addiction as an Attachment Disorder: White Matter Impairment Is Linked to Increased Negative Affective States in Poly-Drug Use. Front Hum Neurosci 2017; 11:208. [PMID: 28503141 PMCID: PMC5408064 DOI: 10.3389/fnhum.2017.00208] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/10/2017] [Indexed: 01/19/2023] Open
Abstract
Substance use disorders (SUD) have been shown to be linked to various neuronal and behavioral impairments. In this study, we investigate whether there is a connection between the integrity of white matter (WM) and attachment styles as well as different affective states including spirituality in a group of patients diagnosed for poly-drug use disorder (PUD) in comparison to non-clinical controls. A total sample of 59 right-handed men, comprising the groups of patients with PUD (n = 19), recreational drug-using individuals (RUC; n = 20) as well as non-drug using controls were recruited (NUC; n = 20). For the behavioral assessment, we applied the Adult Attachment-Scale, the Affective Neuroscience Personality-Scale (short version) and the Multidimensional Inventory for Religious/Spiritual Well-Being. Diffusion Tensor Imaging was used to investigate differences in WM neural connectivity. Analyses revealed decreased Fractional Anisotropy and decreased Mean Diffusivity in PUD patients as compared to RUC and NUC. No differences were found between RUC and NUC. Additional ROI analyses suggested that WM impairment in the superior longitudinal fasciculus (SLF) and the superior corona radiata (SCR) was linked to more insecure attachment as well as to more negative affectivity. No substantial correlation was observed with spirituality. These findings are mainly limited by the cross-sectional design of the study. However, our preliminary results support the idea of addiction as an attachment disorder, both at neuronal and behavioral levels. Further research might be focused on the changes of insecure attachment patterns in SUD treatment and their correlation with changes in the brain.
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Affiliation(s)
- Human-Friedrich Unterrainer
- Institute of Psychology, University of GrazGraz, Austria.,Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | | | - Jürgen Fuchshuber
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | | | - Maria Url
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria
| | - Jolana Wagner-Skacel
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria.,Department of Medical Psychology and Psychotherapy, Medical University GrazGraz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | - Ilona Papousek
- Institute of Psychology, University of GrazGraz, Austria
| | | | - Andreas Fink
- Institute of Psychology, University of GrazGraz, Austria
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24
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Global white matter microstructural abnormalities associated with addiction liability score in drug naïve youth. Brain Imaging Behav 2017; 12:274-283. [PMID: 28271440 DOI: 10.1007/s11682-017-9679-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abnormalities in brain white matter (WM) structure have been reported in youths having a family history of substance use disorders (SUDs). It was hypothesized that these abnormalities constitute features of the liability for SUDs transmitted across generations. The association between severity of intergenerational risk for SUD, measured by the Transmissible Liability Index (TLI), and white matter microstructure was examined. Diffusion tensor imaging (DTI) measured WM microstructure in forty-four drug-naïve 10-14 year-olds (N = 19 with parental SUD). Metrics of WM microstructure (i.e., fractional anisotropy, radial diffusivity, mean diffusivity and axial diffusivity) were quantified across the whole brain and in four tracts of interest: anterior corona radiata, superior and inferior longitudinal fasciculi and superior fronto-occipital fasciculi. The TLI was completed by the youths, their parents and, when available, their teachers. The relationship between WM structure and TLI score across the entire group was evaluated using linear multiple regression and between group comparisons were also examined. Fractional anisotropy and radial diffusivity in multiple tracts across the brain were significantly associated with TLI scores. Confirming and extending prior research, the findings indicate that global atypicality in WM tracts was linearly related to liability for eventual SUD development in drug naïve youths.
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25
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Aberrant Temporal Connectivity in Persons at Clinical High Risk for Psychosis. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:696-705. [PMID: 29202110 DOI: 10.1016/j.bpsc.2016.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Schizophrenia, a neurodevelopmental disorder, involves abnormalities in functional connectivity (FC) across distributed neural networks, which are thought to antedate the emergence of psychosis. In a cohort of adolescents and young adults at clinical high risk (CHR) for psychosis, we applied data-driven approaches to resting-state fMRI data so as to systematically characterize FC abnormalities during this period and determine whether these abnormalities are associated with psychosis risk and severity of psychotic symptoms. Methods Fifty-one CHR participants and 47 matched healthy controls (HCs) were included in our analyses. Twelve of these CHR participants developed psychosis within 3.9 years. We estimated one multivariate measure of FC and studied its relationship to CHR status, conversion to psychosis and positive symptom severity. Results Multivariate analyses revealed between-group differences in whole-brain connectivity patterns of bilateral temporal areas, mostly affecting their functional connections to the thalamus. Further, more severe positive symptoms were associated with greater connectivity abnormalities in the anterior cingulate and frontal cortex. Conclusions Our study demonstrates that the well-established FC abnormalities of the thalamus and temporal areas observed in schizophrenia are also present in the CHR period, with aberrant connectivity of the temporal cortex most associated with psychosis risk.
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26
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Mandelbaum DE, de la Monte SM. Adverse Structural and Functional Effects of Marijuana on the Brain: Evidence Reviewed. Pediatr Neurol 2017; 66:12-20. [PMID: 27789118 PMCID: PMC9954727 DOI: 10.1016/j.pediatrneurol.2016.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 01/30/2023]
Abstract
The growing use and legalization of cannabis are leading to increased exposures across all age groups, including in adolescence. The touting of its medicinal values stems from anecdotal reports related to treatment of a broad range of illnesses including epilepsy, multiple sclerosis, muscle spasms, arthritis, obesity, cancer, Alzheimer disease, Parkinson disease, post-traumatic stress, inflammatory bowel disease, and anxiety. However, anecdotal data and the high level of interest in this treatment must not obscure objective assessments of any potential and realized short- and long-term adverse effects of cannabis, particularly with respect to age of onset and chronicity of exposure. This critical review focuses on evidence-based research designed to assess both therapeutic benefits and harmful effects of cannabis exposure and is combined with an illustration of the neuropathologic findings in a fatal case of cannabis-induced psychosis. The literature and reported case provide strong evidence that chronic cannabis abuse causes cognitive impairment and damages the brain, particularly white matter, where cannabinoid 1 receptors abound. Contrary to popular perception, there are few objective data supporting preferential use of cannabis over conventional therapy for restoration of central nervous system structure and function in disease states such as multiple sclerosis, epilepsy, or schizophrenia. Additional research is needed to determine if subsets of individuals with various neurological and psychiatric diseases derive therapeutic benefits from cannabis.
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Affiliation(s)
- David E. Mandelbaum
- Departments of Neurology and Pediatrics, Hasbro Children’s Hospital and Rhode Island Hospital, and the Alpert Medical School of Brown University, Providence, Rhode Island
| | - Suzanne M. de la Monte
- Departments of Neuropathology and Neurosurgery, Hasbro Children’s Hospital and Rhode Island Hospital, and the Alpert Medical School of Brown University, Providence, Rhode Island,Communications should be addressed to: Dr. de la Monte; Rhode Island Hospital; Pierre Galletti Research Building; 55 Claverick Street; Room 419; Providence, RI 02903.
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27
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Tam PGE. 'White matter connectivity and Internet gaming disorder' and broader considerations in the field. Addict Biol 2017; 22:44-46. [PMID: 26011380 DOI: 10.1111/adb.12265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This invited commentary on the paper 'White Matter Connectivity and Internet gaming disorder' by Jeong et al. (unpublished) looks at the implications and importance of the MRI findings in the present study-one of the largest to date-and also considers the broader developments of neuroimaging within the complex, emerging field of 'Internet psychology' and problematic Internet usage.
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28
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Kelly C, Castellanos FX, Tomaselli O, Lisdahl K, Tamm L, Jernigan T, Newman E, Epstein JN, Molina BSG, Greenhill LL, Potkin SG, Hinshaw S, Swanson JM. Distinct effects of childhood ADHD and cannabis use on brain functional architecture in young adults. NEUROIMAGE-CLINICAL 2016; 13:188-200. [PMID: 27995073 PMCID: PMC5153452 DOI: 10.1016/j.nicl.2016.09.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/04/2016] [Accepted: 09/15/2016] [Indexed: 12/23/2022]
Abstract
One of the most salient long-term implications of a childhood diagnosis of ADHD is an increased risk for substance use, abuse, or dependence in adolescence and adulthood. The extent to which cannabis use affects ADHD-related alterations in brain functional organization is unknown, however. To address this research gap, we recruited a sample of 75 individuals aged 21-25 years with and without a childhood diagnosis of ADHD Combined Type, who were either frequent users or non-users of cannabis. These participants have been followed longitudinally since age 7-9.9 years as part of a large multi-site longitudinal study of ADHD, the Multimodal Treatment Study of Children with ADHD (MTA). We examined task-independent intrinsic functional connectivity (iFC) within 9 functional networks using a 2 × 2 design, which compared four groups of participants: (1) individuals with a childhood diagnosis of ADHD who currently use cannabis (n = 23); (2) individuals with ADHD who do not currently use cannabis (n = 22); (3) comparisons who currently use cannabis (n = 15); and (4) comparisons who do not currently use cannabis (n = 15). The main effects of childhood ADHD were primarily weakened iFC in networks supporting executive function and somatomotor control. Contrary to expectations, effects of cannabis use were distinct from those of diagnostic group and no interactions were observed. Exploratory brain-behavior analyses suggested that ADHD-related effects were primarily linked with poorer neurocognitive performance. Deficits in the integrity of functional networks supporting executive function and somatomotor control are consistent with the phenotypic and neurocognitive features of ADHD. Our data suggest that cannabis use does not exacerbate ADHD-related alterations, but this finding awaits replication in a larger sample. Longitudinal neuroimaging studies are urgently required to delineate the neurodevelopmental cascade that culminates in positive and negative outcomes for those diagnosed with ADHD in childhood.
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Affiliation(s)
- Clare Kelly
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Center for Neurodevelopmental Disorders, Child Study Center, New York University Langone Medical Center, New York, NY, USA
| | - F Xavier Castellanos
- Center for Neurodevelopmental Disorders, Child Study Center, New York University Langone Medical Center, New York, NY, USA; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Olivia Tomaselli
- Center for Neurodevelopmental Disorders, Child Study Center, New York University Langone Medical Center, New York, NY, USA; National Adoption & Fostering Team, Michael Rutter Center, Maudsley Hospital, London, UK
| | - Krista Lisdahl
- University of Wisconsin-Milwaukee, Psychology Department, 2441 E. Hartford Ave, Milwaukee, WI, USA
| | - Leanne Tamm
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML10006 Cincinnati, OH, USA
| | - Terry Jernigan
- Center for Human Development, University of California, San Diego, La Jolla, CA, USA; Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Erik Newman
- Center for Human Development, University of California, San Diego, La Jolla, CA, USA
| | - Jeffery N Epstein
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Steven G Potkin
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Stephen Hinshaw
- Department of Psychology, University of California-Berkeley, Berkeley, CA, USA
| | - James M Swanson
- Child Development Center, University of California, Irvine, Irvine, CA, USA
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29
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Fishbein DH, Rose EJ, Darcey VL, Belcher AM, VanMeter JW. Neurodevelopmental Precursors and Consequences of Substance Use during Adolescence: Promises and Pitfalls of Longitudinal Neuroimaging Strategies. Front Hum Neurosci 2016; 10:296. [PMID: 27445743 PMCID: PMC4919318 DOI: 10.3389/fnhum.2016.00296] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/01/2016] [Indexed: 01/09/2023] Open
Abstract
Neurocognitive and emotional regulatory deficits in substance users are often attributed to misuse; however most studies do not include a substance-naïve baseline to justify that conclusion. The etiological literature suggests that pre-existing deficits may contribute to the onset and escalation of use that are then exacerbated by subsequent use. To address this, there is burgeoning interest in conducting prospective, longitudinal neuroimaging studies to isolate neurodevelopmental precursors and consequences of adolescent substance misuse, as reflected in recent initiatives such as the NIH-led Adolescent Brain Cognitive Development (ABCD) study and the National Consortium on Alcohol and Neurodevelopment (NCANDA). To distinguish neurodevelopmental precursors from the consequences of adolescent substance use specifically, prospective, longitudinal neuroimaging studies with substance-naïve pre-adolescents are needed. The exemplar described in this article—i.e., the ongoing Adolescent Development Study (ADS)—used a targeted recruitment strategy to bolster the numbers of pre-adolescent individuals who were at increased risk of substance use (i.e., “high-risk”) in a sample that was relatively small for longitudinal studies of similar phenomena, but historically large for neuroimaging (i.e., N = 135; 11–13 years of age). At baseline participants underwent MRI testing and a large complement of cognitive and behavioral assessments along with genetics, stress physiology and interviews. The study methods include repeating these measures at three time points (i.e., baseline/Wave 1, Wave 2 and Wave 3), 18 months apart. In this article, rather than outlining specific study outcomes, we describe the breadth of the numerous complexities and challenges involved in conducting this type of prospective, longitudinal neuroimaging study and “lessons learned” for subsequent efforts are discussed. While these types of large longitudinal neuroimaging studies present a number of logistical and scientific challenges, the wealth of information obtained about the precursors and consequences of adolescent substance use provides unique insights into the neurobiological bases for adolescent substance use that will lay the groundwork for targeted interventions.
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Affiliation(s)
- Diana H Fishbein
- Bennett Pierce Prevention Research Center and The Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University University Park, PA, USA
| | - Emma J Rose
- Bennett Pierce Prevention Research Center and The Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University University Park, PA, USA
| | - Valerie L Darcey
- Center for Functional and Molecular Imaging (CFMI), Department of Neurology, Georgetown University Washington, DC, USA
| | - Annabelle M Belcher
- Department of Psychiatry, University of Maryland School of Medicine Baltimore, MD, USA
| | - John W VanMeter
- Center for Functional and Molecular Imaging (CFMI), Department of Neurology, Georgetown University Washington, DC, USA
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30
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Hollins SL, Cairns MJ. MicroRNA: Small RNA mediators of the brains genomic response to environmental stress. Prog Neurobiol 2016; 143:61-81. [PMID: 27317386 DOI: 10.1016/j.pneurobio.2016.06.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/24/2016] [Accepted: 06/11/2016] [Indexed: 01/09/2023]
Abstract
The developmental processes that establish the synaptic architecture of the brain while retaining capacity for activity-dependent remodeling, are complex and involve a combination of genetic and epigenetic influences. Dysregulation of these processes can lead to problems with neural circuitry which manifest in humans as a range of neurodevelopmental syndromes, such as schizophrenia, bipolar disorder and fragile X mental retardation. Recent studies suggest that prenatal, postnatal and intergenerational environmental factors play an important role in the aetiology of stress-related psychopathology. A number of these disorders have been shown to display epigenetic changes in the postmortem brain that reflect early life experience. These changes affect the regulation of gene expression though chromatin remodeling (transcriptional) and post-transcriptional influences, especially small noncoding microRNA (miRNA). These dynamic and influential molecules appear to play an important function in both brain development and its adaption to stress. In this review, we examine the role of miRNA in mediating the brain's response to both prenatal and postnatal environmental perturbations and explore how stress- induced alterations in miRNA expression can regulate the stress response via modulation of the immune system. Given the close relationship between environmental stress, miRNA, and brain development/function, we assert that miRNA hold a significant position at the molecular crossroads between neural development and adaptations to environmental stress. A greater understanding of the dynamics that mediate an individual's predisposition to stress-induced neuropathology has major human health benefits and is an important area of research.
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Affiliation(s)
- Sharon L Hollins
- School of Biomedical Sciences and Pharmacy and the Hunter Medical Research Institute, the University of Newcastle, Callaghan, NSW 2308, Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy and the Hunter Medical Research Institute, the University of Newcastle, Callaghan, NSW 2308, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia.
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31
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Abstract
Adolescence is an important neurodevelopmental period marked by rapidly escalating rates of alcohol and drug use. Over the past decade, research has attempted to disentangle pre- and post-substance use effects on brain development by using sophisticated longitudinal designs. This review focuses on recent, prospective studies and addresses the following important questions: (1) what neuropsychological and neural features predate adolescent substance use, making youth more vulnerable to engage in heavy alcohol or drug use, and (2) how does heavy alcohol and drug use affect normal neural development and cognitive functioning? Findings suggest that pre-existing neural features that relate to increased substance use during adolescence include poorer neuropsychological functioning on tests of inhibition and working memory, smaller gray and white matter volume, changes in white matter integrity, and altered brain activation during inhibition, working memory, reward, and resting state. After substance use is initiated, alcohol and marijuana use are associated with poorer cognitive functioning on tests of verbal memory, visuospatial functioning, psychomotor speed, working memory, attention, cognitive control, and overall IQ. Heavy alcohol use during adolescence is related to accelerated decreases in gray matter and attenuated increases in white matter volume, as well as increased brain activation during tasks of inhibition and working memory, relative to controls. Larger longitudinal studies with more diverse samples are needed to better understand the interactive effects of alcohol, marijuana, and other substances, as well as the role of sex, co-occurring psychopathology, genetics, sleep, and age of initiation on substance use.
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32
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Yu D, Yuan K, Zhang B, Liu J, Dong M, Jin C, Luo L, Zhai J, Zhao L, Zhao Y, Gu Y, Xue T, Liu X, Lu X, Qin W, Tian J. White matter integrity in young smokers: a tract-based spatial statistics study. Addict Biol 2016; 21:679-87. [PMID: 25752453 DOI: 10.1111/adb.12237] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies revealed contradictory effects of smoking on fractional anisotropy (FA). Multiple DTI-derived indices may help to deduce the pathophysiological type of white matter (WM) changes and provide more specific biomarkers of WM neuropathology in the whole brain of young smokers. Twenty-three young smokers and 22 age-, education- and gender-matched healthy non-smoking controls participated in this study. Tract-based spatial statistics was employed to investigate the WM microstructure in young smokers by integrating multiple indices, including FA, mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD). Compared with healthy non-smoking controls, young smokers showed significantly increased FA with increased AD and decreased RD in several brain regions, while no difference in MD was observed. Specifically, the overlapped WM regions with increased FA, increased AD and decreased RD were found in the right posterior limb of the internal capsule, the right external capsule and the right superior corona radiata. Additionally, average FA and RD values in the WM regions mentioned earlier were significantly correlated with pack-years and Fagerström Test for Nicotine Dependence, while no correlation in AD was found. The WM tracts with increased FA may be more associated with RD, rather than AD in young smokers. We suggested that WM properties of several fibres in young smokers may be the biomarker as the cumulative effect and severity of nicotine dependence.
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Affiliation(s)
- Dahua Yu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Kai Yuan
- Life Sciences Research Center; School of Life Science and Technology; Xidian University; China
| | - Baohua Zhang
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Jixin Liu
- Life Sciences Research Center; School of Life Science and Technology; Xidian University; China
| | - Minghao Dong
- Life Sciences Research Center; School of Life Science and Technology; Xidian University; China
| | - Chenwang Jin
- Department of Medical Imaging; The First Affiliated Hospital of Medical College; Xi'an Jiaotong University; China
| | - Lin Luo
- Department of Medical Imaging; The First Affiliated Hospital of Baotou Medical College; Inner Mongolia University of Science and Technology; China
| | - Jinquan Zhai
- Department of Medical Imaging; The First Affiliated Hospital of Baotou Medical College; Inner Mongolia University of Science and Technology; China
| | - Ling Zhao
- The 3rd Teaching Hospital; Chengdu University of Traditional Chinese Medicine; China
| | - Ying Zhao
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Yu Gu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Ting Xue
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Xin Liu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Xiaoqi Lu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
| | - Wei Qin
- Life Sciences Research Center; School of Life Science and Technology; Xidian University; China
| | - Jie Tian
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing; School of Information Engineering; Inner Mongolia University of Science and Technology; China
- Institute of Automation; Chinese Academy of Sciences; China
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Why young people's substance use matters for global health. Lancet Psychiatry 2016; 3:265-79. [PMID: 26905482 DOI: 10.1016/s2215-0366(16)00013-4] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 01/16/2023]
Abstract
During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.
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Tong M, Yu R, Silbermann E, Zabala V, Deochand C, de la Monte SM. Differential Contributions of Alcohol and Nicotine-Derived Nitrosamine Ketone (NNK) to White Matter Pathology in the Adolescent Rat Brain. Alcohol Alcohol 2015; 50:680-9. [PMID: 26373813 DOI: 10.1093/alcalc/agv102] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 08/17/2015] [Indexed: 12/30/2022] Open
Abstract
AIM Epidemiologic studies have demonstrated high rates of smoking among alcoholics, and neuroimaging studies have detected white matter atrophy and degeneration in both smokers and individuals with alcohol-related brain disease (ARBD). These findings suggest that tobacco smoke exposure may be a co-factor in ARBD. The present study examines the differential and additive effects of tobacco-specific nitrosamine (NNK) and ethanol exposures on the structural and functional integrity of white matter in an experimental model. METHODS Adolescent Long Evans rats were fed liquid diets containing 0 or 26% ethanol for 8 weeks. In weeks 3-8, rats were treated with nicotine-derived nitrosamine ketone (NNK) (2 mg/kg, 3×/week) or saline by i.p. injection. In weeks 7-8, the ethanol group was binge-administered ethanol (2 g/kg; 3×/week). RESULTS Ethanol, NNK and ethanol + NNK caused striking degenerative abnormalities in white matter myelin and axons, with accompanying reductions in myelin-associated glycoprotein expression. Quantitative RT-PCR targeted array and heatmap analyses demonstrated that ethanol modestly increased, whereas ethanol + NNK sharply increased expression of immature and mature oligodendroglial genes, and that NNK increased immature but inhibited mature oligodendroglial genes. In addition, NNK modulated expression of neuroglial genes in favor of growth cone collapse and synaptic disconnection. Ethanol- and NNK-associated increases in FOXO1, FOXO4 and NKX2-2 transcription factor gene expression could reflect compensatory responses to brain insulin resistance in this model. CONCLUSION Alcohol and tobacco exposures promote ARBD by impairing myelin synthesis, maturation and integrity via distinct but overlapping mechanisms. Public health measures to reduce ARBD should target both alcohol and tobacco abuses.
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Affiliation(s)
- Ming Tong
- Department of Medicine, Division of Gastroenterology, and the Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rosa Yu
- Departments of Pathology and Neurology, and the Division of Neuropathology, Rhode Island Hospital, Providence, RI, USA
| | | | - Valerie Zabala
- Molecular Pharmacology and Physiology Graduate Program, Brown University, Providence, RI, USA
| | - Chetram Deochand
- Biotechnology Graduate Program, Brown University, Providence, RI, USA
| | - Suzanne M de la Monte
- Department of Medicine, Division of Gastroenterology, and the Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA Departments of Pathology and Neurology, and the Division of Neuropathology, Rhode Island Hospital, Providence, RI, USA
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Isokuortti H, Iverson GL, Kataja A, Brander A, Öhman J, Luoto TM. Who Gets Head Trauma or Recruited in Mild Traumatic Brain Injury Research? J Neurotrauma 2015; 33:232-41. [PMID: 26054639 DOI: 10.1089/neu.2015.3888] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is a public health problem. Outcome from mTBI is heterogeneous in part due to pre-injury individual differences that typically are not well described or understood. Pre-injury health characteristics of all consecutive patients (n=3023) who underwent head computed tomography due to acute head trauma in the emergency department of Tampere University Hospital, Finland, between August 2010 and July 2012 were examined. Patients were screened to obtain a sample of working age adults with no pre-injury medical or mental health problems who had sustained a "pure" mTBI. Of all patients screened, 1990 (65.8%) fulfilled the mTBI criteria, 257 (8.5%) had a more severe TBI, and 776 (25.7%) had a head trauma without obvious signs of brain injury. Injury-related data and participant-related data (e.g., age, sex, diagnosed diseases, and medications) were collected from hospital records. The most common pre-injury diseases were circulatory (39.4%-43.2%), neurological (23.7%-25.2%), and psychiatric (25.8%-27.5%) disorders. Alcohol abuse was present in 18.4%-26.8%. The most common medications were for cardiovascular (33.1%-36.6%), central nervous system (21.4%-30.8%), and blood clotting and anemia indications (21.5%-22.6%). Of the screened patients, only 2.5% met all the enrollment criteria. Age, neurological conditions, and psychiatric problems were the most common reasons for exclusion. Most of the patients sustaining an mTBI have some pre-injury diseases or conditions that could affect clinical outcome. By excluding patients with pre-existing conditions, the patients with known risk factors for poor outcome remain poorly studied.
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Affiliation(s)
| | - Grant L Iverson
- 2 Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; MassGeneral Hospital for Children Sports Concussion Program; Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts
| | - Anneli Kataja
- 3 Department of Radiology, Tampere University Hospital , Tampere, Finland
| | - Antti Brander
- 3 Department of Radiology, Tampere University Hospital , Tampere, Finland
| | - Juha Öhman
- 4 Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland
| | - Teemu M Luoto
- 5 Department of Neurosurgery, Tampere University Hospital , Tampere, Finland
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Development of the uncinate fasciculus: Implications for theory and developmental disorders. Dev Cogn Neurosci 2015; 14:50-61. [PMID: 26143154 PMCID: PMC4795006 DOI: 10.1016/j.dcn.2015.06.003] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/29/2015] [Accepted: 06/18/2015] [Indexed: 12/27/2022] Open
Abstract
The uncinate fasciculus (UF) is a long-range white matter tract that connects limbic regions in the temporal lobe to the frontal lobe. The UF is one of the latest developing tracts, and continues maturing into the third decade of life. As such, individual differences in the maturational profile of the UF may serve to explain differences in behavior. Indeed, atypical macrostructure and microstructure of the UF have been reported in numerous studies of individuals with developmental and psychiatric disorders such as social deprivation and maltreatment, autism spectrum disorders, conduct disorder, risk taking, and substance abuse. The present review evaluates what we currently know about the UF's developmental trajectory and reviews the literature relating UF abnormalities to specific disorders. Additionally, we take a dimensional approach and critically examine symptoms and behavioral impairments that have been demonstrated to cluster with UF aberrations, in an effort to relate these impairments to our speculations regarding the functionality of the UF. We suggest that developmental disorders with core problems relating to memory retrieval, reward and valuation computation, and impulsive decision making may be linked to aberrations in uncinate microstructure.
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The Clinical Impact of the Brain Disease Model of Alcohol and Drug Addiction: Exploring the Attitudes of Community-Based AOD Clinicians in Australia. NEUROETHICS-NETH 2015. [DOI: 10.1007/s12152-015-9236-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Epstein KA, Kumra S. White matter fractional anisotropy over two time points in early onset schizophrenia and adolescent cannabis use disorder: A naturalistic diffusion tensor imaging study. Psychiatry Res 2015; 232:34-41. [PMID: 25779033 DOI: 10.1016/j.pscychresns.2014.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/15/2014] [Accepted: 10/12/2014] [Indexed: 12/18/2022]
Abstract
Recurrent exposure to cannabis in adolescence increases the risk for later development of psychosis, but there are sparse data regarding the impact of cannabis use on brain structure during adolescence. This pilot study investigated the effect of cannabis use disorder (CUD) upon white matter fractional anisotropy (WM FA) values in non-psychotic treatment-seeking adolescents relative to adolescents with early onset schizophrenia-spectrum disorders (EOSS) and to healthy control (HC) participants. Diffusion tensor imaging (DTI) and tractography methods were used to examine fractional anisotropy (FA) of the cingulum bundle, superior longitudinal fasciculus (SLF), corticospinal tract (CST), inferior longitudinal fasciculus (ILF), inferior fronto-occipital fasciculus (IFOF) and uncinate fasciculus in adolescents with EOSS (n=34), CUD (n=19) and HC (n=29). Participants received DTI and substance use assessments at baseline and at 18-month follow-up. Using multivariate analysis of variance, a significant main effect of diagnostic group was observed. Post-hoc testing revealed that adolescents with CUD showed an altered change in FA values in the left ILF and in the left IFOF (trend level) compared with HC adolescents. Greater consumption of cannabis during the inter-scan interval predicted a greater decrease in left ILF FA in CUD. These preliminary longitudinal data suggest that heavy cannabis use during adolescence, or some factor associated with cannabis use, is associated with an altered change in WM FA values in a fiber bundle that has been implicated in the pathophysiology of EOSS (i.e., the left ILF). Additional studies are needed to clarify the clinical significance of these findings.
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Affiliation(s)
- Katherine A Epstein
- Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Sanjiv Kumra
- Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, USA.
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Hall W. What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 2015; 110:19-35. [PMID: 25287883 DOI: 10.1111/add.12703] [Citation(s) in RCA: 346] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 05/21/2014] [Accepted: 08/04/2014] [Indexed: 12/11/2022]
Abstract
AIMS To examine changes in the evidence on the adverse health effects of cannabis since 1993. METHODS A comparison of the evidence in 1993 with the evidence and interpretation of the same health outcomes in 2013. RESULTS Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco. CONCLUSIONS The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.
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Affiliation(s)
- Wayne Hall
- The University of Queensland Centre for Youth Substance Abuse Research and The UQ Centre for Clinical Research, Herston, Australia; The National Addiction Centre, Kings College London, London, UK; National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia
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Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther 2014; 148:1-16. [PMID: 25460036 DOI: 10.1016/j.pharmthera.2014.11.009] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/14/2022]
Abstract
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Monash Clinical & Imaging Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Ewing SWF, Sakhardande A, Blakemore SJ. The effect of alcohol consumption on the adolescent brain: A systematic review of MRI and fMRI studies of alcohol-using youth. NEUROIMAGE-CLINICAL 2014; 5:420-37. [PMID: 26958467 PMCID: PMC4749850 DOI: 10.1016/j.nicl.2014.06.011] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background A large proportion of adolescents drink alcohol, with many engaging in high-risk patterns of consumption, including binge drinking. Here, we systematically review and synthesize the existing empirical literature on how consuming alcohol affects the developing human brain in alcohol-using (AU) youth. Methods For this systematic review, we began by conducting a literature search using the PubMED database to identify all available peer-reviewed magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) studies of AU adolescents (aged 19 and under). All studies were screened against a strict set of criteria designed to constrain the impact of confounding factors, such as co-occurring psychiatric conditions. Results Twenty-one studies (10 MRI and 11 fMRI) met the criteria for inclusion. A synthesis of the MRI studies suggested that overall, AU youth showed regional differences in brain structure as compared with non-AU youth, with smaller grey matter volumes and lower white matter integrity in relevant brain areas. In terms of fMRI outcomes, despite equivalent task performance between AU and non-AU youth, AU youth showed a broad pattern of lower task-relevant activation, and greater task-irrelevant activation. In addition, a pattern of gender differences was observed for brain structure and function, with particularly striking effects among AU females. Conclusions Alcohol consumption during adolescence was associated with significant differences in structure and function in the developing human brain. However, this is a nascent field, with several limiting factors (including small sample sizes, cross-sectional designs, presence of confounding factors) within many of the reviewed studies, meaning that results should be interpreted in light of the preliminary state of the field. Future longitudinal and large-scale studies are critical to replicate the existing findings, and to provide a more comprehensive and conclusive picture of the effect of alcohol consumption on the developing brain. A large proportion of adolescents drink alcohol. Studies show how alcohol affects human adolescent brain development. This includes a systematic review of MRI and fMRI studies in alcohol-using youth. Changes in structure and function are observed in the brain in alcohol-using youth.
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Affiliation(s)
| | - Ashok Sakhardande
- UCL Institute of Cognitive Neuroscience, 17 Queen Square, London WC1N 3AR, UK
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Cookey J, Bernier D, Tibbo PG. White matter changes in early phase schizophrenia and cannabis use: an update and systematic review of diffusion tensor imaging studies. Schizophr Res 2014; 156:137-42. [PMID: 24842540 DOI: 10.1016/j.schres.2014.04.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/11/2014] [Accepted: 04/16/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The impact of cannabis use on the brain tissue is still unclear, both in the healthy developing brain and in people with schizophrenia. The focus of this review is on white matter, the primary connective infrastructure of the brain. METHODS We systematically reviewed diffusion tensor imaging (DTI) studies of early phase schizophrenia (illness effect), of cannabis use in otherwise healthy brains (drug effect), and of early phase schizophrenia with cannabis use (combined effects). Studies had to include a healthy, non-cannabis using, control group as well as report on fractional anisotropy as it is the most commonly used DTI index. We excluded cohorts with heavy alcohol or illicit drug use and studies with a sample size of less than 20 in the clinical group. RESULTS We retained 17 studies of early phase schizophrenia, which together indicate deficits in white matter integrity observed in all fiber tract families, but most frequently in association, callosal and projection fibers. In otherwise healthy cannabis users (2 studies), deficits in white matter tracts were reported mainly in callosal fibers, but also in projection and limbic fibers. In cannabis users with early phase schizophrenia (1 study), deficits in white matter integrity were also observed in all fiber tract families, except for limbic fibers. CONCLUSIONS The current literature points to several families of white matter tracts being differentially affected in early phase schizophrenia. Further work is required to reveal the impact of cannabis use in otherwise healthy people as well as those with schizophrenia. LIMITATIONS Paucity of available studies as well as restricting analysis to FA values represent the main limitations of this review.
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Affiliation(s)
- Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2
| | - Denise Bernier
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2.
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Brooks SJ, Dalvie S, Cuzen NL, Cardenas V, Fein G, Stein DJ. Childhood adversity is linked to differential brain volumes in adolescents with alcohol use disorder: a voxel-based morphometry study. Metab Brain Dis 2014; 29:311-21. [PMID: 24496784 PMCID: PMC4023014 DOI: 10.1007/s11011-014-9489-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/13/2014] [Indexed: 01/11/2023]
Abstract
Previous neuroimaging studies link both alcohol use disorder (AUD) and early adversity to neurobiological differences in the adult brain. However, the association between AUD and childhood adversity and effects on the developing adolescent brain are less clear, due in part to the confound of psychiatric comorbidity. Here we examine early life adversity and its association with brain volume in a unique sample of 116 South African adolescents (aged 12-16) with AUD but without psychiatric comorbidity. Participants were 58 adolescents with DSM-IV alcohol dependence and with no other psychiatric comorbidities, and 58 age-, gender- and protocol-matched light/non-drinking controls (HC). Assessments included the Childhood Trauma Questionnaire (CTQ). MR images were acquired on a 3T Siemens Magnetom Allegra scanner. Volumes of global and regional structures were estimated using SPM8 Voxel Based Morphometry (VBM), with analysis of covariance (ANCOVA) and regression analyses. In whole brain ANCOVA analyses, a main effect of group when examining the AUD effect after covarying out CTQ was observed on brain volume in bilateral superior temporal gyrus. Subsequent regression analyses to examine how childhood trauma scores are linked to brain volumes in the total cohort revealed a negative correlation in the left hippocampus and right precentral gyrus. Furthermore, bilateral (but most significantly left) hippocampal volume was negatively associated with sub-scores on the CTQ in the total cohort. These findings support our view that some alterations found in brain volumes in studies of adolescent AUD may reflect the impact of confounding factors such as psychiatric comorbidity rather than the effects of alcohol per se. In particular, early life adversity may influence the developing adolescent brain in specific brain regions, such as the hippocampus.
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