1
|
Xu H, Li J, Huang H, Yin B, Li DD. Abnormal developmental of structural covariance networks in young adults with heavy cannabis use: a 3-year follow-up study. Transl Psychiatry 2024; 14:45. [PMID: 38245512 PMCID: PMC10799944 DOI: 10.1038/s41398-024-02764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Heavy cannabis use (HCU) exerts adverse effects on the brain. Structural covariance networks (SCNs) that illustrate coordinated regional maturation patterns are extensively employed to examine abnormalities in brain structure. Nevertheless, the unexplored aspect remains the developmental alterations of SCNs in young adults with HCU for three years, from the baseline (BL) to the 3-year follow-up (FU). These changes demonstrate dynamic development and hold potential as biomarkers. A total of 20 young adults with HCU and 22 matched controls were recruited. All participants underwent magnetic resonance imaging (MRI) scans at both the BL and FU and were evaluated using clinical measures. Both groups used cortical thickness (CT) and cortical surface area (CSA) to construct structural covariance matrices. Subsequently, global and nodal network measures of SCNs were computed based on these matrices. Regarding global network measures, the BL assessment revealed significant deviations in small-worldness and local efficiency of CT and CSA in young adults with HCU compared to controls. However, no significant differences between the two groups were observed at the FU evaluation. Young adults with HCU displayed changes in nodal network measures across various brain regions during the transition from BL to FU. These alterations included abnormal nodal degree, nodal efficiency, and nodal betweenness in widespread areas such as the entorhinal cortex, superior frontal gyrus, and parahippocampal cortex. These findings suggest that the topography of CT and CSA plays a role in the typical structural covariance topology of the brain. Furthermore, these results indicate the effect of HCU on the developmental changes of SCNs in young adults.
Collapse
Affiliation(s)
- Hui Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325007, China.
| | - Jiahao Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Huang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan-Dong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
| |
Collapse
|
2
|
Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Psychiatr Clin North Am 2023; 46:655-676. [PMID: 37879830 DOI: 10.1016/j.psc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
Collapse
Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
| |
Collapse
|
3
|
Ertl N, Lawn W, Mokrysz C, Freeman TP, Alnagger N, Borissova A, Fernandez-Vinson N, Lees R, Ofori S, Petrilli K, Trinci K, Viding E, Curran HV, Wall MB. Associations between regular cannabis use and brain resting-state functional connectivity in adolescents and adults. J Psychopharmacol 2023; 37:904-919. [PMID: 37515469 DOI: 10.1177/02698811231189441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND/AIM Cannabis use is highly prevalent in adolescents; however, little is known about its effects on adolescent brain function. METHOD Resting-state functional magnetic resonance imaging was used in matched groups of regular cannabis users (N = 70, 35 adolescents: 16-17 years old, 35 adults: 26-29 years old) and non-regular-using controls (N = 70, 35 adolescents/35 adults). Pre-registered analyses examined the connectivity of seven major cortical and sub-cortical brain networks (default mode network, executive control network (ECN), salience network, hippocampal network and three striatal networks) using seed-based analysis methods with cross-sectional comparisons between user groups and age groups. RESULTS The regular cannabis use group (across both age groups), relative to controls, showed localised increases in connectivity only in the ECN analysis. All networks showed localised connectivity differences based on age group, with the adolescents generally showing weaker connectivity than adults, consistent with the developmental effects. Mean connectivity across entire network regions of interest (ROIs) was also significantly decreased in the ECN in adolescents. However, there were no significant interactions found between age group and user group in any of the seed-based or ROI analyses. There were also no associations found between cannabis use frequency and any of the derived connectivity measures. CONCLUSION Regular cannabis use is associated with changes in connectivity of the ECN, which may reflect allostatic or compensatory changes in response to regular cannabis intoxication. However, these associations were not significantly different in adolescents compared to adults.
Collapse
Affiliation(s)
- Natalie Ertl
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Will Lawn
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Naji Alnagger
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, University College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | | | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Essi Viding
- Clinical, Educational, and Health Psychology Research Department, University College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
4
|
Lamanna-Rama N, MacDowell KS, López G, Leza JC, Desco M, Ambrosio E, Soto-Montenegro ML. Neuroimaging revealed long-lasting glucose metabolism changes to morphine withdrawal in rats pretreated with the cannabinoid agonist CP-55,940 during periadolescence. Eur Neuropsychopharmacol 2023; 69:60-76. [PMID: 36780817 DOI: 10.1016/j.euroneuro.2023.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/28/2022] [Accepted: 01/22/2023] [Indexed: 02/13/2023]
Abstract
This study evaluates the long-term effects of a six and 14-week morphine withdrawal in rats pretreated with a cannabinoid agonist (CP-55,940, CP) during periadolescence. Wistar rats (33 males; 32 females) were treated with CP or its vehicle (VH) from postnatal day (PND) 28-38. At PND100, rats performed morphine self-administration (MSA, 15d/12 h/session). Eight groups were defined according to pretreatment (CP), treatment (morphine), and sex. Three [18F]FDG-PET brain images were acquired: after MSA, and after six and 14 weeks of withdrawal. PET data were analyzed with SPM12. Endocannabinoid (EC) markers were evaluated in frozen brain tissue at endpoint. Females showed a higher mean number of self-injections than males. A main Sex effect on global brain metabolism was found. FDG uptake in males was discrete, whereas females showed greater brain metabolism changes mainly in areas of the limbic system after morphine treatment. Moreover, the morphine-induced metabolic pattern in females was exacerbated when CP was previously present. In addition, the CP-Saline male group showed reduced CB1R, MAGL expression, and NAPE/FAAH ratio compared to the control group, and morphine was able to reverse CB1R and MAGL expression almost to control levels. In conclusion, females showed greater and longer-lasting metabolic changes after morphine withdrawal than males, indicating a higher vulnerability and a different sensitivity to morphine in subjects pre-exposed to CP. In contrast, males primarily showed changes in EC markers. Together, our results suggest that CP pre-exposure contributes to the modulation of brain metabolism and EC systems in a sex-dependent manner.
Collapse
Affiliation(s)
- N Lamanna-Rama
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés, Spain
| | - K S MacDowell
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Farmacología & Toxicología, Facultad de Medicina, Universidad Complutense de Madrid, Imas12, IUIN, Spain
| | - G López
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Psicobiología, Facultad de Psicología, National University for Distance Learning (UNED), Madrid, Spain; Faculty of Health Science, Universidad Internacional de La Rioja (UNIR), Spain
| | - J C Leza
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Farmacología & Toxicología, Facultad de Medicina, Universidad Complutense de Madrid, Imas12, IUIN, Spain
| | - M Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - E Ambrosio
- Departamento de Psicobiología, Facultad de Psicología, National University for Distance Learning (UNED), Madrid, Spain.
| | - M L Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Grupo de Fisiopatología y Farmacología del Sistema Digestivo de la Universidad Rey Juan Carlos (NEUGUT), Madrid, España.
| |
Collapse
|
5
|
Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Child Adolesc Psychiatr Clin N Am 2023; 32:21-42. [PMID: 36410904 DOI: 10.1016/j.chc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
Collapse
Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
| |
Collapse
|
6
|
Hubbard NA, Miller KB, Aloi J, Bajaj S, Wakabayashi KT, Blair RJR. Evaluating instrumental learning and striatal-cortical functional connectivity in adolescent alcohol and cannabis use. Addict Biol 2023; 28:e13258. [PMID: 36577718 PMCID: PMC10173870 DOI: 10.1111/adb.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
Adolescence is a vulnerable time for the acquisition of substance use disorders, potentially relating to ongoing development of neural circuits supporting instrumental learning. Striatal-cortical circuits undergo dynamic changes during instrumental learning and are implicated in contemporary addiction theory. Human studies have not yet investigated these dynamic changes in relation to adolescent substance use. Here, functional magnetic resonance imaging was used while 135 adolescents without (AUD-CUDLow ) and with significant alcohol (AUDHigh ) or cannabis use disorder symptoms (CUDHigh ) performed an instrumental learning task. We assessed how cumulative experience with instrumental cues altered cue selection preferences and functional connectivity strength between reward-sensitive striatal and cortical regions. Adolescents in AUDHigh and CUDHigh groups were slower in learning to select optimal instrumental cues relative to AUD-CUDLow adolescents. The relatively fast learning observed for AUD-CUDLow adolescents coincided with stronger functional connectivity between striatal and frontoparietal regions during early relative to later periods of task experience, whereas the slower learning for the CUDHigh group coincided with the opposite pattern. The AUDHigh group not only exhibited slower learning but also produced more instrumental choice errors relative to AUD-CUDLow adolescents. For the AUDHigh group, Bayesian analyses evidenced moderate support for no experience-related changes in striatal-frontoparietal connectivity strength during the task. Findings suggest that adolescent cannabis use is related to slowed instrumental learning and delays in peak functional connectivity strength between the striatal-frontoparietal regions that support this learning, whereas adolescent alcohol use may be more closely linked to broader impairments in instrumental learning and a general depression of the neural circuits supporting it.
Collapse
Affiliation(s)
- NA Hubbard
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - KB Miller
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - J Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - S Bajaj
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE
| | - KT Wakabayashi
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - RJR Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| |
Collapse
|
7
|
Rafei P, Rezapour T, Batouli SAH, Verdejo-García A, Lorenzetti V, Hatami J. How do cannabis users mentally travel in time? Evidence from an fMRI study of episodic future thinking. Psychopharmacology (Berl) 2022; 239:1441-1457. [PMID: 34694424 DOI: 10.1007/s00213-021-06002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Episodic future thinking (EFT) is a cognitive function that allows individuals to imagine novel experiences that may happen in the future. Prior studies show that EFT is impaired in different groups of substance users. However, there is no evidence regarding the neurobiological mechanisms of EFT in cannabis users. OBJECTIVES We aimed to compare brain activations of regular cannabis users and non-using controls during an EFT fMRI task. Exploratory analyses were also conducted to investigate the association between EFT and cannabis use variables (e.g., duration of use, age onset, frequency of use). METHODS Twenty current cannabis users and 22 drug-naïve controls underwent an fMRI scanning session while completing a task involving envisioning future-related events and retrieval of past memories as a control condition. The EFT fMRI task was adapted from the autobiographical interview and composed of 20 auditory cue sentences (10 cues for past and 10 cues for future events). Participants were asked to recall a past or generate a future event, in response to the cues, and then rate their vividness after each response. RESULTS We found that cannabis users compared to non-user controls had lower activation within the cerebellum, medial and superior temporal gyrus, lateral occipital cortex, and occipital fusiform gyrus while envisioning future events. Cannabis users rated the vividness of past events significantly lower than non-users (P < 0.005). There were marginal group differences for rating the vividness of future events (P = 0.052). Significant correlations were also found between the medial and superior temporal gyrus activities and behavioral measures of EFT and episodic memory. CONCLUSIONS Cannabis users, compared to drug-naïve controls, have lower brain activation in EFT relevant regions. Thus, any attempts to improve aberrant EFT performance in cannabis users may benefit from EFT training.
Collapse
Affiliation(s)
- Parnian Rafei
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute of Cognitive Sciences Studies (ICSS), Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Medical Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- Healthy Brain and Mind Research Centre, School of Behavioral & Health Sciences, Neuroscience of Addiction and Mental Health Program, Australian Catholic University, Victoria, Australia
| | - Javad Hatami
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
| |
Collapse
|
8
|
Testai FD, Gorelick PB, Aparicio HJ, Filbey FM, Gonzalez R, Gottesman RF, Melis M, Piano MR, Rubino T, Song SY. Use of Marijuana: Effect on Brain Health: A Scientific Statement From the American Heart Association. Stroke 2022; 53:e176-e187. [PMID: 35142225 DOI: 10.1161/str.0000000000000396] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Marijuana is perceived as a harmless drug, and its recreational use has gained popularity among young individuals. The concentration of active ingredients in recreational formulations has gradually increased over time, and high-potency illicit cannabinomimetics have become available. Thus, the consumption of cannabis in the general population is rising. Data from preclinical models demonstrate that cannabinoid receptors are expressed in high density in areas involved in cognition and behavior, particularly during periods of active neurodevelopment and maturation. In addition, growing evidence highlights the role of endogenous cannabinoid pathways in the regulation of neurotransmitter release, synaptic plasticity, and neurodevelopment. In animal models, exogenous cannabinoids disrupt these important processes and lead to cognitive and behavioral abnormalities. These data correlate with the higher risk of cognitive impairment reported in some observational studies done in humans. It is unclear whether the effect of cannabis on cognition reverts after abstinence. However, this evidence, along with the increased risk of stroke reported in marijuana users, raises concerns about its potential long-term effects on cognitive function. This scientific statement reviews the safety of cannabis use from the perspective of brain health, describes mechanistically how cannabis may cause cognitive dysfunction, and advocates for a more informed health care worker and consumer about the potential for cannabis to adversely affect the brain.
Collapse
|
9
|
Fischer B, Robinson T, Bullen C, Curran V, Jutras-Aswad D, Medina-Mora ME, Pacula RL, Rehm J, Room R, van den Brink W, Hall W. Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103381. [PMID: 34465496 DOI: 10.1016/j.drugpo.2021.103381] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based 'Lower Risk Cannabis Use Guidelines' (LRCUG) and recommendations were previously developed to reduce modifiable risk factors of cannabis-related adverse health outcomes; related evidence has evolved substantially since. We aimed to review new scientific evidence and to develop comprehensively up-to-date LRCUG, including their recommendations, on this evidence basis. METHODS Targeted searches for literature (since 2016) on main risk factors for cannabis-related adverse health outcomes modifiable by the user-individual were conducted. Topical areas were informed by previous LRCUG content and expanded upon current evidence. Searches preferentially focused on systematic reviews, supplemented by key individual studies. The review results were evidence-graded, topically organized and narratively summarized; recommendations were developed through an iterative scientific expert consensus development process. RESULTS A substantial body of modifiable risk factors for cannabis use-related health harms were identified with varying evidence quality. Twelve substantive recommendation clusters and three precautionary statements were developed. In general, current evidence suggests that individuals can substantially reduce their risk for adverse health outcomes if they delay the onset of cannabis use until after adolescence, avoid the use of high-potency (THC) cannabis products and high-frequency/-intensity of use, and refrain from smoking-routes for administration. While young people are particularly vulnerable to cannabis-related harms, other sub-groups (e.g., pregnant women, drivers, older adults, those with co-morbidities) are advised to exercise particular caution with use-related risks. Legal/regulated cannabis products should be used where possible. CONCLUSIONS Cannabis use can result in adverse health outcomes, mostly among sub-groups with higher-risk use. Reducing the risk factors identified can help to reduce health harms from use. The LRCUG offer one targeted intervention component within a comprehensive public health approach for cannabis use. They require effective audience-tailoring and dissemination, regular updating as new evidence become available, and should be evaluated for their impact.
Collapse
Affiliation(s)
- Benedikt Fischer
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Tessa Robinson
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Chris Bullen
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; National Institute for Health Innovation (NIHI), The University of Auckland, Auckland, New Zealand
| | - Valerie Curran
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada; Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Maria Elena Medina-Mora
- Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico; Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosalie Liccardo Pacula
- Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction & Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wim van den Brink
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, QLD 4072, Australia; National Addiction Centre, Institute of Psychiatry, Kings College London, United Kingdom
| |
Collapse
|
10
|
Flannery JS, Riedel MC, Salo T, Poudel R, Laird AR, Gonzalez R, Sutherland MT. HIV infection is linked with reduced error-related default mode network suppression and poorer medication management abilities. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110398. [PMID: 34224796 PMCID: PMC8380727 DOI: 10.1016/j.pnpbp.2021.110398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/07/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Brain activity linked with error processing has rarely been examined among persons living with HIV (PLWH) despite importance for monitoring and modifying behaviors that could lead to adverse health outcomes (e.g., medication non-adherence, drug use, risky sexual practices). Given that cannabis (CB) use is prevalent among PLWH and impacts error processing, we assessed the influence of HIV serostatus and chronic CB use on error-related brain activity while also considering associated implications for everyday functioning and clinically-relevant disease management behaviors. METHODS A sample of 109 participants, stratified into four groups by HIV and CB (HIV+/CB+, n = 32; HIV+/CB-, n = 27; HIV-/CB+, n = 28; HIV-/CB-, n = 22), underwent fMRI scanning while completing a modified Go/NoGo paradigm called the Error Awareness Task (EAT). Participants also completed a battery of well-validated instruments including a subjective report of everyday cognitive failures and an objective measure of medication management abilities. RESULTS Across all participants, we observed expected error-related anterior insula (aI) activation which correlated with better task performance (i.e., less errors) and, among HIV- participants, fewer self-reported cognitive failures. Regarding awareness, greater insula activation as well as greater posterior cingulate cortex (PCC) deactivation were notably linked with aware (vs. unaware) errors. Regarding group effects, unlike HIV- participants, PLWH displayed a lack of error-related deactivation in two default mode network (DMN) regions (i.e., PCC, medial prefrontal cortex [mPFC]). No CB main or interaction effects were detected. Across all participants, reduced error-related PCC deactivation correlated with reduced medication management abilities and PCC deactivation mediated the effect of HIV on such abilities. More lifetime CB use was linked with reduced error-related mPFC deactivation among HIV- participants and poorer medication management across CB users. CONCLUSIONS These results demonstrate that insufficient error-related DMN suppression linked with HIV infection, as well as chronic CB use among HIV- participants, has real-world consequences for medication management behaviors. We speculate that insufficient DMN suppression may reflect an inability to disengage task irrelevant mental operations, ultimately hindering error monitoring and behavior modification.
Collapse
Affiliation(s)
| | | | - Taylor Salo
- Department of Psychology, Florida International University, Miami, FL
| | - Ranjita Poudel
- Department of Psychology, Florida International University, Miami, FL
| | - Angela R. Laird
- Department of Physics, Florida International University, Miami, FL
| | - Raul Gonzalez
- Department of Psychology, Florida International University, Miami, FL
| | - Matthew T. Sutherland
- Department of Psychology, Florida International University, Miami, FL,Correspondence: Matthew T. Sutherland, Ph.D., Florida International University, Department of Psychology, AHC-4, RM 312, 11299 S.W. 8th St, Miami, FL 33199, , 305-348-7962
| |
Collapse
|
11
|
Ellingson JM, Hinckley JD, Ross JM, Schacht JP, Bidwell LC, Bryan AD, Hopfer CJ, Riggs P, Hutchison KE. The Neurocognitive Effects of Cannabis Across the Lifespan. Curr Behav Neurosci Rep 2021; 8:124-133. [DOI: 10.1007/s40473-021-00244-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
Abstract
PURPOSE Alcohol and cannabis are the most commonly used substances during adolescence and are typically initiated during this sensitive neurodevelopmental period. The aim of this review is to provide a comprehensive overview of the most recent literature focused on understanding how these substances affect the developing brain. SEARCH METHODS Articles included in this review were identified by entering 30 search terms focused on substance use, adolescence, and neurodevelopment into MEDLINE, Embase, PsycINFO, ProQuest Central, and Web of Science. Studies were eligible for inclusion if they longitudinally examined the effect of adolescent alcohol and/or cannabis use on structural or functional outcomes in 50 or more participants. SEARCH RESULTS More than 700 articles were captured by the search, and 43 longitudinal studies met inclusion criteria, including 18 studies focused on alcohol use, 13 on cannabis use, and 12 on alcohol and cannabis co-use. DISCUSSION AND CONCLUSIONS Existing studies suggest heavy alcohol and cannabis use during adolescence are related to small to moderate disruptions in brain structure and function, as well as neurocognitive impairment. The effects of alcohol use include widespread decreases in gray matter volume and cortical thickness across time; slowed white matter growth and poorer integrity; disrupted network efficiency; and poorer impulse and attentional control, learning, memory, visuospatial processing, and psychomotor speed. The severity of some effects is dependent on dose. Heavy to very heavy cannabis use is associated with decreased subcortical volume and increased frontoparietal cortical thickness, disrupted functional development, and decreased executive functioning and IQ compared to non-using controls. Overall, co-use findings suggest more pronounced effects related to alcohol use than to cannabis use. Several limitations exist in the literature. Sample sizes are relatively small and demographically homogenous, with significant heterogeneity in substance use patterns and methodologies across studies. More research is needed to clarify how substance dosing and interactions between substances, as well as sociodemographic and environmental factors, affect outcomes. Larger longitudinal studies, already underway, will help clarify the relationship between brain development and substance use.
Collapse
Affiliation(s)
- Briana Lees
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Jennifer Debenham
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
13
|
MacDonald B, Sadek J. Naturalistic exploratory study of the associations of substance use on ADHD outcomes and function. BMC Psychiatry 2021; 21:251. [PMID: 33980212 PMCID: PMC8117494 DOI: 10.1186/s12888-021-03263-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/29/2021] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Although Attention Deficit Hyperactivity Disorder (ADHD) is associated with an increased risk of substance use disorder (SUD), existing literature on how SUD interacts with ADHD outcomes is limited. This study investigates whether SUD among individuals with ADHD is associated with worse ADHD outcomes and prognosis, and the association between overall functioning and SUD. In addition, we seek to understand whether heavy cannabis use is a better predictor of poorer outcomes compared to SUD status alone. METHOD We conducted a retrospective analysis on 50 ADHD patient charts, which were allocated based on SUD status. Subgroup analysis was performed on the total sample population, with allocation based on heavy cannabis use. Mann-Whitney and Chi-Square tests were used for both the primary and subgroup analyses. RESULTS SUD status highly correlated with more ADHD-related cognitive impairments and poorer functional outcomes at the time of diagnosis. ADHD patients with comorbid ADHD-SUD scored significantly lower (p = < 0.0001) on objective cognitive testing (Integrated Auditory and Visual Continuous Performance Test (IVA/CPT)) than ADHD patients without SUD. The correlation with poorer ADHD outcomes was more pronounced when groups were allocated based on heavy cannabis use status; in addition to significantly lower IVA/CPT scores (p = 0.0011), heavy cannabis use was associated with more severe fine motor hyperactivity and self-reported hyperactivity/impulsivity scores (p = 0.0088 and 0.0172, respectively). CONCLUSION Future research is needed to determine how substance abuse can be a barrier to improved ADHD outcomes, and the effect cannabis and other substances have on cognitive function and pharmacotherapy of ADHD.
Collapse
Affiliation(s)
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
14
|
Blest-Hopley G, O'Neill A, Wilson R, Giampietro V, Bhattacharyya S. Disrupted parahippocampal and midbrain function underlie slower verbal learning in adolescent-onset regular cannabis use. Psychopharmacology (Berl) 2021; 238:1315-1331. [PMID: 31814047 PMCID: PMC8062355 DOI: 10.1007/s00213-019-05407-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/18/2019] [Indexed: 11/18/2022]
Abstract
RATIONALE Prolonged use of cannabis, the most widely used illicit drug worldwide, has been consistently associated with impairment in memory and verbal learning. Although the neurophysiological underpinnings of these impairments have been investigated previously using functional magnetic resonance imaging (fMRI), while performing memory tasks, the results of these studies have been inconsistent and no clear picture has emerged yet. Furthermore, no previous studies have investigated trial-by-trial learning. OBJECTIVES We aimed to investigate the neural underpinnings of impaired verbal learning in cannabis users as estimated over repeated learning trials. METHODS We studied 21 adolescent-onset regular cannabis users and 21 non-users using fMRI performed at least 12 h after last cannabis use, while they performed a paired associate verbal learning task that allowed us to examine trial-by-trial learning. Brain activation during repeated verbal encoding and recall conditions of the task was indexed using the blood oxygen level-dependent haemodynamic response fMRI signal. RESULTS There was a significant improvement in recall score over repeated trials indicating learning occurring across the two groups of participants. However, learning was significantly slower in cannabis users compared to non-users (p = 0.032, partial eta-squared = 0.108). While learning verbal stimuli over repeated encoding blocks, non-users displayed progressive increase in recruitment of the midbrain, parahippocampal gyrus and thalamus (p = 0.00939, partial eta-squared = 0.180). In contrast, cannabis users displayed a greater but disrupted activation pattern in these regions, which showed a stronger correlation with new word-pairs learnt over the same blocks in cannabis users than in non-users. CONCLUSIONS These results suggest that disrupted medial temporal and midbrain function underlie slower learning in adolescent-onset cannabis users.
Collapse
Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
| |
Collapse
|
15
|
Hernandez Mejia M, Wade NE, Baca R, Diaz VG, Jacobus J. The Influence of Cannabis and Nicotine Co-use on Neuromaturation: A Systematic Review of Adolescent and Young Adult Studies. Biol Psychiatry 2021; 89:162-171. [PMID: 33334432 PMCID: PMC7749265 DOI: 10.1016/j.biopsych.2020.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that the use of cannabis and nicotine and tobacco-related products (NTPs) during the adolescent years has harmful effects on the developing brain. Yet, few studies have focused on the developing brain as it relates to the co-administration of cannabis and NTPs, despite the high prevalence rates of co-use in adolescence. This review aims to synthesize the existing literature on neurocognitive, structural neuroimaging, and functional neuroimaging outcomes associated with cannabis and NTP co-use. A systematic search of peer-reviewed articles resulted in a pool of 1107 articles. Inclusion criteria were 1) data-based study; 2) age range of 13 to 35 years or, for preclinical studies, nonadult subjects; 3) cannabis and NTP group jointly considered; and 4) neurocognitive, structural neuroimaging, or functional neuroimaging as an outcome measure. Twelve studies met inclusion criteria. Consistent with the literature, cannabis and nicotine were found to have independent effects on cognition. The available research on the co-use of cannabis and NTPs demonstrates a potential nicotine-related masking effect on cognitive deficits associated with cannabis use, yet there is little research on co-use and associations with neuroimaging indices. In neuroimaging studies, there is preliminary evidence for hippocampal volume differences in co-users and a lack of evidence for co-use differences related to nucleus accumbens activity during reward processing. Notably, no structural neuroimaging studies were found to examine the combined effects of nicotine and cannabis in adolescent-only populations. Further research, including longitudinal studies, is warranted to investigate the influence of cannabis and NTP co-use on maturation.
Collapse
Affiliation(s)
- Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California
| | - Natasha E Wade
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Vanessa G Diaz
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, San Diego, California.
| |
Collapse
|
16
|
Blest‐Hopley G, O'Neill A, Wilson R, Giampietro V, Lythgoe D, Egerton A, Bhattacharyya S. Adolescent-onset heavy cannabis use associated with significantly reduced glial but not neuronal markers and glutamate levels in the hippocampus. Addict Biol 2020; 25:e12827. [PMID: 31478302 DOI: 10.1111/adb.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
Cannabis use has been associated with adverse mental health outcomes, the neurochemical underpinnings of which are poorly understood. Although preclinical evidence suggests glutamatergic dysfunction following cannabis exposure in several brain regions including the hippocampus, evidence from human studies have been inconsistent. We investigated the effect of persistent cannabis use on the brain levels of N-acetyl aspartate (NAA) and myoinositol, the metabolite markers of neurons and glia, the site of the main central cannabinoid CB1 receptor, and the levels of glutamate, the neurotransmitter directly affected by CB1 modulation. We investigated cannabis users (CUs) who started using during adolescence, the period of greatest vulnerability to cannabis effects and focused on the hippocampus, where type 1 cannabinoid receptors (CBR1) are expressed in high density and have been linked to altered glutamatergic neurotransmission. Twenty-two adolescent-onset CUs and 21 nonusing controls (NU), completed proton magnetic resonance spectroscopy, to measure hippocampal metabolite concentrations. Glutamate, NAA, and myoinositol levels were compared between CU and NU using separate analyses of covariance. CU had significantly lower myoinositol but not glutamate or NAA levels in the hippocampus compared with NU. Myoinositol levels in CU positively correlated with glutamate levels, whereas this association was absent in NU. Altered myoinositol levels may be a marker of glia dysfunction and is consistent with experimental preclinical evidence that cannabinoid-induced glial dysfunction may underlie cannabinoid-induced memory impairments. Future studies using appropriate imaging techniques such as positron emission tomography should investigate whether glial dysfunction associated with cannabis use underlies hippocampal dysfunction and memory impairment in CUs.
Collapse
Affiliation(s)
- Grace Blest‐Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - David Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- South London and Maudsley NHS Foundation Trust London UK
| |
Collapse
|
17
|
Visuospatial Processing Decline Due to Cannabis Consumption in Nondependent High School Students. EDUCATIONAL PSYCHOLOGY REVIEW 2020. [DOI: 10.1007/s10648-020-09564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
18
|
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
Collapse
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
| |
Collapse
|
19
|
Krebs MO, Demars F, Frajerman A, Kebir O, Jay T. [Neurodevelopment and cannabis]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2020; 204:561-569. [PMID: 32308209 PMCID: PMC7162744 DOI: 10.1016/j.banm.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/07/2020] [Indexed: 11/23/2022]
Abstract
Brain development is a complex phenomenon, stretching from fetal life to adolescence, during which brain maturation proceeds through a series of ordered events including critical periods of plasticity. The brain is particularly sensitive to the environment during these changes. The endocannabinoid system participates directly and indirectly in these plasticity and maturation processes. The main psychoactive component of cannabis, the delta-9-tetrahydrocanabinol, can cross the placental barrier, is present in breastmilk and diffuses in the brain. It interacts with the endocannabinoid signaling, especially through the activation of cannabinoid receptors 1 CB1R, which can lead to abnormal neurodevelopmental processes and neuronal circuits functions. Therefore, exposure to cannabis in utero, in perinatal phase, as well as during the adolescence disrupts the brain maturation and can cause disturbances on the cognitive, psychotic and addictive levels that persist far beyond the period of exposure. Several factors modulate the risk of such complications, but studies performed in animal models as well as in human cohorts have shown that exposure during both the critical perinatal and adolescence phases is a risk factor per se. Current knowledge encourages the dissemination of objective information to young people, to prevent and limit early exposure and its consequences.
Collapse
Affiliation(s)
- M.-O. Krebs
- Pôle hospitalo-universitaire évaluation, prévention et innovation thérapeutique, centre d’évaluation pour jeunes adultes et adolescents (CJAAD), GHU psychiatrie et neurosciences, site Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - F. Demars
- Pôle hospitalo-universitaire évaluation, prévention et innovation thérapeutique, centre d’évaluation pour jeunes adultes et adolescents (CJAAD), GHU psychiatrie et neurosciences, site Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - A. Frajerman
- Pôle hospitalo-universitaire évaluation, prévention et innovation thérapeutique, centre d’évaluation pour jeunes adultes et adolescents (CJAAD), GHU psychiatrie et neurosciences, site Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - O. Kebir
- Pôle hospitalo-universitaire évaluation, prévention et innovation thérapeutique, centre d’évaluation pour jeunes adultes et adolescents (CJAAD), GHU psychiatrie et neurosciences, site Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
- Pôle hospitalo-universitaire 15è, service d’addictologie, GHU psychiatrie et neurosciences, Paris, France
| | - T. Jay
- Pôle hospitalo-universitaire évaluation, prévention et innovation thérapeutique, centre d’évaluation pour jeunes adultes et adolescents (CJAAD), GHU psychiatrie et neurosciences, site Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| |
Collapse
|
20
|
Colizzi M, Ruggeri M, Bhattacharyya S. Unraveling the Intoxicating and Therapeutic Effects of Cannabis Ingredients on Psychosis and Cognition. Front Psychol 2020; 11:833. [PMID: 32528345 PMCID: PMC7247841 DOI: 10.3389/fpsyg.2020.00833] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/03/2020] [Indexed: 12/14/2022] Open
Abstract
Research evidence suggests a dose–response relationship for the association between cannabis use and risk of psychosis. Such relationship seems to reflect an increased risk of psychosis not only as a function of frequent cannabis use, but also of high-potency cannabis use in terms of concentration of Δ-9-tetrahydrocannabinol (Δ9-THC), its main psychoactive component. This finding would be in line with the evidence that Δ9-THC administration induces transient psychosis-like symptoms in otherwise healthy individuals. Conversely, low-potency varieties would be less harmful because of their lower amount of Δ9-THC and potential compresence of another cannabinoid, cannabidiol (CBD), which seems to mitigate Δ9-THC detrimental effects. A growing body of studies begins to suggest that CBD may have not only protective effects against the psychotomimetic effects of Δ9-THC but even therapeutic properties on its own, opening new prospects for the treatment of psychosis. Despite being more limited, evidence of the effects of cannabis on cognition seems to come to similar conclusions, with increasing Δ9-THC exposure being responsible for the cognitive impairments attributed to recreational cannabis use while CBD preventing such effects and, when administered alone, enhancing cognition. Molecular evidence indicates that Δ9-THC and CBD may interact with cannabinoid receptors with almost opposite mechanisms, with Δ9-THC being a partial agonist and CBD an inverse agonist/antagonist. With the help of imaging techniques, pharmacological studies in vivo have been able to show opposite effects of Δ9-THC and CBD also on brain function. Altogether, they may account for the intoxicating and therapeutic effects of cannabis on psychosis and cognition.
Collapse
Affiliation(s)
- Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
21
|
Neuropsychological Trajectories Associated with Adolescent Alcohol and Cannabis Use: A Prospective 14-Year Study. J Int Neuropsychol Soc 2020; 26:480-491. [PMID: 31822320 PMCID: PMC7205577 DOI: 10.1017/s1355617719001395] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Alcohol and cannabis remain the substances most widely used by adolescents. Better understanding of the dynamic relationship between trajectories of substance use in relation to neuropsychological functioning is needed. The aim of this study was to examine the different impacts of within- and between-person changes in alcohol and cannabis use on neuropsychological functioning over multiple time points. METHODS Hierarchical linear modeling examined the effects of alcohol and cannabis use on neuropsychological functioning over the course of 14 years in a sample of 175 adolescents (aged 12-15 years at baseline). RESULTS Time-specific fluctuations in alcohol use (within-person effect) predicted worse performance across time on the Wechsler Abbreviated Scale of Intelligence Block Design subtest (B = -.05, SE = .02, p = .01). Greater mean levels of percent days of cannabis use across time (between-person effect) were associated with an increased contrast score between Delis-Kaplan Executive Function System Color Word Inhibition and Color Naming conditions (B = .52, SE = .14, p < .0001) and poorer performance over time on Block Design (B = -.08, SE = .04, p = .03). Neither alcohol and/nor cannabis use over time was associated with performance in the verbal memory and processing speed domains. CONCLUSIONS Greater cumulative cannabis use over adolescence may be linked to poorer inhibitory control and visuospatial functioning performance, whereas more proximal increases in alcohol consumption during adolescence may drive alcohol-related performance decrements in visuospatial functioning. Results from this prospective study add to the growing body of literature on the impact of alcohol and cannabis use on cognition from adolescent to young adulthood.
Collapse
|
22
|
Macías-Triana L, Romero-Cordero K, Tatum-Kuri A, Vera-Barrón A, Millán-Aldaco D, Arankowsky-Sandoval G, Piomelli D, Murillo-Rodríguez E. Exposure to the cannabinoid agonist WIN 55, 212–2 in adolescent rats causes sleep alterations that persist until adulthood. Eur J Pharmacol 2020; 874:172911. [DOI: 10.1016/j.ejphar.2020.172911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/10/2019] [Accepted: 01/07/2020] [Indexed: 12/15/2022]
|
23
|
Kashyap R, Bhattacharjee S, Yeo BTT, Chen SHA. Maximizing dissimilarity in resting state detects heterogeneous subtypes in healthy population associated with high substance use and problems in antisocial personality. Hum Brain Mapp 2020; 41:1261-1273. [PMID: 31773817 PMCID: PMC7267929 DOI: 10.1002/hbm.24873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/05/2019] [Accepted: 11/12/2019] [Indexed: 01/08/2023] Open
Abstract
Patterns in resting-state fMRI (rs-fMRI) are widely used to characterize the trait effects of brain function. In this aspect, multiple rs-fMRI scans from single subjects can provide interesting clues about the rs-fMRI patterns, though scan-to-scan variability pose challenges. Therefore, rs-fMRI's are either concatenated or the functional connectivity is averaged. This leads to loss of information. Here, we use an alternative way to extract the rs-fMRI features that are common across all the scans by applying common-and-orthogonal-basis-extraction (COBE) technique. To address this, we employed rs-fMRI of 788 subjects from the human connectome project and estimated the common-COBE-component of each subject from the four rs-fMRI runs. Since the common-COBE-component is specific to a subject, the pattern was used to classify the subjects based on the similarity/dissimilarity of the features. The subset of subjects (n = 107) with maximal-COBE-dissimilarity (MCD) was extracted and the remaining subjects (n = 681) formed the COBE-similarity (CS) group. The distribution of weights of the common-COBE-component for the two groups across rs-fMRI networks and subcortical regions was evaluated. We found the weights in the default mode network to be lower in the MCD compared to the CS. We compared the scores of 69 behavioral measures and found six behaviors related to the use of marijuana, illicit drugs, alcohol, and tobacco; and including a measure of antisocial personality to differentiate the two groups. Gender differences were also significant. Altogether the findings suggested that subtypes exist even in healthy control population, and comparison studies (case vs. control) need to be mindful of it.
Collapse
Affiliation(s)
- Rajan Kashyap
- Centre for Research and Development in Learning (CRADLE)Nanyang Technological UniversitySingaporeSingapore
- Department of Electrical and Computer EngineeringCentre for Sleep and Cognition, Clinical Imaging Research Centre, N.1 Institute for Health, National University of SingaporeSingapore
| | - Sagarika Bhattacharjee
- Psychology, School of Social Sciences (SSS)Nanyang Technological UniversitySingaporeSingapore
| | - B. T. Thomas Yeo
- Department of Electrical and Computer EngineeringCentre for Sleep and Cognition, Clinical Imaging Research Centre, N.1 Institute for Health, National University of SingaporeSingapore
- Centre for Cognitive Neuroscience, Neuroscience and Behavioral Disorders ProgramDuke‐NUS Medical SchoolSingaporeSingapore
- Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownMassachusetts
- NUS Graduate School for Integrative Sciences and EngineeringNational University of SingaporeSingaporeSingapore
| | - S. H. Annabel Chen
- Centre for Research and Development in Learning (CRADLE)Nanyang Technological UniversitySingaporeSingapore
- Psychology, School of Social Sciences (SSS)Nanyang Technological UniversitySingaporeSingapore
- Lee Kong Chian School of Medicine (LKC Medicine)Nanyang Technological UniversitySingaporeSingapore
| |
Collapse
|
24
|
A Systematic Review of Human Neuroimaging Evidence of Memory-Related Functional Alterations Associated with Cannabis Use Complemented with Preclinical and Human Evidence of Memory Performance Alterations. Brain Sci 2020; 10:brainsci10020102. [PMID: 32069958 PMCID: PMC7071506 DOI: 10.3390/brainsci10020102] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Cannabis has been associated with deficits in memory performance. However, the neural correlates that may underpin impairments remain unclear. We carried out a systematic review of functional magnetic resonance imaging (fMRI) studies investigating brain functional alterations in cannabis users (CU) compared to nonusing controls while performing memory tasks, complemented with focused narrative reviews of relevant preclinical and human studies. Twelve studies employing fMRI were identified finding functional brain activation during memory tasks altered in CU. Memory performance studies showed CU performed worse particularly during verbal memory tasks. Longitudinal studies suggest that cannabis use may have a causal role in memory deficits. Preclinical studies have not provided conclusive evidence of memory deficits following cannabinoid exposure, although they have shown evidence of cannabinoid-induced structural and histological alteration. Memory performance deficits may be related to cannabis use, with lower performance possibly underpinned by altered functional activation. Memory impairments may be associated with the level of cannabis exposure and use of cannabis during developmentally sensitive periods, with possible improvement following cessation of cannabis use.
Collapse
|
25
|
Attentional bias towards cannabis cues in cannabis users: A systematic review and meta-analysis. Drug Alcohol Depend 2020; 206:107719. [PMID: 31753732 DOI: 10.1016/j.drugalcdep.2019.107719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Attentional bias, the automatic selective attentional orientation towards drug-related stimuli is well demonstrated in substance users. However, attentional bias studies of cannabis users specifically have thus far been inconclusive. Thus, the aim of this systematic review and meta-analysis was to synthesize the currently available literature regarding cannabis related attentional bias in cannabis users. METHODS Literature search and selection was carried out, following the PRISMA guidelines, with all included studies investigating the relationship between cannabis use and attentional bias towards cannabis cues. RESULTS Fourteen manuscripts, reporting on 1271 participants (cannabis users n = 1044; controls n = 217), were considered for the systematic-review and majority were included in a meta-analysis. Studies reviewed used three types of attentional bias tasks: pictorial stimuli, word stimuli, and non-cannabis stimuli tasks. Greater attentional bias towards cannabis pictures (d = 0.42, P < 0.0001) and words (d = 0.63, P = 0.03) as well as both types of stimuli overall (d = 0.53, P < 0.0001) was observed in cannabis users compared to controls, though there was evidence of significant heterogeneity for both word stimuli and overall meta-analysis. Bigger effect sizes were associated with shorter durations of exposure to cannabis stimuli suggesting mainly automatic orientating rather than controlled attention processing. CONCLUSIONS These findings suggest that cannabis users display greater attentional bias towards cannabis cues, likely an automatic process, than control groups. Future studies employing shorter exposure durations may validate attentional bias as a treatment target for the development of interventions in people with cannabis use disorder.
Collapse
|
26
|
Abstract
Objective: Shifting policies and widespread acceptance of cannabis for medical and/or recreational purposes have fueled worries of increased cannabis initiation and use in adolescents. In particular, the adolescent period is thought to be associated with an increased susceptibility to the potential harms of repeated cannabis use, due to being a critical period for neuromaturational events in the brain. This review investigates the neuroimaging evidence of brain harms attributable to adolescent cannabis use. Methods: PubMed and Scopus searches were conducted for empirical articles that examined neuroimaging effects in both adolescent cannabis users and adult user studies that explored the effect of age at cannabis use onset on the brain. Results: We found 43 studies that examined brain effect (structural and functional magnetic resonance imaging) in adolescent cannabis users and 20 that examined the link between onset age of cannabis use and brain effects in adult users. Studies on adolescent cannabis users relative to nonusers mainly implicate frontal and parietal regions and associated brain activation in relation to inhibitory control, reward, and memory. However, studies in adults are more mixed, many of which did not observe an effect of onset age of cannabis use on brain imaging metrics. Conclusions: While there is some evidence of compromised frontoparietal structure and function in adolescent cannabis use, it remains unclear whether the observed effects are specifically attributable to adolescent onset of use or general cannabis use-related factors such as depressive symptoms. The relative contribution of adolescent onset of cannabis use and use chronicity will have to be more comprehensively examined in prospective, longitudinal studies with more rigorous measures of cannabis use (dosage, exposure, dependence, constituent compounds such as the relative cannabinoid levels).
Collapse
Affiliation(s)
- Yann Chye
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Erynn Christensen
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Murat Yücel
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
27
|
Blest-Hopley G, Colizzi M, Giampietro V, Bhattacharyya S. Is the Adolescent Brain at Greater Vulnerability to the Effects of Cannabis? A Narrative Review of the Evidence. Front Psychiatry 2020; 11:859. [PMID: 33005157 PMCID: PMC7479242 DOI: 10.3389/fpsyt.2020.00859] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/06/2020] [Indexed: 01/01/2023] Open
Abstract
Cannabis use during the critical neurodevelopmental period of adolescence, may lead to brain structural, functional, and histological alterations that may underpin some of the longer-term behavioral and psychological harms associated with it. The endocannabinoid system performs a key regulatory and homeostatic role, that undergoes developmental changes during adolescence making it potentially more susceptible to the effects of exposure to cannabis during adolescence. Here, we synthesize evidence from human studies of adolescent cannabis users showing alterations in cognitive performance as well as in brain structure and function with relevant preclinical evidence to summarize the current state of knowledge. We also focus on the limited evidence that speaks to the hypothesis that cannabis use during adolescence, may pose a greater risk than use during adulthood, identify gaps in current evidence and suggest directions for new research. Existing literature is consistent with the association of cannabis use during adolescence and neurological changes. Adolescence cannabis users show altered functional connectivity within known functional circuits, that may underlie inefficient recruitment of brain regions, as largely increased functional activation has been observed compared to controls. This disruption in some cases may contribute to the development of adverse mental health conditions; increasing the chances or accelerating the onset, of their development. Preclinical evidence, further supports disruption from cannabis use being specific to the developmental period. Future studies are required to better investigate adolescent cannabis use with more accuracy using better defined groups or longitudinal studies and examine the permanency of these changes following caseation of use. Furthermore, research is required to identify heritable risk factors to cannabis use. There is a need for caution when considering the therapeutic potential of cannabis for adolescence and particularly in public discourse leading to potential trivialization of possible harm from cannabis use in adolescence. Current evidence indicates that adolescence is a sensitive period during which cannabis use may result in adverse neurocognitive effects that appear to show a level of permanency into adulthood.
Collapse
Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Vincent Giampietro
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
28
|
Duperrouzel JC, Granja K, Pacheco-Colón I, Gonzalez R. Adverse Effects of Cannabis Use on Neurocognitive Functioning: A Systematic Review of Meta- Analytic Studies. J Dual Diagn 2020; 16:43-57. [PMID: 31232216 PMCID: PMC6925658 DOI: 10.1080/15504263.2019.1626030] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: As the perceived risk of cannabis use continues to decline among youths and access continues to increase, it has become more important to synthesize the rapidly growing literature on the effects of cannabis on neurocognition. Hundreds of studies examining associations between cannabis use and neurocognitive functioning have been published in recent decades. However, results often differ across individual studies, particularly when sample sizes are small. Meta-analytic methods help to make sense of this literature and have been increasingly applied to studies on cannabis use and neurocognition. Methods: A systematic literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify peer-reviewed meta-analyses of neurocognitive or functional neuroimaging data that examined associations between cannabis use and non-acute effects on neurocognitive functioning (n = 8). Results: Current findings suggest that regular healthy cannabis users, regardless of age, display poorer neurocognitive functioning relative to nonusers of small to medium effect sizes across many neurocognitive domains, as well as functional brain alterations when compared to non-users. Adverse effects are not uniform across neurocognitive domains and evidence for adolescent-onset users having poorer neurocognitive outcomes remains equivocal based on these studies. However, less is known about cannabis effects on neurocognition among clinical samples, as findings from specific clinical samples revealed mixed results. Conclusions: Meta-analyses have played an important role in helping to grasp the totality of results from a large body of literature on cannabis effects on neurocognition, yet more research (particularly large-scale longitudinal studies) is needed to identify critical periods or patterns of use that are more likely to result in negative outcomes.
Collapse
Affiliation(s)
- Jacqueline C Duperrouzel
- Department of Psychology, Center for Children and Families Florida International University, Miami, FL, USA
| | - Karen Granja
- Department of Psychology, Center for Children and Families Florida International University, Miami, FL, USA
| | - Ileana Pacheco-Colón
- Department of Psychology, Center for Children and Families Florida International University, Miami, FL, USA
| | - Raul Gonzalez
- Department of Psychology, Center for Children and Families Florida International University, Miami, FL, USA
| |
Collapse
|
29
|
Aguinaldo LD, Squeglia LM, Gray KM, Coronado C, Lees B, Tomko RL, Jacobus J. Behavioral Treatments for Adolescent Cannabis Use Disorder: a Rationale for Cognitive Retraining. CURRENT ADDICTION REPORTS 2019; 6:437-442. [PMID: 32257767 DOI: 10.1007/s40429-019-00287-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose of Review Adolescent cannabis use represents a significant public health concern. Cannabis experimentation typically begins in adolescence and increases the odds of meeting criteria for cannabis use disorder. Cannabis use disorder is associated with numerous short- and long-term adverse consequences for adolescents, highlighting the critical need for efficacious behavioral treatments. This brief review aims to synthesize the state of the behavioral treatment literature on adolescents with cannabis use disorder and to discuss new pathways to leverage neuroscience to inform novel targets for behavioral intervention. Recent Findings To date, effective treatment options for adolescent cannabis use disorder that have been tested in randomized controlled trials include cognitive behavioral therapy, motivational enhancement therapy, and multidimensional family therapy. However, established behavioral treatment approaches focus on higher-order cognitive control and have only been modestly effective. Summary There is a need to develop new pathways that translate neuroscience findings into novel targets for behavioral interventions.
Collapse
Affiliation(s)
- Laika D Aguinaldo
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Clarisa Coronado
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
| |
Collapse
|
30
|
Fatima H, Howlett AC, Whitlow CT. Reward, Control & Decision-Making in Cannabis Use Disorder: Insights from Functional MRI. Br J Radiol 2019; 92:20190165. [PMID: 31364398 PMCID: PMC6732906 DOI: 10.1259/bjr.20190165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 01/22/2023] Open
Abstract
The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States, 4.1 million are currently diagnosed with cannabis use disorder. Cannabis dependence and abuse was combined into a single entity as a behavioral disorder with a problematic pattern of cannabis use and termed cannabis use disorder by the Diagnostic and Statistical Manual of Mental Disorders. Chronic use of cannabis has been linked with region-specific effects across the brain mediating reward processing, cognitive control and decision-making that are central to understanding addictive behaviors. This review presents a snapshot of the current literature assessing the effects of chronic cannabis use on human brain function via functional MRI. Studies employing various paradigms and contrasting cognitive activation amongst cannabis users and non-users were incorporated. The effects of trans-del-ta-9-tetrahydrocannabinol (Δ9-THC) in marijuana and other preparations of cannabis are mediated by the endocannabinoid system, which is also briefly introduced.Much variation exists in the current literature regarding the functional changes associated with chronic cannabis use. One possible explanation for this variation is the heterogeneity in study designs, with little implementation of standardized diagnostic criteria when selecting chronic users, distinct time points of participant assessment, differing cognitive paradigms and imaging protocols. As such, there is an urgent requirement for future investigations that further characterize functional changes associated with chronic cannabis use.
Collapse
Affiliation(s)
- Hudaisa Fatima
- Department of Radiology, Wake Forest School of Medicine, Section of Neuroradiology, Winston-Salem, North Carolina, United States
| | | | | |
Collapse
|