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Burdinski D, Kodibagkar A, Potter K, Schuster R, Evins AE, Ghosh S, Gilman J. Impact of year-long cannabis use for medical symptoms on brain activation during cognitive processes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.29.24306516. [PMID: 38746368 PMCID: PMC11092687 DOI: 10.1101/2024.04.29.24306516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Importance Cannabis is increasingly being used to treat medical symptoms, but the effects of cannabis use on brain function in those using cannabis for these symptoms is not known. Objective To test whether brain activation during working memory, reward, and inhibitory control tasks, areas of cognition impacted by cannabis, showed increases following one year of cannabis use for medical symptoms. Design This observational cohort study took place from July 2017 to July 2020 and is reported on in 2024. Setting Participants were from the greater Boston area. Participants Participants were recruited as part of a clinical trial based on seeking medical cannabis cards for anxiety, depression, pain, or sleep disorders, and were between 18 and 65 years. Exclusion criteria were daily cannabis use and cannabis use disorder at baseline. Main Outcomes and Measures Outcomes were whole brain functional activation during tasks involving working memory, reward and inhibitory control at baseline and after one year of cannabis use. Results Imaging was collected in participants before and one year after obtaining medical cannabis cards; 57 at baseline (38 female [66.7%]; mean [SD] age, 38.0 [14.6] years) at baseline, and 54 at one-year (37 female [68.5%]; mean [SD] age, 38.7 [14.3] years). Imaging was also collected in 32 healthy control participants (22 female [68.8%]; mean [SD] age, 33.8 [11.8] years) at baseline. In all groups and at both time points, functional imaging revealed canonical activations of the probed cognitive processes. No statistically significant difference in brain activation between the two timepoints (baseline and one-year) in those with medical cannabis cards and no association of changes in cannabis use frequency with brain activation were found. Conclusions and Relevance Findings suggest that adults do not show significant neural effects in the areas of cognition of working memory, reward, and inhibitory control after one year of cannabis use for medical symptoms. The results warrant further studies that probe effects of cannabis at higher doses, with greater frequency, in younger age groups, and with larger, more diverse cohorts. Trial Registration NCT03224468, https://clinicaltrials.gov/.
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Affiliation(s)
- Debbie Burdinski
- McGovern Institute for Brain Research, MIT, Cambridge, MA
- Harvard Medical School, Boston, MA
| | - Alisha Kodibagkar
- McGovern Institute for Brain Research, MIT, Cambridge, MA
- University of Pennsylvania School of Engineering and Applied Science, Philadelphia, PA
| | - Kevin Potter
- Harvard Medical School, Boston, MA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA
| | - Randi Schuster
- Harvard Medical School, Boston, MA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA
| | - A Eden Evins
- Harvard Medical School, Boston, MA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA
| | - Satrajit Ghosh
- McGovern Institute for Brain Research, MIT, Cambridge, MA
- Harvard Medical School, Boston, MA
| | - Jodi Gilman
- Harvard Medical School, Boston, MA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital
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Skala K, Trabi T, Fuchs M, Gössler R, Haas-Stockmair CW, Kriechbaumer N, Leitner M, Ortner N, Reiter M, Müller C, Wladika W. [Cannabis use in adolescents : Narrative Review and Position paper of the "Addiction Disorders in Adolescents" task force of the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP)]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023; 37:175-195. [PMID: 35900691 DOI: 10.1007/s40211-022-00424-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cannabis is the illegal drug most frequently used by Minors in Austria. Due to the gradual decriminalization and legalization that has taken place in many European countries in recent years, the ÖGKJP would like to take a balanced and scientifically based stand on the complex issue of cannabis use and abuse among young people. METHODS The authors searched the medline for current studies using searches tailored to each specific subtopic. Furthermore, recognized compendiums were quoted. RESULTS While occasional recreational use of cannabis in adults with completed brain maturation and no risk profile for mental disorders is likely to be relatively harmless, early initiation of use with regular use and the increasingly available, highly potent cannabis varieties can lead to explicit and sometimes irreversible neurocognitive brain dysfunction. CONCLUSION Legalisation of cannabis consumption for minors needs to be objected to due to the risks of the expected damage in the area of brain development. At the same time, however, it is important to establish sensible legal regulations in order to be able to adequately counteract the fact that over 30% of all European young people occasionally consume cannabis. We are also clearly recommending to not criminalize cannabis users and provide necessary support to vulnerable and addicted cannabis users.
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Affiliation(s)
- Katrin Skala
- Univ. Klinik für Kinder und Jugendpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
| | - Thomas Trabi
- Abteilung für Kinder- und Jugendpsychiatrie, LKH Graz II, Graz, Österreich
| | - Martin Fuchs
- Univ. Klinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Ralf Gössler
- Abteilung für Kinder- und Jugendpsychiatrie, Klinik Floridsdorf, Floridsdorf, Österreich
| | | | | | - Monika Leitner
- Praxis für Kinder- und Jugendpsychiatrie, Graz, Österreich
| | - Nora Ortner
- Univ. Klinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Melanie Reiter
- Univ. Klinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Christian Müller
- Ambulatorium für Kinder- u. Jugendpsychiatrie, PSD Einsenstadt, Einsenstadt, Österreich
| | - Wolfgang Wladika
- Abteilung für Neurologie und Psychiatrie des Kindes- und Jugendalters, Klinikum Klagenfurt, Klagenfurt, Österreich
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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: 5] [Impact Index Per Article: 5.0] [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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Knodt AR, Meier MH, Ambler A, Gehred MZ, Harrington H, Ireland D, Poulton R, Ramrakha S, Caspi A, Moffitt TE, Hariri AR. Diminished Structural Brain Integrity in Long-term Cannabis Users Reflects a History of Polysubstance Use. Biol Psychiatry 2022; 92:861-870. [PMID: 36008158 PMCID: PMC9637748 DOI: 10.1016/j.biopsych.2022.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cannabis legalization and use are outpacing our understanding of its long-term effects on brain and behavior, which is fundamental for effective policy and health practices. Existing studies are limited by small samples, cross-sectional measures, failure to separate long-term from recreational use, and inadequate control for other substance use. Here, we address these limitations by determining the structural brain integrity of long-term cannabis users in the Dunedin Study, a longitudinal investigation of a population-representative birth cohort followed to midlife. METHODS We leveraged prospective measures of cannabis, alcohol, tobacco, and other illicit drug use in addition to structural neuroimaging in 875 study members at age 45 to test for differences in both global and regional gray and white matter integrity between long-term cannabis users and lifelong nonusers. We additionally tested for dose-response associations between continuous measures of cannabis use and brain structure, including careful adjustments for use of other substances. RESULTS Long-term cannabis users had a thinner cortex, smaller subcortical gray matter volumes, and higher machine learning-predicted brain age than nonusers. However, these differences in structural brain integrity were explained by the propensity of long-term cannabis users to engage in polysubstance use, especially with alcohol and tobacco. CONCLUSIONS These findings suggest that diminished midlife structural brain integrity in long-term cannabis users reflects a broader pattern of polysubstance use, underlining the importance of understanding comorbid substance use in efforts to curb the negative effects of cannabis on brain and behavior as well as establish more effective policy and health practices.
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Affiliation(s)
- Annchen R Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Madeline H Meier
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Antony Ambler
- Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom; Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Maria Z Gehred
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - David Ireland
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina; Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina; Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom
| | - Ahmad R Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
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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.
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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.
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Ho W, Kolla NJ. The endocannabinoid system in borderline personality disorder and antisocial personality disorder: A scoping review. BEHAVIORAL SCIENCES & THE LAW 2022; 40:331-350. [PMID: 35575169 DOI: 10.1002/bsl.2576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/06/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Individuals with borderline personality disorder (BPD) or antisocial personality disorder (ASPD) are overrepresented in forensic settings. Yet, despite the burden these disorders place on healthcare and criminal justice systems, there remains a lack of evidence-based pharmacological treatments. Epidemiological data have shown that comorbid cannabis use disorders are common in BPD and ASPD. ∆9 -Tetrahydrocannabinol, the primary psychoactive constituent of cannabis, is an exogenous cannabinoid that stimulates the endocannabinoid system (ECS). Hence, an investigation of the ECS in these conditions is warranted. This scoping review screened 105 records and summarized the extant research on the ECS in ASPD (n = 69) and BPD (n = 61) participants. Preliminary results suggest that alterations of the ECS may be present in these disorders. Although research examining the ECS in personality disorders is still in its infancy, more research is warranted given initial positive findings.
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Affiliation(s)
- Wilson Ho
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nathan J Kolla
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
- Waypoint/University of Toronto Research Chair in Forensic Mental Health Science, Penetanguishene, ON, Canada
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7
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Borst JM, Costantini TW, Reilly L, Smith AM, Stabley R, Steele J, Wintz D, Bansal V, Biffl WL, Godat LN. Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization. Trauma Surg Acute Care Open 2021; 6:e000736. [PMID: 34786487 PMCID: PMC8587622 DOI: 10.1136/tsaco-2021-000736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background Eleven states have instituted laws allowing recreational cannabis use leading to growing public health concerns surrounding the effects of cannabis intoxication on driving safety. We hypothesized that after the 2016 legalization of cannabis in California, the use among vehicular injury patients would increase and be associated with increased injury severity. Methods San Diego County’s five adult trauma center registries in were queried from January 2010 to June 2018 for motor vehicle or motorcycle crash patients with completed toxicology screens. Patients were stratified as toxicology negative (TOX−), positive for only THC (THC+), only blood alcohol >0.08% (ETOH+), THC+ETOH, or THC+ with any combination with methamphetamine or cocaine (M/C). County medical examiner data were reviewed to characterize THC use in those with deaths at the scene of injury. Results Of the 11,491 patients identified, there were 61.6% TOX−, 11.7% THC+, 13.7% ETOH+, 5.0% THC+ETOH, and 7.9% M/C. THC+ increased from 7.3% to 14.8% over the study period and peaked at 14.9% post-legalization in 2017. Compared with TOX− patients, THC+ patients were more likely to be male and younger. THC+ patients were also less likely to wear seatbelts (8.5% vs 14.3%, p<0.001) and had increased mean Injury Severity Score (8.4±9.4 vs 9.0±9.9, p<0.001) when compared with TOX− patients. There was no difference in in-hospital mortality between groups. From the medical examiner data of the 777 deaths on scene, 27% were THC+. Discussion THC+ toxicology screens in vehicular injury patients peaked after the 2016 legalization of cannabis. Public education on the risks of driving under the influence of cannabis should be a component of injury prevention initiatives. Level of evidence III, Prognostic
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Affiliation(s)
- Johanna Marie Borst
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Todd W Costantini
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Lindsay Reilly
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Alan M Smith
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Robert Stabley
- Examiner's Office, San Diego County Medical Examiner's Office, San Diego, California, USA
| | - John Steele
- Trauma, Palomar Medical Center, Escondido, California, USA
| | - Diane Wintz
- Trauma, Sharp Memorial Medical Center, San Diego, California, USA
| | - Vishal Bansal
- Trauma, Scripps Mercy Hospital, San Diego, California, USA
| | - Walter L Biffl
- Trauma, Scripps Memorial Hospital, La Jolla, California, USA
| | - Laura N Godat
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, University of California San Diego School of Medicine, San Diego, California, USA
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Lew BJ, Salimian A, Wilson TW. Occipital neural dynamics in cannabis and alcohol use: independent effects of addiction. Sci Rep 2021; 11:22258. [PMID: 34782632 PMCID: PMC8593162 DOI: 10.1038/s41598-021-01493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 10/28/2021] [Indexed: 11/15/2022] Open
Abstract
Alcohol and cannabis use disorder (AUD/CUD) are two of the most common addictive disorders. While studies are beginning to understand the neural changes related to acute and chronic use, few studies have examined the independent effects of AUD and CUD on neural oscillatory activity. We examined 45 adults who reported current use of both cannabis and alcohol. Participants underwent the SCID-V to determine whether they met criteria for AUD and/or CUD. Participants also completed a visual-spatial processing task while undergoing magnetoencephalography (MEG). ANCOVA with a 2 × 2 design was then used to identify the main effects of AUD and CUD on source-level oscillatory activity. Of the 45 adults, 17 met criteria for AUD, and 26 met criteria for CUD. All participants, including comparison groups, reported use of both cannabis and alcohol. Statistical analyses showed a main effect of AUD, such that participants with AUD displayed a blunted occipital alpha (8-16 Hz) response. Post-hoc testing showed this decreased alpha response was related to increased AUD symptoms, above and beyond amount of use. No effects of AUD or CUD were identified in visual theta or gamma activity. In conclusion, AUD was associated with reduced alpha responses and scaled with increasing severity, independent of CUD. These findings indicate that alpha oscillatory activity may play an integral part in networks affected by alcohol addiction.
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Affiliation(s)
- Brandon J Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, 378 Bucher Drive, Boys Town, NE, 68010, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anabel Salimian
- Institute for Human Neuroscience, Boys Town National Research Hospital, 378 Bucher Drive, Boys Town, NE, 68010, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, 378 Bucher Drive, Boys Town, NE, 68010, USA.
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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9
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Roberts BZ, Minassian A, Halberstadt AL, He YV, Chatha M, Geyer MA, Grant I, Young JW. HIV Transgenic Rats Demonstrate Impaired Sensorimotor Gating But Are Insensitive to Cannabinoid (Δ9-Tetrahydrocannabinol)-Induced Deficits. Int J Neuropsychopharmacol 2021; 24:894-906. [PMID: 34338765 PMCID: PMC8598295 DOI: 10.1093/ijnp/pyab053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/24/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND HIV-associated neurocognitive disorder (HAND) is commonly observed in persons living with HIV (PWH) and is characterized by cognitive deficits implicating disruptions of fronto-striatal neurocircuitry. Such circuitry is also susceptible to alteration by cannabis and other drugs of abuse. PWH use cannabis at much higher rates than the general population, thus prioritizing the characterization of any interactions between HIV and cannabinoids on cognitively relevant systems. Prepulse inhibition (PPI) of the startle response, the process by which the motor response to a startling stimulus is attenuated by perception of a preceding non-startling stimulus, is an operational assay of fronto-striatal circuit integrity that is translatable across species. PPI is reduced in PWH. The HIV transgenic (HIVtg) rat model of HIV infection mimics numerous aspects of HAND, although to date the PPI deficit observed in PWH has yet to be fully recreated in animals. METHODS PPI was measured in male and female HIVtg rats and wild-type controls following acute, nonconcurrent treatment with the primary constituents of cannabis: Δ 9-tetrahydrocannabinol (THC; 1 and 3 mg/kg, s.c.) and cannabidiol (1, 10, and 30 mg/kg, i.p.). RESULTS HIVtg rats exhibited a significant PPI deficit relative to wild-type controls. THC reduced PPI in controls but not HIVtg rats. Cannabidiol exerted only minor, genotype-independent effects on PPI. CONCLUSIONS HIVtg rats exhibit a relative insensitivity to the deleterious effects of THC on the fronto-striatal function reflected by PPI, which may partially explain the higher rates of cannabis use among PWH.
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Affiliation(s)
- Benjamin Z Roberts
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Arpi Minassian
- Department of Psychiatry, University of California, San Diego, California, USA,VA Center of Excellence for Stress and Mental Health, Veterans Administration San Diego HealthCare System, San Diego, California, USA
| | - Adam L Halberstadt
- Department of Psychiatry, University of California, San Diego, California, USA,VISN-22 Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Yinong V He
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Muhammad Chatha
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Mark A Geyer
- Department of Psychiatry, University of California, San Diego, California, USA,VISN-22 Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Jared W Young
- Department of Psychiatry, University of California, San Diego, California, USA,VISN-22 Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA,Correspondence: Jared W. Young, PhD, Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA ()
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Kearney-Ramos T, Haney M. Repetitive transcranial magnetic stimulation as a potential treatment approach for cannabis use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110290. [PMID: 33677045 PMCID: PMC9165758 DOI: 10.1016/j.pnpbp.2021.110290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
The expanding legalization of cannabis across the United States is associated with increases in cannabis use, and accordingly, an increase in the number and severity of individuals with cannabis use disorder (CUD). The lack of FDA-approved pharmacotherapies and modest efficacy of psychotherapeutic interventions means that many of those who seek treatment for CUD relapse within the first few months. Consequently, there is a pressing need for innovative, evidence-based treatment development for CUD. Preliminary evidence suggests that repetitive transcranial magnetic stimulation (rTMS) may be a novel, non-invasive therapeutic neuromodulation tool for the treatment of a variety of substance use disorders (SUDs), including recently receiving FDA clearance (August 2020) for use as a smoking cessation aid in tobacco cigarette smokers. However, the potential of rTMS for CUD has not yet been reviewed. This paper provides a primer on therapeutic neuromodulation techniques for SUDs, with a particular focus on reviewing the current status of rTMS research in people who use cannabis. Lastly, future directions are proposed for rTMS treatment development in CUD, with suggestions for study design parameters and clinical endpoints based on current gold-standard practices for therapeutic neuromodulation research.
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Affiliation(s)
- Tonisha Kearney-Ramos
- New York State Psychiatric Institute, New York, NY, USA; Columbia University Irving Medical Center, New York, NY, USA.
| | - Margaret Haney
- New York State Psychiatric Institute, New York, New York, USA,Columbia University Irving Medical Center, New York, New York, USA
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11
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Sex Differences in Neuropsychological Functioning are Domain-Specific in Adolescent and Young Adult Regular Cannabis Users. J Int Neuropsychol Soc 2021; 27:592-606. [PMID: 34261559 DOI: 10.1017/s1355617720001435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Adolescence into young adulthood represents a sensitive period in which brain development significantly diverges by sex. Regular cannabis use by young people is associated with neuropsychological vulnerabilities, but the potential impact of sex on these relationships is unclear. METHOD In a cross-sectional study, we examined sex differences in multi-domain neuropsychological functioning using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and tested whether sex moderated the relationship between cognitive performance and age of initiation, frequency of cannabis use, amount of cannabis use, and withdrawal symptoms in at least weekly adolescent and young adult cannabis users (n = 171; aged 13-25 years; 46.2% female). RESULTS Male cannabis users had poorer visual recognition memory and female cannabis users showed worse attention and executive functions, with medium to large effect sizes. These sex effects persisted, when controlling for age, IQ, amount of alcohol and nicotine use, mood and anxiety symptoms, emotional stability and impulsive behavior. Earlier age of initiated use and more use were associated with worse attentional functions in females, but not males. More use was more strongly associated with worse episodic memory in males than in females. More use was associated with poorer learning in males only. CONCLUSIONS Domain-specific patterns of neuropsychological performance were found by sex, such that males showed poorer visual memory and females showed worse performance on measures of attention (sustained visual, multitasking) and executive functioning (spatial planning/working memory subdomains). Larger studies including healthy controls are needed to determine if the observed sex differences are more exaggerated relative to non-users.
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12
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Pintori N, Castelli MP, Miliano C, Simola N, Fadda P, Fattore L, Scherma M, Ennas MG, Mostallino R, Flore G, De Felice M, Sagheddu C, Pistis M, Di Chiara G, De Luca MA. Repeated exposure to JWH-018 induces adaptive changes in the mesolimbic and mesocortical dopaminergic pathways, glial cells alterations, and behavioural correlates. Br J Pharmacol 2021; 178:3476-3497. [PMID: 33837969 PMCID: PMC8457172 DOI: 10.1111/bph.15494] [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] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022] Open
Abstract
Background and Purpose Spice/K2 herbal mixtures, containing synthetic cannabinoids such as JWH‐018, have been marketed as marijuana surrogates since 2004. JWH‐018 has cannabinoid CB1 receptor‐dependent reinforcing properties and acutely increases dopaminergic transmission selectively in the NAc shell. Here, we tested the hypothesis that repeated administration of JWH‐018 (i) modulates behaviour, (ii) affects dopaminergic transmission and its responsiveness to motivational stimuli, and (iii) is associated with a neuroinflammatory phenotype. Experimental Approach Rats were administered with JWH‐018 once a day for 14 consecutive days. We then performed behavioural, electrophysiological, and neurochemical evaluation at multiple time points after drug discontinuation. Key Results Repeated JWH‐018 exposure (i) induced anxious and aversive behaviours, transitory attentional deficits, and withdrawal signs; (ii) decreased spontaneous activity and number of dopamine neurons in the VTA; and (iii) reduced stimulation of dopaminergic transmission in the NAc shell while potentiating that in the NAc core, in response to acute JWH‐018 challenge. Moreover, (iv) we observed a decreased dopamine sensitivity in the NAc shell and core, but not in the mPFC, to a first chocolate exposure; conversely, after a second exposure, dialysate dopamine fully increased in the NAc shell and core but not in the mPFC. Finally, selected dopamine brain areas showed (v) astrogliosis (mPFC, NAc shell and core, VTA), microgliosis (NAc shell and core), and downregulation of CB1 receptors (mPFC, NAc shell and core). Conclusion and Implications Repeated exposure to JWH‐018 may provide a useful model to clarify the detrimental effects of recurring use of Spice/K2 drugs.
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Affiliation(s)
- Nicholas Pintori
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Cristina Miliano
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Nicola Simola
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Fadda
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Maria Scherma
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Grazia Ennas
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Rafaela Mostallino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giovanna Flore
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Marta De Felice
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Claudia Sagheddu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Marco Pistis
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Gaetano Di Chiara
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
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13
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Harper J, Malone SM, Wilson S, Hunt RH, Thomas KM, Iacono WG. The Effects of Alcohol and Cannabis Use on the Cortical Thickness of Cognitive Control and Salience Brain Networks in Emerging Adulthood: A Co-twin Control Study. Biol Psychiatry 2021; 89:1012-1022. [PMID: 33726938 PMCID: PMC8106644 DOI: 10.1016/j.biopsych.2021.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/05/2021] [Accepted: 01/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Impairments in inhibitory control and its underlying brain networks (control/salience areas) are associated with substance misuse. Research often assumes a causal substance exposure effect on brain structure. This assumption remains largely untested, and other factors (e.g., familial risk) may confound exposure effects. We leveraged a genetically informative sample of twins aged 24 years and a quasi-experimental co-twin control design to separate alcohol or cannabis exposure effects during emerging adulthood from familial risk on control/salience network cortical thickness. METHODS In a population-based sample of 436 twins aged 24 years, dimensional measures of alcohol and cannabis use (e.g., frequency, density, quantity, intoxications) across emerging adulthood were assessed. Cortical thickness of control/salience network areas were assessed using magnetic resonance imaging and defined by a fine-grained cortical atlas. RESULTS Greater alcohol, but not cannabis, misuse was associated with reduced thickness of prefrontal (e.g., dorso/ventrolateral, right frontal operculum) and frontal medial cortices, as well as temporal lobe, intraparietal sulcus, insula, parietal operculum, precuneus, and parietal medial areas. Effects were predominately (pre)frontal and right lateralized. Co-twin control analyses suggested that the effects likely reflect both the familial predisposition to misuse alcohol and, specifically for lateral prefrontal, frontal/parietal medial, and right frontal operculum, an alcohol exposure effect. CONCLUSIONS This study provides novel evidence that alcohol-related reductions in cortical thickness of control/salience brain networks likely represent the effects of alcohol exposure and premorbid characteristics of the genetic predisposition to misuse alcohol. The dual effects of these two alcohol-related causal influences have important and complementary implications regarding public health and prevention efforts to curb youth drinking.
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Affiliation(s)
- Jeremy Harper
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Twin Cities, Minneapolis, Minnesota.
| | | | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Twin Cities
| | - Ruskin H. Hunt
- Institute of Child Development, University of Minnesota, Twin Cities
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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.
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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.
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15
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Batalla A, Bos J, Postma A, Bossong MG. The Impact of Cannabidiol on Human Brain Function: A Systematic Review. Front Pharmacol 2021; 11:618184. [PMID: 33551817 PMCID: PMC7858248 DOI: 10.3389/fphar.2020.618184] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Accumulating evidence suggests that the non-intoxicating cannabinoid compound cannabidiol (CBD) may have antipsychotic and anxiolytic properties, and thus may be a promising new agent in the treatment of psychotic and anxiety disorders. However, the neurobiological substrates underlying the potential therapeutic effects of CBD are still unclear. The aim of this systematic review is to provide a detailed and up-to-date systematic literature overview of neuroimaging studies that investigated the acute impact of CBD on human brain function. Methods: Papers published until May 2020 were included from PubMed following a comprehensive search strategy and pre-determined set of criteria for article selection. We included studies that examined the effects of CBD on brain function of healthy volunteers and individuals diagnosed with a psychiatric disorder, comprising both the effects of CBD alone as well as in direct comparison to those induced by ∆9-tetrahydrocannabinol (THC), the main psychoactive component of Cannabis. Results: One-ninety four studies were identified, of which 17 met inclusion criteria. All studies investigated the acute effects of CBD on brain function during resting state or in the context of cognitive tasks. In healthy volunteers, acute CBD enhanced fronto-striatal resting state connectivity, both compared to placebo and THC. Furthermore, CBD modulated brain activity and had opposite effects when compared to THC following task-specific patterns during various cognitive paradigms, such as emotional processing (fronto-temporal), verbal memory (fronto-striatal), response inhibition (fronto-limbic-striatal), and auditory/visual processing (temporo-occipital). In individuals at clinical high risk for psychosis and patients with established psychosis, acute CBD showed intermediate brain activity compared to placebo and healthy controls during cognitive task performance. CBD modulated resting limbic activity in subjects with anxiety and metabolite levels in patients with autism spectrum disorders. Conclusion: Neuroimaging studies have shown that acute CBD induces significant alterations in brain activity and connectivity patterns during resting state and performance of cognitive tasks in both healthy volunteers and patients with a psychiatric disorder. This included modulation of functional networks relevant for psychiatric disorders, possibly reflecting CBD’s therapeutic effects. Future studies should consider replication of findings and enlarge the inclusion of psychiatric patients, combining longer-term CBD treatment with neuroimaging assessments.
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Affiliation(s)
- Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Julian Bos
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Amber Postma
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
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16
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Linked patterns of biological and environmental covariation with brain structure in adolescence: a population-based longitudinal study. Mol Psychiatry 2021; 26:4905-4918. [PMID: 32444868 PMCID: PMC7981783 DOI: 10.1038/s41380-020-0757-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 01/11/2023]
Abstract
Adolescence is a period of major brain reorganization shaped by biologically timed and by environmental factors. We sought to discover linked patterns of covariation between brain structural development and a wide array of these factors by leveraging data from the IMAGEN study, a longitudinal population-based cohort of adolescents. Brain structural measures and a comprehensive array of non-imaging features (relating to demographic, anthropometric, and psychosocial characteristics) were available on 1476 IMAGEN participants aged 14 years and from a subsample reassessed at age 19 years (n = 714). We applied sparse canonical correlation analyses (sCCA) to the cross-sectional and longitudinal data to extract modes with maximum covariation between neuroimaging and non-imaging measures. Separate sCCAs for cortical thickness, cortical surface area and subcortical volumes confirmed that each imaging phenotype was correlated with non-imaging features (sCCA r range: 0.30-0.65, all PFDR < 0.001). Total intracranial volume and global measures of cortical thickness and surface area had the highest canonical cross-loadings (|ρ| = 0.31-0.61). Age, physical growth and sex had the highest association with adolescent brain structure (|ρ| = 0.24-0.62); at baseline, further significant positive associations were noted for cognitive measures while negative associations were observed at both time points for prenatal parental smoking, life events, and negative affect and substance use in youth (|ρ| = 0.10-0.23). Sex, physical growth and age are the dominant influences on adolescent brain development. We highlight the persistent negative influences of prenatal parental smoking and youth substance use as they are modifiable and of relevance for public health initiatives.
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17
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Kallianpur KJ, Birn R, Ndhlovu LC, Souza SA, Mitchell B, Paul R, Chow DC, Kohorn L, Shikuma CM. Impact of Cannabis Use on Brain Structure and Function in Suppressed HIV Infection. JOURNAL OF BEHAVIORAL AND BRAIN SCIENCE 2020; 10:344-370. [PMID: 32968547 DOI: 10.4236/jbbs.2020.108022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Brain atrophy and cognitive deficits persist among individuals with suppressed HIV disease. The impact of cannabis use is unknown. METHODS HIV+ and HIV- participants underwent cross-sectional magnetic resonance imaging and neuropsychological testing. Lifetime frequency, duration (years), and recency of cannabis use were self-reported. Relationships of cannabis use to resting-state functional connectivity (RSFC) and to 9 regional brain volumes were assessed with corrections for multiple comparisons. Peripheral blood cytokines and monocyte subsets were measured in the HIV+ group and examined in relation to cannabis exposure. RESULTS We evaluated 52 HIV+ [50.8 ± 7.1 years old; 100% on antiretroviral therapy ≥ 3 months; 83% with plasma viral load < 50 copies/mL] and 55 HIV- [54.0 ± 7.5 years old] individuals. Among HIV+ participants, recent cannabis use (within 12 months) was associated with diminished RSFC, including of occipital cortex, controlling for age. Duration of use correlated negatively with volumes of all regions (most strikingly the nucleus accumbens) independently of recent use and intracranial volume. Recent use was associated with larger caudate and white matter volumes and lower soluble vascular cell adhesion molecule-1 and monocyte chemoattractant protein-1 concentrations. Duration of use correlated positively with psychomotor speed. Use > 10 times/lifetime was linked to more somatic symptoms, better executive function, and lower CD14+CD16++ monocyte count. CONCLUSION HIV+ individuals demonstrated opposing associations with cannabis. Recent use may weaken RSFC and prolonged consumption may exacerbate atrophy of the accumbens and other brain regions. More frequent or recent cannabis use may reduce the inflammation and CD14+CD16++ monocytes that facilitate HIV neuroinvasion. HIV-specific cannabis studies are necessary.
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Affiliation(s)
- Kalpana J Kallianpur
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii-Manoa, Honolulu, HI, USA
- Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, USA
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Rasmus Birn
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Lishomwa C Ndhlovu
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii-Manoa, Honolulu, HI, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Scott A Souza
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
- The Queen's Medical Center, Honolulu, HI, USA
| | - Brooks Mitchell
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St Louis, St. Louis, MO, USA
| | - Dominic C Chow
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Lindsay Kohorn
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
| | - Cecilia M Shikuma
- Hawaii Center for AIDS, University of Hawaii-Manoa, Honolulu, HI, USA
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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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19
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Ogunbiyi MO, Hindocha C, Freeman TP, Bloomfield MAP. Acute and chronic effects of Δ 9-tetrahydrocannabinol (THC) on cerebral blood flow: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109900. [PMID: 32109508 DOI: 10.1016/j.pnpbp.2020.109900] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 12/12/2022]
Abstract
Acute and chronic exposure to cannabis and its main psychoactive component, Δ9-tetrahydrocannabinol (THC), is associated with changes in brain function and cerebral blood flow (CBF). We therefore sought to systematically review the literature on the effects of THC on CBF following PRISMA guidelines. Studies assessing the acute and chronic effects of THC on CBF, perfusion and volume were searched in the PubMed database between January 1972 and June 2019. We included thirty-four studies, which altogether investigated 1259 humans and 28 animals. Acute and chronic THC exposure have contrasting and regionally specific effects on CBF. While acute THC causes an overall increase in CBF in the anterior cingulate cortex, frontal cortex and insula, in a dose-dependent manner, chronic cannabis use results in an overall reduction in CBF, especially in the prefrontal cortex, which may be reversed upon prolonged abstinence from the drug. Future studies should focus on standardised methodology and longitudinal assessment to strengthen our understanding of the region-specific effects of THC on CBF and its clinical and functional significance.
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Affiliation(s)
- M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, UCL Institute of Mental Health, University College London, UK; Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, UK; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK; The Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK; The National Hospital for Neurology and Neurosurgery, Queen Square, University College London Hospitals NHS Foundation Trust, London, UK.
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Dellazizzo L, Potvin S, Dou BY, Beaudoin M, Luigi M, Giguère CÉ, Dumais A. Association Between the Use of Cannabis and Physical Violence in Youths: A Meta-Analytical Investigation. Am J Psychiatry 2020; 177:619-626. [PMID: 32456503 DOI: 10.1176/appi.ajp.2020.19101008] [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: 11/30/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to investigate the extent to which cannabis use among youths is associated with the risk of perpetrating physical violence. METHODS Searches were conducted in PubMed, PsycINFO, Web of Science, and Google Scholar for articles published from the inception of each database to July 2019. All studies that examined both cannabis use and the perpetration of physical violence in a sample of youths and young adults <30 years old were included. The meta-analysis was performed with a random-effects model. Risk of publication bias was assessed with Egger's test. Guidelines from the Meta-Analysis of Observational Studies in Epidemiology were followed. RESULTS After screening 11,348 potential studies, 30 study arms were included, yielding a total of 296,815 adolescents and young adults. The odds ratio for the pooled studies was 2.11 (95% CI=1.64, 2.72). The pooled odds ratios were 2.15 (95% CI=1.58, 2.94) and 2.02 (95% CI=1.26, 3.23) for the cross-sectional and longitudinal studies, respectively. Preliminary evidence suggests that the risk of violence was higher for persistent heavy users (odds ratio=2.81, 95% CI=1.68, 4.74) compared with past-year users (odds ratio=2.05, 95% CI=1.5, 2.8) and lifetime users (odds ratio=1.94, 95% CI=1.29, 2.93). The odds ratio for unadjusted studies was 2.62 (95% CI=1.89, 3.62), and for studies using odds ratios adjusted for potential confounding factors, 2.01 (95% CI=1.57, 2.56). CONCLUSIONS These results demonstrate a moderate association between cannabis use and physical violence, which remained significant regardless of study design and adjustment for confounding factors (i.e., socioeconomic factors, other substance use). Cannabis use in this population is a risk factor for violence.
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Affiliation(s)
- Laura Dellazizzo
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Stéphane Potvin
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Bo Yi Dou
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Mélissa Beaudoin
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Mimosa Luigi
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Charles-Édouard Giguère
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Alexandre Dumais
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
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21
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Liao WT, Chang CL, Hsiao YT. Activation of cannabinoid type 1 receptors decreases the synchronization of local field potential oscillations in the hippocampus and entorhinal cortex and prolongs the interresponse time during a differential-reinforcement-of-low-rate task. Eur J Neurosci 2020; 52:4249-4266. [PMID: 32510690 DOI: 10.1111/ejn.14856] [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: 01/19/2020] [Revised: 05/01/2020] [Accepted: 05/30/2020] [Indexed: 01/04/2023]
Abstract
Marijuana intoxication impairs neurocognitive functions. Common side effects of consuming cannabis include time distortion and memory loss. However, the underlying neurophysiological mechanisms involved in these effects remain unclear. We hypothesized that communication between the hippocampal CA1 region and medial entorhinal cortex (MEC) is essential for the transmission of temporal-associated information. We used a differential-reinforcement-of-low-rate (DRL) task, which requires subjects to press a lever at an optimal time point, to correlate the distributions of interresponse time (IRT) with local field potentials (LFPs) recorded in the CA1 and MEC under the effects of a cannabinoid type 1 (CB1) receptor agonist. We used a DRL 10-s schedule and trained the rats to withhold for 10 s before pressing a lever. Our data showed that the percentage of 12.4- to 14-s IRT events rose after activation of CB1 receptors in the MEC. In addition, gamma amplitude synchronization and CA1 theta phase-MEC gamma amplitude coupling decreased during the 6- to 14-s IRT events. These results suggest that activation of CB1 receptors in the MEC disrupt the functional connectivity between the CA1 and the MEC. This inefficient communication may result in increased IRT during a DRL schedule. Overall, we postulate that marijuana intoxication impairs the communication between the CA1 and MEC and influences behavioral performances that require precise timing ability.
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Affiliation(s)
- Wan-Ting Liao
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Lin Chang
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Tse Hsiao
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
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22
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Associations between cannabis use and retinal vessel diameter in young adults. Schizophr Res 2020; 219:62-68. [PMID: 30837202 DOI: 10.1016/j.schres.2019.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 12/14/2022]
Abstract
Cannabis appears to have vascular effects that may have implications for cerebrovascular function, but no studies have directly visualized the microvasculature in living cannabis users. The current study used retinal imaging, a tool taken from ophthalmology, to visualize the small retinal microvessels in cannabis users. We compared retinal arteriolar (small arteries) and venular (small veins) diameters in 55 frequent cannabis users and 51 comparison individuals with a mean age of 19.25 years (SD = 2.43). Results indicated that mean arteriolar diameter was statistically significantly wider for cannabis users (M = 157.98, SE = 1.42) than for comparison individuals (M = 153.56, SE = 1.46; F(1,103) = 4.67, p = .033), even after controlling for a variety of covariates and after excluding from analyses cannabis users who had used cannabis in the past 24 h. There was no statistically significant difference in retinal venular diameter between cannabis users and comparison individuals. Findings suggest that frequent cannabis use is associated with wider retinal arterioles, which might represent a residual vasodilatory effect of recent cannabis use or impaired autoregulation resulting from chronic cannabis use. Retinal imaging is a non-invasive, cost-effective tool for visualizing the microvasculature in living individuals and can be combined, in future research, with neuroimaging and other measures of retinal vascular function to better understand the acute and longer-term effects of cannabis use on the microvasculature.
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23
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Sullivan RM, Wallace AL, Wade NE, Swartz AM, Lisdahl KM. Assessing the Role of Cannabis Use on Cortical Surface Structure in Adolescents and Young Adults: Exploring Gender and Aerobic Fitness as Potential Moderators. Brain Sci 2020; 10:E117. [PMID: 32098300 PMCID: PMC7071505 DOI: 10.3390/brainsci10020117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 12/05/2022] Open
Abstract
Cannabis use in adolescents and young adults is linked with aberrant brain structure, although findings to date are inconsistent. We examined whether aerobic fitness moderated the effects of cannabis on cortical surface structure and whether gender may play a moderating role. Seventy-four adolescents and young adults completed three-weeks of monitored abstinence, aerobic fitness testing, and structural magnetic resonance imaging (sMRI). Whole-sample linear regressions examined the effects of gender, VO2 max, cannabis use, and their interactions on the surface area (SA) and local gyrification index (LGI). Cannabis use was associated with greater cuneus SA. Gender-by-cannabis predicted precuneus and frontal SA, and precentral, supramarginal, and frontal LGI; female cannabis users demonstrated greater LGI, whereas male cannabis users demonstrated decreased LGI compared to non-users. Aerobic fitness was positively associated with various SA and LGI regions. Cannabis-by-aerobic fitness predicted cuneus SA and occipital LGI. These findings demonstrate that aerobic fitness moderates the impact of cannabis on cortical surface structure, and gender differences are evident. These moderating factors may help explain inconsistencies in the literature and warrant further investigation. Present findings and aerobic fitness literature jointly suggest aerobic intervention may be a low-cost avenue for improving cortical surface structure, although the impact may be gender-specific.
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Affiliation(s)
- Ryan M. Sullivan
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (R.M.S.); (A.L.W.)
| | - Alexander L. Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (R.M.S.); (A.L.W.)
| | - Natasha E. Wade
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA;
| | - Ann M. Swartz
- Department of Kinesiology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (R.M.S.); (A.L.W.)
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24
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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.
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25
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Grigsby TM, Hoffmann LM, Moss MJ. Marijuana Use and Potential Implications of Marijuana Legalization. Pediatr Rev 2020; 41:61-72. [PMID: 32005683 DOI: 10.1542/pir.2018-0347] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Most states in the United States have legalized medical and/or recreational cannabis in response to public demand. Trends in states adopting such legislation demonstrate an increasing prevalence of cannabis use coincident to decreasing perceptions of risk of harm from cannabis products. When providing anticipatory guidance, pediatricians should be prepared to address childhood unintentional ingestion management and prevention, adolescent problem use, and cannabis as an alternative therapy for seizure disorders and other conditions.
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Affiliation(s)
- Tamara M Grigsby
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
| | - Laurel M Hoffmann
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
| | - Michael J Moss
- Utah Poison Center, University of Utah College of Pharmacy, Salt Lake City, UT.,Division of Emergency Medicine, University of Utah, Salt Lake City, UT
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26
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Biasutti WR, Leffers KSH, Callaghan RC. Systematic Review of Cannabis Use and Risk of Occupational Injury. Subst Use Misuse 2020; 55:1733-1745. [PMID: 32441179 DOI: 10.1080/10826084.2020.1759643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aim: A range of nations, including countries of the European Union, Australia, and the Americas have recently implemented or proposed reforms to how they control cannabis use, thereby departing from traditional approaches of criminal prohibition that have dominated throughout most of the twentieth century. Given these policy developments and the widespread global use of cannabis, it is critically important to understand the possible risks associated with cannabis use in relation to major societal harms. Methods: This systematic review investigates the potential link between cannabis use and occupational injury. Consequently, it appraises all available current literature from five databases, following Cochrane and PRISMA guidelines. Results: Seven of the 16 reviewed studies show evidence supporting a positive association between cannabis use and occupational injury. One study shows evidence supporting a negative association and the remaining eight studies show no evidence of a significant relation. None of the studies assessed cannabis-related impairment. Only three of the reviewed studies show clear evidence that cannabis use preceded the occupational-injury event. Conclusion: The current body of evidence does not provide sufficient evidence to support the position that cannabis users are at increased risk of occupational injury. Further, the study quality assessment suggests significant biases in the extant literature are present due to potential confounding variables, selection of participants, and measurement of exposures and outcomes. Future high-quality evidence will be needed to elucidate the relation between cannabis use and occupational injury.
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Affiliation(s)
- Wade R Biasutti
- Northern Medical Program, University of British Columbia, Prince George, British Columbia
| | - Kurt S H Leffers
- Northern Medical Program, University of British Columbia, Prince George, British Columbia
| | - Russell C Callaghan
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia; Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, British Columbia, Canada
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27
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Blair Thies M, DeRosse P, Sarpal DK, Argyelan M, Fales CL, Gallego JA, Robinson DG, Lencz T, Homan P, Malhotra AK. Interaction of Cannabis Use Disorder and Striatal Connectivity in Antipsychotic Treatment Response. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa014. [PMID: 32803161 PMCID: PMC7418867 DOI: 10.1093/schizbullopen/sgaa014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Antipsychotic (AP) medications are the mainstay for the treatment of schizophrenia spectrum disorders (SSD), but their efficacy is unpredictable and widely variable. Substantial efforts have been made to identify prognostic biomarkers that can be used to guide optimal prescription strategies for individual patients. Striatal regions involved in salience and reward processing are disrupted as a result of both SSD and cannabis use, and research demonstrates that striatal circuitry may be integral to response to AP drugs. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate the relationship between a history of cannabis use disorder (CUD) and a striatal connectivity index (SCI), a previously developed neural biomarker for AP treatment response in SSD. Patients were part of a 12-week randomized, double-blind controlled treatment study of AP drugs. A sample of 48 first-episode SSD patients with no more than 2 weeks of lifetime exposure to AP medications, underwent a resting-state fMRI scan pretreatment. Treatment response was defined a priori as a binary (response/nonresponse) variable, and a SCI was calculated in each patient. We examined whether there was an interaction between lifetime CUD history and the SCI in relation to treatment response. We found that CUD history moderated the relationship between SCI and treatment response, such that it had little predictive value in SSD patients with a CUD history. In sum, our findings highlight that biomarker development can be critically impacted by patient behaviors that influence neurobiology, such as a history of CUD.
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Affiliation(s)
- Melanie Blair Thies
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Deepak K Sarpal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Miklos Argyelan
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Christina L Fales
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Juan A Gallego
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Graduate Center—City University of New York, New York, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Delbert G Robinson
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Philipp Homan
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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28
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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: 29] [Impact Index Per Article: 7.3] [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.
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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
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29
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Fekih-Romdhane F, Hakiri A, Fadhel SB, Cheour M. [Cannabis use in subjects at ultra high risk for psychosis]. Presse Med 2019; 48:1229-1236. [PMID: 31732360 DOI: 10.1016/j.lpm.2019.09.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 07/10/2019] [Accepted: 09/23/2019] [Indexed: 11/30/2022] Open
Abstract
Cannabis use is widespread among people at ultra-high risk (UHR) for psychosis. The causal link as well as the temporal link between cannabis use and further occurrence of psychosis in UHR people remain inconclusive. Current science data supported an increased risk of transition to psychosis in cannabis users who are genetically predisposed to psychosis. This risk would be even greater in the presence of a family history of psychosis, in case of a strong use and an early onset use. Several models have been cited to explain the link between cannabis use and the subsequent onset of psychosis or prepsychotic states: cannabis-induced modifications of some brain structures, a dysregulation of the hypothalamic-pituitary axis and an alteration of normal neurological development via the endocannabinoid system. Cannabis represents a modifiable risk for psychosis. Current interventions aim to reduce or stop the cannabis use in order to reduce the risk of transition to psychosis.
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Affiliation(s)
- Feten Fekih-Romdhane
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie.
| | - Abir Hakiri
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
| | - Sinda Ben Fadhel
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
| | - Majda Cheour
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
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30
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Meade CS, Bell RP, Towe SL, Chen N, Hobkirk AL, Huettel SA. Synergistic effects of marijuana abuse and HIV infection on neural activation during a cognitive interference task. Addict Biol 2019; 24:1235-1244. [PMID: 30239074 DOI: 10.1111/adb.12678] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 08/06/2018] [Accepted: 08/11/2018] [Indexed: 01/28/2023]
Abstract
Marijuana use, which is disproportionately prevalent among human immunodeficiency virus (HIV)-infected persons, can alter activity in fronto-parietal regions during cognitively demanding tasks. While HIV is also associated with altered neural activation, it is not known how marijuana may further affect brain function in this population. Our study examined the independent and additive effects of HIV infection and regular marijuana use on neural activation during a cognitive interference task. The sample included 93 adults who differed on marijuana (MJ) and HIV statuses (20 MJ+/HIV+, 19 MJ+/HIV-, 29 MJ-/HIV+, 25 MJ-/HIV-). Participants completed a counting Stroop task during a functional magnetic resonance imaging scan. Main and interactive effects on neural activation during interference versus neutral blocks were examined using a mixed-effects analysis. The sample showed the expected Stroop effect for both speed and accuracy. There were main effects of MJ in the right and left inferior parietal lobules, with the left cluster extending into the posterior middle temporal gyrus and a main effect of HIV in the dorsal anterior cingulate cortex. There was an interaction in the left fronto-insular cortex, such that the MJ+/HIV+ group had the largest increase in activation compared with other groups. Among MJ+, signal change in this cluster correlated positively with cumulative years of regular marijuana use. These results suggest that comorbid HIV and marijuana use is associated with complex neural alterations in multiple brain regions during cognitive interference. Follow-up research is needed to determine how marijuana-related characteristics may moderate HIV neurologic disease and impact real-world functioning.
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Affiliation(s)
- Christina S. Meade
- Department of Psychiatry and Behavioral SciencesDuke University School of Medicine Durham North Carolina USA
- Department of Psychology & NeuroscienceDuke University Durham North Carolina USA
- Brain Imaging and Analysis CenterDuke University Medical Center Durham North Carolina USA
| | - Ryan P. Bell
- Department of Psychiatry and Behavioral SciencesDuke University School of Medicine Durham North Carolina USA
| | - Sheri L. Towe
- Department of Psychiatry and Behavioral SciencesDuke University School of Medicine Durham North Carolina USA
| | - Nan‐kuei Chen
- Brain Imaging and Analysis CenterDuke University Medical Center Durham North Carolina USA
- Department of RadiologyDuke University School of Medicine Durham North Carolina USA
| | - Andrea L. Hobkirk
- Department of Psychiatry and Behavioral SciencesDuke University School of Medicine Durham North Carolina USA
| | - Scott A. Huettel
- Department of Psychology & NeuroscienceDuke University Durham North Carolina USA
- Brain Imaging and Analysis CenterDuke University Medical Center Durham North Carolina USA
- Center for Cognitive NeuroscienceDuke University Durham North Carolina USA
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31
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Hurd YL, Manzoni OJ, Pletnikov MV, Lee FS, Bhattacharyya S, Melis M. Cannabis and the Developing Brain: Insights into Its Long-Lasting Effects. J Neurosci 2019; 39:8250-8258. [PMID: 31619494 PMCID: PMC6794936 DOI: 10.1523/jneurosci.1165-19.2019] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 12/24/2022] Open
Abstract
The recent shift in sociopolitical debates and growing liberalization of cannabis use across the globe has raised concern regarding its impact on vulnerable populations, such as pregnant women and adolescents. Epidemiological studies have long demonstrated a relationship between developmental cannabis exposure and later mental health symptoms. This relationship is especially strong in people with particular genetic polymorphisms, suggesting that cannabis use interacts with genotype to increase mental health risk. Seminal animal research directly linked prenatal and adolescent exposure to delta-9-tetrahydrocannabinol, the major psychoactive component of cannabis, with protracted effects on adult neural systems relevant to psychiatric and substance use disorders. In this article, we discuss some recent advances in understanding the long-term molecular, epigenetic, electrophysiological, and behavioral consequences of prenatal, perinatal, and adolescent exposure to cannabis/delta-9-tetrahydrocannabinol. Insights are provided from both animal and human studies, including in vivo neuroimaging strategies.
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Affiliation(s)
- Yasmin L Hurd
- Department of Psychiatry and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York 10029,
| | - Olivier J Manzoni
- Aix Marseille University, Institut National de la Santé et de la Recherche Médicale, Institut de neurobiologie de la méditerranée, 13273 Marseille, France, and Cannalab, Cannabinoids Neuroscience Research International Associated Laboratory, Institut National de la Santé et de la Recherche Médicale, 13273 Marseille, France
| | - Mikhail V Pletnikov
- Department of Psychiatry and Behavioral Sciences, Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Francis S Lee
- Department of Psychiatry, Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, New York 10065
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom, and
| | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
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Zaytseva Y, Horáček J, Hlinka J, Fajnerová I, Androvičová R, Tintěra J, Salvi V, Balíková M, Hložek T, Španiel F, Páleníček T. Cannabis-induced altered states of consciousness are associated with specific dynamic brain connectivity states. J Psychopharmacol 2019; 33:811-821. [PMID: 31154891 DOI: 10.1177/0269881119849814] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cannabis, and specifically one of its active compounds delta-9-tetrahydrocannabinol in recreational doses, has a variety of effects on cognitive processes. Most studies employ resting state functional magnetic resonance imaging techniques to assess the stationary effects of cannabis and to-date one report addressed the impact of delta-9-tetrahydrocannabinol on the dynamics of whole-brain functional connectivity. METHODS Using a repeated-measures, within-subjects design, 19 healthy occasional cannabis users (smoking cannabis ⩽2 per week) underwent resting state functional magnetic resonance imaging scans. Each subject underwent two scans: in the intoxicated condition, shortly after smoking a cannabis cigarette, and in the non-intoxicated condition, with the subject being free from cannabinoids for at least one week before. All sessions were randomized and performed in a four-week interval. Data were analysed employing a standard independent component analysis approach with subsequent tracking of the functional connectivity dynamics, which allowed six connectivity clusters (states) to be individuated. RESULTS Using standard independent component analysis in resting state functional connectivity, a group effect was found in the precuneus connectivity. With a dynamic independent component analysis approach, we identified one transient connectivity state, characterized by high connectivity within and between auditory and somato-motor cortices and anti-correlation with subcortical structures and the cerebellum that was only found during the intoxicated condition. Behavioural measures of the subjective experiences of changed perceptions and tetrahydrocannabinol plasma levels during intoxication were associated with this state. CONCLUSIONS With the help of the dynamic connectivity approach we could elucidate neural correlates of the transitory perceptual changes induced by delta-9-tetrahydrocannabinol in cannabis users, and possibly identify a biomarker of cannabis intoxication.
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Affiliation(s)
- Yuliya Zaytseva
- 1 National Institute of Mental Health, Klecany, Czech Republic.,3 Human Science Centre, Ludwig-Maximilian University, Munich, Germany
| | - Jiří Horáček
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jaroslav Hlinka
- 1 National Institute of Mental Health, Klecany, Czech Republic.,4 Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic
| | - Iveta Fajnerová
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Renata Androvičová
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | | | - Virginio Salvi
- 5 Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marie Balíková
- 6 Institute of Forensic Medicine and Toxicology, Charles University in Prague, Czech Republic
| | - Tomáš Hložek
- 6 Institute of Forensic Medicine and Toxicology, Charles University in Prague, Czech Republic
| | - Filip Španiel
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Tomáš Páleníček
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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Cohen K, Weizman A, Weinstein A. Modulatory effects of cannabinoids on brain neurotransmission. Eur J Neurosci 2019; 50:2322-2345. [DOI: 10.1111/ejn.14407] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Koby Cohen
- Department of Behavioral Science Ariel University Science Park 40700 Ariel Israel
| | | | - Aviv Weinstein
- Department of Behavioral Science Ariel University Science Park 40700 Ariel Israel
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Mackey S, Algaier N, Chaarani B, Spechler P, Orr C, Bunn J, Allen NB, Alia-Klein N, Batalla A, Blaine S, Brooks S, Caparelli E, Chye YY, Cousijn J, Dagher A, Desrivieres S, Feldstein-Ewing S, Foxe JJ, Goldstein RZ, Goudriaan AE, Heitzeg MM, Hester R, Hutchison K, Korucuoglu O, Li CSR, London E, Lorenzetti V, Luijten M, Martin-Santos R, May A, Momenan R, Morales A, Paulus MP, Pearlson G, Rouseau ME, Salmeron BJ, Schluter R, Schmaal L, Schumann G, Sjoerds Z, Stein DJ, Stein EA, Sinha R, Solowij N, Tapert S, Uhlmann A, Veltman D, van Holst R, Wittle S, Wright MJ, Yucel M, Zhang S, Yurgelun-Todd D, Hibar DP, Jahanshad N, Evans A, Thompson PM, Glahn DC, Conrod P, Garavan H. Mega-Analysis of Gray Matter Volume in Substance Dependence: General and Substance-Specific Regional Effects. Am J Psychiatry 2019; 176:119-128. [PMID: 30336705 PMCID: PMC6427822 DOI: 10.1176/appi.ajp.2018.17040415] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Although lower brain volume has been routinely observed in individuals with substance dependence compared with nondependent control subjects, the brain regions exhibiting lower volume have not been consistent across studies. In addition, it is not clear whether a common set of regions are involved in substance dependence regardless of the substance used or whether some brain volume effects are substance specific. Resolution of these issues may contribute to the identification of clinically relevant imaging biomarkers. Using pooled data from 14 countries, the authors sought to identify general and substance-specific associations between dependence and regional brain volumes. METHOD Brain structure was examined in a mega-analysis of previously published data pooled from 23 laboratories, including 3,240 individuals, 2,140 of whom had substance dependence on one of five substances: alcohol, nicotine, cocaine, methamphetamine, or cannabis. Subcortical volume and cortical thickness in regions defined by FreeSurfer were compared with nondependent control subjects when all sampled substance categories were combined, as well as separately, while controlling for age, sex, imaging site, and total intracranial volume. Because of extensive associations with alcohol dependence, a secondary contrast was also performed for dependence on all substances except alcohol. An optimized split-half strategy was used to assess the reliability of the findings. RESULTS Lower volume or thickness was observed in many brain regions in individuals with substance dependence. The greatest effects were associated with alcohol use disorder. A set of affected regions related to dependence in general, regardless of the substance, included the insula and the medial orbitofrontal cortex. Furthermore, a support vector machine multivariate classification of regional brain volumes successfully classified individuals with substance dependence on alcohol or nicotine relative to nondependent control subjects. CONCLUSIONS The results indicate that dependence on a range of different substances shares a common neural substrate and that differential patterns of regional volume could serve as useful biomarkers of dependence on alcohol and nicotine.
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Affiliation(s)
- Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Nicholas Algaier
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Bader Chaarani
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Philip Spechler
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Catherine Orr
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Janice Bunn
- Department of Mathematics and Statistics, University of Vermont, Burlington VT, USA
| | - Nicholas B. Allen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia,Department of Psychology, University of Oregon, Eugene OR, USA,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City NY, USA
| | - Albert Batalla
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sara Blaine
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Samantha Brooks
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Elisabeth Caparelli
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Yann Ying Chye
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Janna Cousijn
- Departments of Developmental and Experimental Psychology, Utrecht University, Utrecht, the Netherlands
| | - Alain Dagher
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester NY, USA
| | - Rita Z. Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City NY, USA
| | - Anna E. Goudriaan
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands,Amsterdam Institute for Addiction Research & Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor MI, USA
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA
| | - Ozlem Korucuoglu
- Department of Psychiatry, Washington University School of Medicine, St. Louis MO, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Edythe London
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Valentina Lorenzetti
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia,School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia,Department of Psycological Sciences, the University of Liverpool, Liverpool, UK
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain
| | - April May
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda MD, USA
| | - Angelica Morales
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, La Jolla, USA,Laureate Institute for Brain Research, Tulsa OK, USA
| | - Godfrey Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Marc-Etienne Rouseau
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Renée Schluter
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Zsuzsika Sjoerds
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Institute of Psychology, Cognitive Psychology Unit & Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Dan J. Stein
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Susan Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Anne Uhlmann
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Dick Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Ruth van Holst
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - Sarah Wittle
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | | | - Murat Yucel
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City UT, USA
| | - Derrek P. Hibar
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - Alan Evans
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Paul M. Thompson
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montreal QC, Canada
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington VT, USA
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Sakuma A, Obara C, Katsura M, Ito F, Ohmuro N, Iizuka K, Kikuchi T, Miyakoshi T, Matsuoka H, Matsumoto K. No regional gray matter volume reduction observed in young Japanese people at ultra-high risk for psychosis: A voxel-based morphometry study. Asian J Psychiatr 2018; 37:167-171. [PMID: 30293050 DOI: 10.1016/j.ajp.2018.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/28/2018] [Accepted: 09/26/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Structural brain magnetic resonance imaging studies of individuals at ultra-high risk (UHR) for psychosis have shown subtle but widespread reductions in baseline gray matter volume (GMV) in the frontal, temporal, and limbic regions compared with healthy controls (HC). These regions coincide with regions of reduced GMV in patients with established psychosis and have led to the consideration of structural changes in UHR as a potential biomarker for future transition to psychosis. However, most studies have been from Europe, North America, and Australia, with few reports from other regions, and two recent studies from Asian countries have failed to detect regional GMV reduction in UHR, suggesting the need for further analysis of an Asian sample. In this study, we investigated GMV reduction in Japanese UHR subjects. RESULTS The study used voxel-based morphometry to compare magnetic resonance imaging brain scans between 45 UHR individuals recruited by a specialist and 33 HCs. This showed no significant GMV reduction in the UHR group compared with the healthy control group. This negative result may be attributable to characteristics of Asian samples, such as a low prevalence of illicit drug use, or to the heterogeneous nature of UHR subjects.
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Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Sendai City Hospital, 1-1 Asuto-nagamachi, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan.
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tetsuo Miyakoshi
- Sapporo Prison, 2-1-5-1 Higashi-naebo, Higashi-ku, Sapporo, 007-8601, Japan.
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan; Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
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Bolbecker AR, Apthorp D, Martin AS, Tahayori B, Moravec L, Gomez KL, O’Donnell BF, Newman SD, Hetrick WP. Disturbances of postural sway components in cannabis users. Drug Alcohol Depend 2018; 190:54-61. [PMID: 29983392 PMCID: PMC7185833 DOI: 10.1016/j.drugalcdep.2018.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A prominent effect of acute cannabis use is impaired motor coordination and driving performance. However, few studies have evaluated balance in chronic cannabis users, even though density of the CB1 receptor, which mediates the psychoactive effects of cannabis, is extremely high in brain regions critically involved in this fundamental behavior. The present study measured postural sway in regular cannabis users and used rambling and trembling analysis to quantify the integrity of central and peripheral nervous system contributions to the sway signal. METHODS Postural sway was measured in 42 regular cannabis users (CB group) and 36 non-cannabis users (N-CB group) by asking participants to stand as still as possible on a force platform in the presence and absence of motor and sensory challenges. Center of pressure (COP) path length was measured, and the COP signal was decomposed into rambling and trembling components. Exploratory correlational analyses were conducted between sway variables, cannabis use history, and neurocognitive function. RESULTS The CB group had significantly increased path length and increased trembling in the anterior-posterior (AP) direction. Exploratory correlational analyses suggested that AP rambling was significantly inversely associated with visuo-motor processing speed. DISCUSSION Regular cannabis use is associated with increased postural sway, and this appears to be predominantly due to the trembling component, which is believed to reflect the peripheral nervous system's contribution to the sway signal.
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Affiliation(s)
- Amanda R. Bolbecker
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States,School of Psychology and Behavioural Science, University of New England, NSW, Australia,Corresponding author at: Dept. of Psychological and Brain Sciences, Indiana University, 1101 E. Tenth St., Bloomington, IN, 47405, United States. (A.R. Bolbecker)
| | - Deborah Apthorp
- School of Psychology and Behavioural Science, University of New England, NSW, Australia,Research School of Computer Science, Australian National University, ACT, Australia
| | | | - Behdad Tahayori
- Department of Biomedical Engineering, Florida International University, Miami, Florida, United States
| | - Leah Moravec
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Karen L. Gomez
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Brian F. O’Donnell
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States
| | - Sharlene D. Newman
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - William P. Hetrick
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States
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Ma L, Steinberg JL, Bjork JM, Keyser-Marcus L, Vassileva J, Zhu M, Ganapathy V, Wang Q, Boone EL, Ferré S, Bickel WK, Gerard Moeller F. Fronto-striatal effective connectivity of working memory in adults with cannabis use disorder. Psychiatry Res Neuroimaging 2018; 278:21-34. [PMID: 29957349 PMCID: PMC6953485 DOI: 10.1016/j.pscychresns.2018.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 10/14/2022]
Abstract
Previous working memory (WM) studies found that relative to controls, subjects with cannabis use disorder (CUD) showed greater brain activation in some regions (e.g., left [L] and right [R] ventrolateral prefrontal cortex [VLPFC], and L dorsolateral prefrontal cortex [L-DLPFC]), and lower activation in other regions (e.g., R-DLPFC). In this study, effective connectivity (EC) analysis was applied to functional magnetic resonance imaging data acquired from 23 CUD subjects and 23 controls (two groups matched for sociodemographic factors and substance use history) while performing an n-back WM task with interleaved 2-back and 0-back periods. A 2-back minus 0-back modulator was defined to measure the modulatory changes of EC corresponding to the 2-back relative to 0-back conditions. Compared to the controls, the CUD group showed smaller modulatory change in the R-DLPFC to L-caudate pathway, and greater modulatory changes in L-DLPFC to L-caudate, R-DLPFC to R-caudate, and R-VLPFC to L-caudate pathways. Based on previous fMRI studies consistently suggesting that greater brain activations are related to a compensatory mechanism for cannabis neural effects (less regional brain activations), the smaller modulatory change in the R-DLPFC to L-caudate EC may be compensated by the larger modulatory changes in the other prefrontal-striatal ECs in the CUD individuals.
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Affiliation(s)
- Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Radiology, Virginia Commonwealth University (VCU), Richmond, VA, USA.
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Lori Keyser-Marcus
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Min Zhu
- Radiology Department, Mu Dang Jiang Medical University, Mu Dang Jiang, Hei Long Jiang, China
| | - Venkatesh Ganapathy
- Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Qin Wang
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Edward L Boone
- Department of Statistical Sciences and Operations Research, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Sergi Ferré
- Integrative Neurobiology Section, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), 203 East Cary Street, Suite 202, Richmond, VA 23219, USA; Department of Psychiatry, Virginia Commonwealth University (VCU), Richmond, VA, USA; Department of Pharmacology & Toxicology, VCU, Richmond, VA, USA; Department of Neurology, VCU, Richmond, VA, USA
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Memedovich KA, Dowsett LE, Spackman E, Noseworthy T, Clement F. The adverse health effects and harms related to marijuana use: an overview review. CMAJ Open 2018; 6:E339-E346. [PMID: 30115639 PMCID: PMC6182105 DOI: 10.9778/cmajo.20180023] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND With impending marijuana legislation in Canada, a broad understanding of the harms associated with marijuana use is needed to inform the clinical community and public, and to support evidence-informed public policy development. The purpose of the review was to synthesize the evidence on adverse health effects and harms of marijuana use. METHODS We searched MEDLINE, The Cochrane Database of Systematic Reviews, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Health Technology Assessment Database from the inception of each database to May 2018. Given that systematic reviews evaluating one or other specific harm have been published, this is an overview review with the primary objective of assessing a health effect or harm. Data on author, country and year of publication, search strategy and results, and outcomes were extracted. Quality was assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist. RESULTS The final analysis included 68 reviews. Evidence of harm was reported in 62 reviews for several mental health disorders, brain changes, cognitive outcomes, pregnancy outcomes and testicular cancer. Inconclusive evidence was found for 20 outcomes (some mental health outcomes, other types of cancers and all-cause mortality). No evidence of harm was reported for 6 outcomes. INTERPRETATION Harm was associated with most outcomes assessed. These results should be viewed with concern by physicians and policy-makers given the prevalence of use, the persistent reporting of a lack of recognition of marijuana as a possibly harmful substance and the emerging context of legalization for recreational use.
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Affiliation(s)
- K Ally Memedovich
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Laura E Dowsett
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Eldon Spackman
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Tom Noseworthy
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Fiona Clement
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta.
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Beale C, Broyd SJ, Chye Y, Suo C, Schira M, Galettis P, Martin JH, Yücel M, Solowij N. Prolonged Cannabidiol Treatment Effects on Hippocampal Subfield Volumes in Current Cannabis Users. Cannabis Cannabinoid Res 2018; 3:94-107. [PMID: 29682609 PMCID: PMC5908414 DOI: 10.1089/can.2017.0047] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: Chronic cannabis use is associated with neuroanatomical alterations in the hippocampus. While adverse impacts of cannabis use are generally attributed to Δ9-tetrahydrocannabinol, emerging naturalistic evidence suggests cannabidiol (CBD) is neuroprotective and may ameliorate brain harms associated with cannabis use, including protection from hippocampal volume loss. This study examined whether prolonged administration of CBD to regular cannabis users within the community could reverse or reduce the characteristic hippocampal harms associated with chronic cannabis use. Materials and Methods: Eighteen regular cannabis users participated in an ∼10-week open-label pragmatic trial involving daily oral administration of 200 mg CBD, with no change to their ongoing cannabis use requested. Participants were assessed at baseline and post-CBD treatment using structural magnetic resonance imaging. Automated longitudinal hippocampal segmentation was performed to assess volumetric change over the whole hippocampus and within 12 subfields. Results: No change was observed in left or right hippocampus as a whole. However, left subicular complex (parasubiculum, presubiculum, and subiculum) volume significantly increased from baseline to post-treatment (p=0.017 uncorrected) by 1.58% (Cohen's d=0.63; 2.83% in parasubiculum). Heavy cannabis users demonstrated marked growth in the left subicular complex, predominantly within the presubiculum, and right cornu ammonis (CA)1 compared to lighter users. Associations between greater right subicular complex and total hippocampal volume and higher plasma CBD concentration were evident, particularly in heavy users. Conclusions: Our findings suggest a restorative effect of CBD on the subicular and CA1 subfields in current cannabis users, especially those with greater lifetime exposure to cannabis. While replication is required in a larger, placebo-controlled trial, these findings support a protective role of CBD against brain structural harms conferred by chronic cannabis use. Furthermore, these outcomes suggest that CBD may be a useful adjunct in treatments for cannabis dependence and may be therapeutic for a range of clinical disorders characterized by hippocampal pathology (e.g., schizophrenia, Alzheimer's disease, and major depressive disorder).
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Affiliation(s)
- Camilla Beale
- School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Samantha J Broyd
- School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Yann Chye
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Chao Suo
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Mark Schira
- School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Peter Galettis
- Discipline of Clinical Pharmacology, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, Australia
| | - Jennifer H Martin
- Discipline of Clinical Pharmacology, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Nadia Solowij
- School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.,The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, Australia
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Moser DA, Doucet GE, Lee WH, Rasgon A, Krinsky H, Leibu E, Ing A, Schumann G, Rasgon N, Frangou S. Multivariate Associations Among Behavioral, Clinical, and Multimodal Imaging Phenotypes in Patients With Psychosis. JAMA Psychiatry 2018; 75. [PMID: 29516092 PMCID: PMC5875357 DOI: 10.1001/jamapsychiatry.2017.4741] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Alterations in multiple neuroimaging phenotypes have been reported in psychotic disorders. However, neuroimaging measures can be influenced by factors that are not directly related to psychosis and may confound the interpretation of case-control differences. Therefore, a detailed characterization of the contribution of these factors to neuroimaging phenotypes in psychosis is warranted. OBJECTIVE To quantify the association between neuroimaging measures and behavioral, health, and demographic variables in psychosis using an integrated multivariate approach. DESIGN, SETTING, AND PARTICIPANTS This imaging study was conducted at a university research hospital from June 26, 2014, to March 9, 2017. High-resolution multimodal magnetic resonance imaging data were obtained from 100 patients with schizophrenia, 40 patients with bipolar disorder, and 50 healthy volunteers; computed were cortical thickness, subcortical volumes, white matter fractional anisotropy, task-related brain activation (during working memory and emotional recognition), and resting-state functional connectivity. Ascertained in all participants were nonimaging measures pertaining to clinical features, cognition, substance use, psychological trauma, physical activity, and body mass index. The association between imaging and nonimaging measures was modeled using sparse canonical correlation analysis with robust reliability testing. MAIN OUTCOMES AND MEASURES Multivariate patterns of the association between nonimaging and neuroimaging measures in patients with psychosis and healthy volunteers. RESULTS The analyses were performed in 92 patients with schizophrenia (23 female [25.0%]; mean [SD] age, 27.0 [7.6] years), 37 patients with bipolar disorder (12 female [32.4%]; mean [SD] age, 27.5 [8.1] years), and 48 healthy volunteers (20 female [41.7%]; mean [SD] age, 29.8 [8.5] years). The imaging and nonimaging data sets showed significant covariation (r = 0.63, P < .001), which was independent of diagnosis. Among the nonimaging variables examined, age (r = -0.53), IQ (r = 0.36), and body mass index (r = -0.25) were associated with multiple imaging phenotypes; cannabis use (r = 0.23) and other substance use (r = 0.33) were associated with subcortical volumes, and alcohol use was associated with white matter integrity (r = -0.15). Within the multivariate models, positive symptoms retained associations with the global neuroimaging (r = -0.13), the cortical thickness (r = -0.22), and the task-related activation variates (r = -0.18); negative symptoms were mostly associated with measures of subcortical volume (r = 0.23), and depression/anxiety was associated with measures of white matter integrity (r = 0.12). CONCLUSIONS AND RELEVANCE Multivariate analyses provide a more accurate characterization of the association between brain alterations and psychosis because they enable the modeling of other key factors that influence neuroimaging phenotypes.
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Affiliation(s)
- Dominik A. Moser
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gaelle E. Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Won Hee Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Rasgon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hannah Krinsky
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Evan Leibu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alex Ing
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Gunter Schumann
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California,Center for Neuroscience in Women’s Health, Stanford University, Palo Alto, California
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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Blest-Hopley G, Giampietro V, Bhattacharyya S. Residual effects of cannabis use in adolescent and adult brains - A meta-analysis of fMRI studies. Neurosci Biobehav Rev 2018. [PMID: 29535069 DOI: 10.1016/j.neubiorev.2018.03.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While numerous studies have investigated the residual effects of cannabis use on human brain function, results of these studies have been inconsistent. Using meta-analytic approaches we summarize the effects of prolonged cannabis exposure on human brain function as measured using task-based functional MRI (fMRI) across studies employing a range of cognitive activation tasks comparing regular cannabis users with non-users. Separate meta-analyses were carried out for studies investigating adult and adolescent cannabis users. Systematic literature search identified 20 manuscripts (13 adult and 7 adolescent studies) meeting study inclusion criteria. Adult analyses compared 530 cannabis users to 580 healthy controls while adolescent analyses compared 219 cannabis users to 224 healthy controls. In adult cannabis users brain activation was increased in the superior and posterior transverse temporal and inferior frontal gyri and decreased in the striate area, insula and middle temporal gyrus. In adolescent cannabis users, activation was increased in the inferior parietal gyrus and putamen compared to healthy controls. Functional alteration in these areas may reflect compensatory neuroadaptive changes in cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, PO Box 089, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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42
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Yanes JA, Riedel MC, Ray KL, Kirkland AE, Bird RT, Boeving ER, Reid MA, Gonzalez R, Robinson JL, Laird AR, Sutherland MT. Neuroimaging meta-analysis of cannabis use studies reveals convergent functional alterations in brain regions supporting cognitive control and reward processing. J Psychopharmacol 2018; 32:283-295. [PMID: 29338547 PMCID: PMC5858977 DOI: 10.1177/0269881117744995] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lagging behind rapid changes to state laws, societal views, and medical practice is the scientific investigation of cannabis's impact on the human brain. While several brain imaging studies have contributed important insight into neurobiological alterations linked with cannabis use, our understanding remains limited. Here, we sought to delineate those brain regions that consistently demonstrate functional alterations among cannabis users versus non-users across neuroimaging studies using the activation likelihood estimation meta-analysis framework. In ancillary analyses, we characterized task-related brain networks that co-activate with cannabis-affected regions using data archived in a large neuroimaging repository, and then determined which psychological processes may be disrupted via functional decoding techniques. When considering convergent alterations among users, decreased activation was observed in the anterior cingulate cortex, which co-activated with frontal, parietal, and limbic areas and was linked with cognitive control processes. Similarly, decreased activation was observed in the dorsolateral prefrontal cortex, which co-activated with frontal and occipital areas and linked with attention-related processes. Conversely, increased activation among users was observed in the striatum, which co-activated with frontal, parietal, and other limbic areas and linked with reward processing. These meta-analytic outcomes indicate that cannabis use is linked with differential, region-specific effects across the brain.
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Affiliation(s)
- Julio A Yanes
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Michael C Riedel
- Center for Imaging Science, Florida International University, Miami, FL, USA
| | - Kimberly L Ray
- Imaging Research Center, University of California Davis, Sacramento, CA, USA
| | - Anna E Kirkland
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Ryan T Bird
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Emily R Boeving
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
| | - Meredith A Reid
- Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Raul Gonzalez
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Jennifer L Robinson
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Angela R Laird
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Physics, Florida International University, Miami, FL, USA
| | - Matthew T Sutherland
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
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43
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Filbey FM, Aslan S, Lu H, Peng SL. Residual Effects of THC via Novel Measures of Brain Perfusion and Metabolism in a Large Group of Chronic Cannabis Users. Neuropsychopharmacology 2018; 43:700-707. [PMID: 28240291 PMCID: PMC5809805 DOI: 10.1038/npp.2017.44] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/17/2022]
Abstract
Given the known vascular effects of cannabis, this study examined the neurophysiological factors that may affect studies of brain activity in cannabis users. We conducted a systematic evaluation in 72 h abstinent, chronic cannabis users (N=74) and nonusing controls (N=101) to determine the association between prolonged cannabis use and the following neurophysiological indicators: (1) global and regional resting cerebral blood flow (CBF), (2) oxygen extraction fraction (OEF), and (3) cerebral metabolic rate of oxygen (CMRO2). We found that cannabis users had greater global OEF and CMRO2 compared with nonusers. Regionally, we found higher CBF in the right pallidum/putamen of the cannabis users compared with nonusers. Global resting CBF and regional CBF of right superior frontal cortex correlated positively with creatinine-normalized Δ9-tetrahydrocannabinol (THC) levels. These findings demonstrate residual effects of cannabis use whereby global and regional brain metabolism are altered in those with prolonged cannabis exposure. These neurophysiological alterations should be considered in both research and clinical applications.
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Affiliation(s)
- Francesca M Filbey
- Center for BrainHealth, University of Texas at Dallas, Dallas, TX, USA,Center for BrainHealth, University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA, Tel: +1 972 883 3311, E-mail:
| | - Sina Aslan
- Center for BrainHealth, University of Texas at Dallas, Dallas, TX, USA,Advance MRI LLC, Frisco, TX, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Shin-Lei Peng
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
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Altered orbitofrontal activity and dorsal striatal connectivity during emotion processing in dependent marijuana users after 28 days of abstinence. Psychopharmacology (Berl) 2018; 235:849-859. [PMID: 29197984 DOI: 10.1007/s00213-017-4803-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/26/2017] [Indexed: 12/28/2022]
Abstract
RATIONALE Intact cognitive and emotional functioning is vital for the long-term success of addiction treatment strategies. Accumulating evidence suggests an association between chronic marijuana use and lasting alterations in cognitive brain function. Despite initial evidence for altered emotion processing in dependent marijuana users after short abstinence periods, adaptations in the domain of emotion processing after longer abstinence remain to be determined. OBJECTIVE AND METHODS Using task-based and resting state fMRI, the present study investigated emotion processing in 19 dependent marijuana users and 18 matched non-using controls after an abstinence period of > 28 days. RESULTS Relative to the control subjects, negative emotional stimuli elicited increased medial orbitofrontal cortex (mOFC) activity and stronger mOFC-dorsal striatal and mOFC-amygdala functional coupling in dependent marijuana users (p < 0.022, FWE-corrected). Furthermore, mOFC-dorsal striatal functional connectivity was increased at rest in marijuana users (p < 0.03, FWE-corrected). Yet, processing of positive stimuli and subjective ratings of valence and arousal were comparable in both groups. CONCLUSIONS Together, the present findings provide the first evidence for persisting emotion processing alterations in dependent marijuana users. Alterations might reflect long-term neural adaptations as a consequence of chronic marijuana use or predisposing risk factors for the development of marijuana dependence.
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Batalla A, Lorenzetti V, Chye Y, Yücel M, Soriano-Mas C, Bhattacharyya S, Torrens M, Crippa JAS, Martín-Santos R. The Influence of DAT1, COMT, and BDNF Genetic Polymorphisms on Total and Subregional Hippocampal Volumes in Early Onset Heavy Cannabis Users. Cannabis Cannabinoid Res 2018; 3:1-10. [PMID: 29404409 PMCID: PMC5797324 DOI: 10.1089/can.2017.0021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction: Hippocampal neuroanatomy is affected by genetic variations in dopaminergic candidate genes and environmental insults, such as early onset of chronic cannabis exposure. Here, we examine how hippocampal total and subregional volumes are affected by cannabis use and functional polymorphisms of dopamine-relevant genes, including the catechol-O-methyltransferase (COMT), dopamine transporter (DAT1), and the brain-derived neurotrophic factor (BDNF) genes. Material and Methods: We manually traced total hippocampal volumes and automatically segmented hippocampal subregions using high-resolution MRI images, and performed COMT, DAT1, and BDNF genotyping in 59 male Caucasian young adults aged 18–30 years. These included 30 chronic cannabis users with early-onset (regular use at <16 years) and 29 age-, education-, and intelligence-matched controls. Results: Cannabis use and dopaminergic gene polymorphism had both distinct and interactive effects on the hippocampus. We found emerging alterations of hippocampal total and specific subregional volumes in cannabis users relative to controls (i.e., CA1, CA2/3, and CA4), and associations between cannabis use levels and total and specific subregional volumes. Furthermore, total hippocampal volume and the fissure subregion were affected by cannabis×DAT1 polymorphism (i.e., 9/9R and in 10/10R alleles), reflecting high and low levels of dopamine availability. Conclusion: These findings suggest that cannabis exposure alters the normal relationship between DAT1 polymorphism and the anatomy of total and subregional hippocampal volumes, and that specific hippocampal subregions may be particularly affected.
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Affiliation(s)
- Albert Batalla
- Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, CIBERSAM and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands
| | - Valentina Lorenzetti
- School of Psychological Sciences, Institute of Psychology Health and Society, The University of Liverpool, Liverpool, United Kingdom.,Laboratory for Brain and Mental Health, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Yann Chye
- Laboratory for Brain and Mental Health, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Murat Yücel
- Laboratory for Brain and Mental Health, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBERSAM G-17, and Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Marta Torrens
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Psychiatric Department of Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José A S Crippa
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina Translational Medicine (INCT-TM), National Council for Scientific and Technological Development, São Paulo, Brazil
| | - Rocío Martín-Santos
- Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, CIBERSAM and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.,Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Psychiatric Department of Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina Translational Medicine (INCT-TM), National Council for Scientific and Technological Development, São Paulo, Brazil
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Mantovani CDC, Silva JPE, Forster G, Almeida RMD, Diniz EMDA, Yonamine M. Simultaneous accelerated solvent extraction and hydrolysis of 11-nor-Δ 9-tetrahydrocannabinol-9-carboxylic acid glucuronide in meconium samples for gas chromatography-mass spectrometry analysis. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1074-1075:1-7. [PMID: 29329090 DOI: 10.1016/j.jchromb.2018.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/19/2017] [Accepted: 01/06/2018] [Indexed: 11/17/2022]
Abstract
Cannabis misuse during pregnancy is associated with severe impacts on the mother and baby health, such as newborn low birth weight, growth restriction, pre-term birth, neurobehavioral and developmental deficits. In most of the cases, drug abuse is omitted or denied by the mothers. Thus, toxicological analyzes using maternal-fetal matrices takes place as a suitable tool to assess drug use. Herein, meconium was the chosen matrix to evaluate cannabis exposure through identification and quantification of 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic (THCCOOH). Accelerated solvent extraction (ASE) was applied for sample preparation technique to simultaneously extract and hydrolyze conjugated THCCOOH from meconium, followed by a solid-phase extraction (SPE) procedure. The method was developed and validated for gas chromatography-mass spectrometry (GC-MS), reaching hydrolysis efficiency of 98%. Limits of detection (LOD) and quantification (LOQ) were, respectively, 5 and 10 ng/g. The range of linearity was LOQ to 500 ng/g. Inter and intra-batch coefficients of variation were <8.4% for all concentration levels. Accuracy was in 101.7-108.9% range. Recovery was on average 60.3%. Carryover effect was not observed. The procedure was applied in six meconium samples from babies whose mothers were drug users and showed satisfactory performance to confirm fetal cannabis exposure.
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Affiliation(s)
- Cinthia de Carvalho Mantovani
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 580, 13B, 05508-900 São Paulo, SP, Brazil
| | - Jefferson Pereira E Silva
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 580, 13B, 05508-900 São Paulo, SP, Brazil.
| | - Guilherme Forster
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 580, 13B, 05508-900 São Paulo, SP, Brazil
| | - Rafael Menck de Almeida
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 580, 13B, 05508-900 São Paulo, SP, Brazil
| | | | - Mauricio Yonamine
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 580, 13B, 05508-900 São Paulo, SP, Brazil
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47
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Thayer RE, YorkWilliams S, Karoly HC, Sabbineni A, Ewing SF, Bryan AD, Hutchison KE. Structural neuroimaging correlates of alcohol and cannabis use in adolescents and adults. Addiction 2017. [PMID: 28646566 PMCID: PMC5673530 DOI: 10.1111/add.13923] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Chronic alcohol use is associated with lower gray matter volume, and we reported recently that alcohol use showed negative associations with widespread gray matter (GM) volume even among young adults. The current study aimed to test the strength of association between (1) alcohol use and GM volume; (2) alcohol use and white matter (WM) integrity; (3) cannabis use and GM volume; and (4) cannabis use and WM integrity among adults and adolescents. DESIGN AND SETTING General linear models within large pooled cross-sectional samples of adolescents and adults who had participated in studies collecting substance use and neuroimaging data in the southwestern United States. PARTICIPANTS The current analysis included adults aged 18-55 years (n = 853) and adolescents aged 14-18 years (n = 439) with a range of alcohol and cannabis use. MEASUREMENTS The dependent variable was GM volume or WM integrity, with key predictors of alcohol use [Alcohol Use Disorders Identification Test (AUDIT) score] and cannabis use (past 30-day use). FINDINGS Alcohol use showed large clusters of negative associations (ηp2 = 0.028-0.145, P < 0.001) with GM volume among adults and to a lesser extent (one cluster; ηp2 = 0.070, P < 0.05) among adolescents. Large clusters showed significant associations (ηp2 = 0.050-0.124, P < 0.001) of higher alcohol use with poorer WM integrity, whereas adolescents showed no significant associations between alcohol use and WM. No associations were observed between structural measures and past 30-day cannabis use in adults or adolescents. CONCLUSIONS Alcohol use severity is associated with widespread lower gray matter volume and white matter integrity in adults, and with lower gray matter volume in adolescents.
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Affiliation(s)
- Rachel E. Thayer
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Sophie YorkWilliams
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Hollis C. Karoly
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Amithrupa Sabbineni
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | | | - Angela D. Bryan
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Kent E. Hutchison
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
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Bhattacharyya S, Egerton A, Kim E, Rosso L, Riano Barros D, Hammers A, Brammer M, Turkheimer FE, Howes OD, McGuire P. Acute induction of anxiety in humans by delta-9-tetrahydrocannabinol related to amygdalar cannabinoid-1 (CB1) receptors. Sci Rep 2017; 7:15025. [PMID: 29101333 PMCID: PMC5670208 DOI: 10.1038/s41598-017-14203-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/04/2017] [Indexed: 12/19/2022] Open
Abstract
Use of Cannabis, the most widely used illicit drug worldwide, is associated with acute anxiety, and anxiety disorders following regular use. The precise neural and receptor basis of these effects have not been tested in man. Employing a combination of functional MRI (fMRI) and positron emission tomography (PET), we investigated whether the effects of delta-9-tetrahydrocannabinol (delta-9-THC), the main psychoactive ingredient of cannabis, on anxiety and on amygdala response while processing fearful stimuli were related to local availability of its main central molecular target, cannabinoid-1 (CB1) receptors in man. Fourteen healthy males were studied with fMRI twice, one month apart, following an oral dose of either delta-9-THC (10 mg) or placebo, while they performed a fear-processing task. Baseline availability of the CB1 receptor was studied using PET with [11C]MePPEP, a CB1 inverse agonist radioligand. Relative to the placebo condition, delta-9-THC induced anxiety and modulated right amygdala activation while processing fear. Both these effects were positively correlated with CB1 receptor availability in the right amygdala. These results suggest that the acute effects of cannabis on anxiety in males are mediated by the modulation of amygdalar function by delta-9-THC and the extent of these effects are related to local availability of CB1 receptors.
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Affiliation(s)
- Sagnik Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Alice Egerton
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Euitae Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Lula Rosso
- Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
| | | | - Alexander Hammers
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, 4th floor Lambeth Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Michael Brammer
- Department of Neuroimaging, Centre for Neuroimaging Sciences, PO Box 089, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Federico E Turkheimer
- Department of Neuroimaging, Centre for Neuroimaging Sciences, PO Box 089, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Oliver D Howes
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
- Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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Abstract
Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for substance abuse. Response inhibition is a hallmark of ADHD, yet the combined effects of ADHD and regular substance use on neural networks associated with response inhibition are unknown. Task-based functional Magnetic Resonance Imaging (fMRI) data from young adults with childhood ADHD with (n = 25) and without (n = 25) cannabis use ≥ monthly in the past year were compared with a local normative comparison group (LNCG) with (n = 11) and without (n = 12) cannabis use. Go/NoGo behavioral and fMRI data were evaluated for main and interaction effects of ADHD diagnosis and cannabis use. ADHD participants made significantly more commission errors on NoGo trials than controls. ADHD participants also had less frontoparietal and frontostriatal activity, independent of cannabis use. No main effects of cannabis use on response inhibition or functional brain activation were observed. An interaction of ADHD diagnosis and cannabis use was found in the right hippocampus and cerebellar vermis, with increased recruitment of these regions in cannabis-using controls during correct response inhibition. ADHD participants had impaired response inhibition combined with less fronto-parietal/striatal activity, regardless of cannabis use history. Cannabis use did not impact behavioral response inhibition. Cannabis use was associated with hippocampal and cerebellar activation, areas rich in cannabinoid receptors, in LNCG but not ADHD participants. This may reflect recruitment of compensatory circuitry in cannabis using controls but not ADHD participants. Future studies targeting hippocampal and cerebellar-dependent function in these groups may provide further insight into how this circuitry is altered by ADHD and cannabis use.
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