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Jung HY, Bak H, Bang M, Lee SH, Lee KS. Neural Correlates of Trait Impulsivity among Adult Healthy Individuals. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:345-353. [PMID: 38627081 PMCID: PMC11024700 DOI: 10.9758/cpn.23.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 04/20/2024]
Abstract
Objective : Impulsivity can be observed in individuals with or without mental illness. The discovery of neural correlates responsible for trait impulsivity can therefore help to understand the severity of psychiatric symptoms, personality characteristics and social adjustment. In this study, we aimed to identify the gray matter substrates of trait impulsivity in healthy individuals. Methods : Seventy-five healthy individuals were enrolled. At baseline, trait impulsivity was assessed using the Barratt Impulsiveness Scale (BIS) and all participants underwent T1-weighted magnetic resonance imaging scan. Beck Anxiety Inventory (BAI), World Health Organization Quality of Life (WHOQOL-BREF) and Connor-Davidson Resilience Scale (CD-RISC) were also assessed. Mean cortical thickness (CT) and the local gyrification index (LGI) were calculated to perform whole-brain vertex-wise correlation analysis, which were performed to investigate the relationship between BIS scores and CT or LGI in each brain region. We also revealed the relationship between brain regions and psychological measurements. Results : Total BIS scores were significantly and negatively correlated with mean CT values in the left lateral occipital cortex (OC) and LGIs in the inferior frontal gyrus (IFG). Correlation analyses revealed that the lateral OC's mean CT values were negatively correlated with BAI scores and positively correlated with WHOQOL-BREF scores, while LGI in the IFG was positively correlated with CD-RISC scores. Conclusion : Our study showed that trait impulsivity might be associated with the lateral OC and IFG in healthy individuals. Understanding the neural correlates of trait impulsivity could provide ways to expect high impulsivity, anxiety, and poor resilience in healthy adults.
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Affiliation(s)
- Hye-Yeon Jung
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Harin Bak
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Boer OD, El Marroun H, Muetzel RL. Adolescent substance use initiation and long-term neurobiological outcomes: insights, challenges and opportunities. Mol Psychiatry 2024:10.1038/s41380-024-02471-2. [PMID: 38409597 DOI: 10.1038/s41380-024-02471-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024]
Abstract
The increased frequency of risk taking behavior combined with marked neuromaturation has positioned adolescence as a focal point of research into the neural causes and consequences of substance use. However, little work has provided a summary of the links between adolescent initiated substance use and longer-term brain outcomes. Here we review studies exploring the long-term effects of adolescent-initiated substance use with structural and microstructural neuroimaging. A quarter of all studies reviewed conducted repeated neuroimaging assessments. Long-term alcohol use, as well as tobacco use were consistently associated with smaller frontal cortices and altered white matter microstructure. This association was mostly observed in the ACC, insula and subcortical regions in alcohol users, and for the OFC in tobacco users. Long-term cannabis use was mostly related to altered frontal cortices and hippocampal volumes. Interestingly, cannabis users scanned more years after use initiation tended to show smaller measures of these regions, whereas those with fewer years since initiation showed larger measures. Long-term stimulant use tended to show a similar trend as cannabis in terms of years since initiation in measures of the putamen, insula and frontal cortex. Long-term opioid use was mostly associated with smaller subcortical and insular volumes. Of note, null findings were reported in all substance use categories, most often in cannabis use studies. In the context of the large variety in study designs, substance use assessment, methods, and sample characteristics, we provide recommendations on how to interpret these findings, and considerations for future studies.
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Affiliation(s)
- Olga D Boer
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Calihan JB, Levy S. Substance Use Screening, Brief Intervention, and Referral to Treatment in Pediatric Primary Care, School-Based Health Clinics, and Mental Health Clinics. Psychiatr Clin North Am 2023; 46:749-760. [PMID: 37879836 DOI: 10.1016/j.psc.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Adolescent cannabis use is a modifiable health behavior with potential adverse developmental, cognitive, psychological, and health effects. Over the last 2 decades, work to promote implementation of screening, brief intervention, and referral to treatment has improved screening, use of validated screening tools, and preventive messaging. Current intervention strategies for cannabis use are associated with modest, short-term effects, and referral to treatment is limited by availability of resources for adolescent substance use. This article provides an update on the evidence base for screening, brief intervention, referral to treatment, and the current state of implementation focused on management of cannabis use disorder.
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Affiliation(s)
- Jessica B Calihan
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Sharon Levy
- Division of Addiction Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
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Orihuel J, Capellán R, Casquero-Veiga M, Soto-Montenegro ML, Desco M, Oteo-Vives M, Ibáñez-Moragues M, Magro-Calvo N, Luján VM, Morcillo MÁ, Ambrosio E, Higuera-Matas A. The long-term effects of adolescent Δ9-tetrahydrocannabinol on brain structure and function assessed through neuroimaging techniques in male and female rats. Eur Neuropsychopharmacol 2023; 74:47-63. [PMID: 37276836 DOI: 10.1016/j.euroneuro.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/24/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
Several studies performed on human subjects have examined the effects of adolescent cannabis consumption on brain structure or function using brain imaging techniques. However, the evidence from these studies is usually heterogenous and affected by several confounding variables. Animal models of adolescent cannabinoid exposure may help to overcome these difficulties. In this exploratory study, we aim to increase our understanding of the protracted effects of adolescent Δ9-tetrahydrocannabinol (THC) in rats of both sexes using magnetic resonance (MR) to obtain volumetric data, assess grey and white matter microstructure with diffusion tensor imaging (DTI) and measure brain metabolites with 1H-MR spectroscopy (MRS); in addition, we studied brain function using positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-d-glucose as the tracer. THC-exposed rats exhibited volumetric and microstructural alterations in the striatum, globus pallidus, lateral ventricles, thalamus, and septal nuclei in a sex-specific manner. THC administration also reduced fractional anisotropy in several white matter tracts, prominently in rostral sections, while in vivo MRS identified lower levels of cortical choline compounds. THC-treated males had increased metabolism in the cerebellum and olfactory bulb and decreased metabolism in the cingulate cortex. By contrast, THC-treated females showed hypermetabolism in a cluster of voxels comprising the entorhinal piriform cortices and in the cingulate cortex. These results indicate that mild THC exposure during adolescence leaves a lingering mark on brain structure and function in a sex-dependant manner. Some of the changes found here resemble those observed in human studies and highlight the importance of studying sex-specific effects in cannabinoid research.
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Affiliation(s)
- Javier Orihuel
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Roberto Capellán
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Marta Casquero-Veiga
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - María Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Grupo de Fisiopatología y Farmacología del Sistema Digestivo de la Universidad Rey Juan Carlos (NEUGUT), Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Marta Oteo-Vives
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Marta Ibáñez-Moragues
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Natalia Magro-Calvo
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Víctor M Luján
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Miguel Ángel Morcillo
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Emilio Ambrosio
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Alejandro Higuera-Matas
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain.
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Hodges CB, Steinberg JL, Zuniga EA, Ma L, Bjork JM, Moeller FG. Chronic Cocaine Use and White Matter Coherence: A Diffusion Tensor Imaging Study. J Stud Alcohol Drugs 2023; 84:585-597. [PMID: 36971714 PMCID: PMC10488304 DOI: 10.15288/jsad.21-00410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/09/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Chronic substance use and its effects on brain function and structure has long been of interest to clinicians and researchers. Prior cross-sectional comparisons of diffusion tensor imaging (DTI) metrics have suggested deleterious effects of chronic substance use (i.e., cocaine use) on white matter coherence. However, it is unclear how these effects may replicate across geographic regions when examined with similar technologies. In this study, we sought to conduct a replication of previous work in this area and determine whether there are any patterns of persistent differences in white matter microstructure between individuals with a history of cocaine use disorder (CocUD, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and healthy controls. METHOD A total of 46 participants (21 healthy controls, 25 chronic cocaine users) were recruited from the Richmond, Virginia metropolitan area. Information regarding past and current substance use was collected from all participants. Participants also completed structural and DTI scans. RESULTS Consistent with previous DTI studies, significant differences were found between fractional anisotropy (FA) and axial diffusivity (AD) CocUD and controls, with CocUD showing lower FA and AD in the right inferior and superior longitudinal fasciculus, the genu, body, and splenium of the corpus callosum, and the anterior, posterior, and superior corona radiata, among several other regions. These differences were not significant for other diffusivity metrics. Lifetime alcohol consumption was greater in the CocUD group, but lifetime alcohol consumption did not show a significant linear relationship with any of the DTI metrics in within-group regression analyses. CONCLUSIONS These data align with previously reported declines in white matter coherence in chronic cocaine users. However, it is less clear whether comorbid alcohol consumption results in an additive deleterious effect on white matter microstructure.
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Affiliation(s)
- Cooper B. Hodges
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Joel L. Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
| | - Edward A. Zuniga
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - James M. Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - F. Gerard Moeller
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
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Cajiao-Manrique MDM, Casadó-Anguera V, García-Blanco A, Maldonado R, Martín-García E. THC exposure during adolescence increases impulsivity-like behavior in adulthood in a WIN 55,212-2 self-administration mouse model. Front Psychiatry 2023; 14:1148993. [PMID: 37304451 PMCID: PMC10248087 DOI: 10.3389/fpsyt.2023.1148993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/04/2023] [Indexed: 06/13/2023] Open
Abstract
Background Cannabis addiction is a chronically relapsing disorder lacking effective treatment. Regular cannabis consumption typically begins during adolescence, and this early cannabinoid exposure may increase the risk for drug addiction in adulthood. Objective This study investigates the development of cannabis addiction-like behavior in adult mice after adolescent exposure to the main psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC). Methods Adolescent male mice were exposed to 5 mg/kg of THC from postnatal days 37 to 57. Operant self-administration sessions of WIN 55,212-2 (12.5 μg/kg/infusion) were conducted for 10 days. Mice were tested for three addiction-like criteria (persistence of response, motivation, and compulsivity), two parameters related to craving (resistance to extinction and drug-seeking behavior), and two phenotypic vulnerability traits related to substance use disorders (impulsivity and reward sensitivity). Additionally, qPCR assays were performed to detect differentially expressed genes in medial prefrontal cortex (mPFC), nucleus accumbens (NAc), dorsal striatum, and hippocampus (HPC) of "addicted" and "non-addicted" mice. Results Adolescent THC exposure did not modify WIN 55,212-2 reinforcement nor the development of cannabis addiction-like behavior. Inversely, THC pre-exposed mice displayed impulsive-like behavior in adulthood, which was more pronounced in mice that developed the addiction-like criteria. Moreover, downregulated drd2 and adora2a gene expression in NAc and HPC was revealed in THC pre-exposed mice, as well as a downregulation of drd2 expression in mPFC of vehicle pre-treated mice that developed addiction-like behaviors. Discussion These findings suggest that adolescent THC exposure may promote impulsivity-like behavior in adulthood, associated with downregulated drd2 and adora2a expression in NAc and HPC.
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Affiliation(s)
- María del Mar Cajiao-Manrique
- Laboratory of Neuropharmacology-Neurophar, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Verònica Casadó-Anguera
- Laboratory of Neuropharmacology-Neurophar, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Alejandra García-Blanco
- Laboratory of Neuropharmacology-Neurophar, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rafael Maldonado
- Laboratory of Neuropharmacology-Neurophar, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Elena Martín-García
- Laboratory of Neuropharmacology-Neurophar, Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Dan-Glauser E, Framorando D, Solida-Tozzi A, Golay P, Gholam MM, Alameda L, Conus P, Moulin V. Evolution of impulsivity levels in relation to early cannabis use in violent patients in the early phase of psychosis. Psychol Med 2023; 53:3210-3219. [PMID: 35142601 PMCID: PMC10235661 DOI: 10.1017/s0033291721005316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 09/27/2021] [Accepted: 12/07/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Prevention of violent behaviors (VB) in the early phase of psychosis (EPP) is a real challenge. Impulsivity was shown to be strongly related to VB, and different evolutions of impulsivity were noticed along treatments. One possible variable involved in the relationship between VB and the evolution of impulsivity is cannabis use (CU). The high prevalence of CU in EPP and its relationship with VB led us to investigate: 1/the impact of CU and 2/the impact of early CU on the evolution of impulsivity levels during a 3-year program, in violent and non-violent EPP patients. METHODS 178 non-violent and 62 violent patients (VPs) were followed-up over a 3 year period. Age of onset of CU was assessed at program entry and impulsivity was assessed seven times during the program. The evolution of impulsivity level during the program, as a function of the violent and non-violent groups of patients and CU precocity were analyzed with linear mixed-effects models. RESULTS Over the treatment period, impulsivity level did not evolve as a function of the interaction between group and CU (coef. = 0.02, p = 0.425). However, when including precocity of CU, impulsivity was shown to increase significantly only in VPs who start consuming before 15 years of age (coef. = 0.06, p = 0.008). CONCLUSION The precocity of CU in VPs seems to be a key variable of the negative evolution of impulsivity during follow-up and should be closely monitored in EPP patients entering care since they have a higher risk of showing VB.
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Affiliation(s)
- Elise Dan-Glauser
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Psychology, Lausanne University, Lausanne, Switzerland
| | - David Framorando
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Solida-Tozzi
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Golay
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - M. Mehdi Gholam
- Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Instituto de Investigación Sanitaria de Sevilla, Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Valerie Moulin
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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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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[Cannabis use and impulsivity in violent behaviour]. L'ENCEPHALE 2023; 49:97-99. [PMID: 35738924 DOI: 10.1016/j.encep.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/18/2022] [Indexed: 01/21/2023]
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10
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Gaudreault PO, King SG, Malaker P, Alia-Klein N, Goldstein RZ. Whole-brain white matter abnormalities in human cocaine and heroin use disorders: association with craving, recency, and cumulative use. Mol Psychiatry 2023; 28:780-791. [PMID: 36369361 PMCID: PMC9911401 DOI: 10.1038/s41380-022-01833-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
Neuroimaging studies in substance use disorder have shown widespread impairments in white matter (WM) microstructure suggesting demyelination and axonal damage. However, substantially fewer studies explored the generalized vs. the acute and/or specific drug effects on WM. Our study assessed whole-brain WM integrity in three subgroups of individuals addicted to drugs, encompassing those with cocaine (CUD) or heroin (HUD) use disorder, compared to healthy controls (CTL). Diffusion MRI was acquired in 58 CTL, 28 current cocaine users/CUD+, 32 abstinent cocaine users/CUD-, and 30 individuals with HUD (urine was positive for cocaine in CUD+ and opiates used for treatment in HUD). Tract-Based Spatial Statistics allowed voxelwise analyses of diffusion metrics [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)]. Permutation statistics (p-corrected < 0.05) were used for between-group t-tests. Compared to CTL, all individuals with addiction showed widespread decreases in FA, and increases in MD, RD, and AD (19-57% of WM skeleton, p < 0.05). The HUD group showed the most impairments, followed by the CUD+, with only minor FA reductions in CUD- (<0.2% of WM skeleton, p = 0.05). Longer periods of regular use were associated with decreased FA and AD, and higher subjective craving was associated with increased MD, RD, and AD, across all individuals with drug addiction (p < 0.05). These findings demonstrate extensive WM impairments in individuals with drug addiction characterized by decreased anisotropy and increased diffusivity, thought to reflect demyelination and lower axonal packing. Extensive abnormalities in both groups with positive urine status (CUD+ and HUD), and correlations with craving, suggest greater WM impairments with more recent use. Results in CUD-, and correlations with regular use, further imply cumulative and/or persistent WM damage.
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Affiliation(s)
- Pierre-Olivier Gaudreault
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sarah G King
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Pias Malaker
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Nelly Alia-Klein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Rita Z Goldstein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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11
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Calihan JB, Levy S. Substance Use Screening, Brief Intervention, and Referral to Treatment in Pediatric Primary Care, School-Based Health Clinics, and Mental Health Clinics. Child Adolesc Psychiatr Clin N Am 2023; 32:115-126. [PMID: 36410898 DOI: 10.1016/j.chc.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Adolescent cannabis use is a modifiable health behavior with potential adverse developmental, cognitive, psychological, and health effects. Over the last 2 decades, work to promote implementation of screening, brief intervention, and referral to treatment has improved screening, use of validated screening tools, and preventive messaging. Current intervention strategies for cannabis use are associated with modest, short-term effects, and referral to treatment is limited by availability of resources for adolescent substance use. This article provides an update on the evidence base for screening, brief intervention, referral to treatment, and the current state of implementation focused on management of cannabis use disorder.
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Affiliation(s)
- Jessica B Calihan
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
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12
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Dahlgren MK, Gonenc A, Sagar KA, Smith RT, Lambros AM, El-Abboud C, Gruber SA. Increased White Matter Coherence Following Three and Six Months of Medical Cannabis Treatment. Cannabis Cannabinoid Res 2022; 7:827-839. [PMID: 36367574 PMCID: PMC9784607 DOI: 10.1089/can.2022.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have demonstrated abnormal white matter (WM) microstructure in recreational cannabis consumers; however, the long-term impact of medical cannabis (MC) use on WM coherence is unknown. Accordingly, this study assessed the longitudinal impact of MC treatment on WM coherence. Given results from preclinical studies, we hypothesized that MC treatment would be associated with increased fractional anisotropy (FA) and reduced mean diffusivity (MD). Methods: As part of a larger, longitudinal investigation, patients interested in treating at least one medical condition with commercially available MC products of their choosing were assessed before initiating MC use (baseline n=37; female=25, male=12) and following three (n=31) and six (n=22) months of treatment. WM coherence was assessed via diffusion tensor imaging for bilateral regions of interest including the genu of the corpus callosum, anterior limb of the internal capsule, external capsule, and anterior corona radiata, as well as an occipital control region not expected to change over time. Results: In MC patients, FA values significantly increased bilaterally in several callosal regions relative to baseline following both 3 and 6 months of treatment; MD values significantly decreased in all callosal regions but only following 6 months of treatment. No significant changes in WM coherence were observed in the control region or in a pilot sample of treatment-as-usual patients (baseline n=14), suggesting that increased WM coherence observed in MC patients may be attributed to MC treatment as opposed to confounding factors. Interestingly, significant reductions in MD values correlated with higher cannabidiol (CBD) exposure but not Δ-9-tetrahydrocannabinol exposure. Conclusions: Overall, MC treatment was associated with increased WM coherence, which contrasts with prior research examining recreational cannabis consumers, likely related to inherent differences between recreational consumers and MC patients (e.g., product choice, age of onset). In addition, increased CBD exposure was associated with reduced MD following 6 months of treatment, extending evidence from preclinical research indicating that CBD may be neuroprotective against demyelination. However, additional research is needed to elucidate the clinical efficacy of MC treatment and the risks and benefits of long-term MC use.
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Affiliation(s)
- Mary Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosemary T Smith
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Ashley M Lambros
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Celine El-Abboud
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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13
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Lichenstein SD, Shaw DS, Forbes EE. Cannabis, connectivity, and coming of age: Associations between cannabis use and anterior cingulate cortex connectivity during the transition to adulthood. Front Hum Neurosci 2022; 16:951204. [PMID: 36438638 PMCID: PMC9692120 DOI: 10.3389/fnhum.2022.951204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/26/2022] [Indexed: 08/10/2023] Open
Abstract
Cannabis use is common among adolescents and emerging adults and is associated with significant adverse consequences for a subset of users. Rates of use peak between the ages of 18-25, yet the neurobiological consequences for neural systems that are actively developing during this time remain poorly understood. In particular, cannabis exposure may interfere with adaptive development of white matter pathways underlying connectivity of the anterior cingulate cortex, including the cingulum and anterior thalamic radiations (ATR). The current study examined the association between cannabis use during adolescence and emerging adulthood and white matter microstructure of the cingulum and ATR among 158 male subjects enrolled in the Pitt Mother and Child Project, a prospective, longitudinal study of risk and resilience among men of low socioeconomic status. Participants were recruited in infancy, completed follow-up assessments throughout childhood and adolescence, and underwent diffusion imaging at ages 20 and 22. At age 20, moderate cannabis use across adolescence (age 12-19) was associated with higher fractional anisotropy (FA) of the cingulum and ATR, relative to both minimal and heavy adolescent use. Longitudinally, moderate and heavy extended cannabis use (age 12-21) was associated with reduced positive change in FA in the cingulum from age 20 to 22, relative to minimal use. These longitudinal results suggest that cannabis exposure may delay cingulum maturation during the transition to adulthood and potentially impact individuals' functioning later in development.
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Affiliation(s)
- Sarah D. Lichenstein
- Yale Imaging and Psychopharmacology (YIP) Lab, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Daniel S. Shaw
- Pitt Parents and Children Laboratory (PPCL), Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Erika E. Forbes
- Affective Neuroscience and Developmental Psychopathology (ANDP) Lab, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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14
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The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex. Neuropsychopharmacology 2022; 47:276-291. [PMID: 34408275 PMCID: PMC8617203 DOI: 10.1038/s41386-021-01153-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023]
Abstract
A growing preclinical and clinical body of work on the effects of chronic drug use and drug addiction has extended the scope of inquiry from the putative reward-related subcortical mechanisms to higher-order executive functions as regulated by the prefrontal cortex. Here we review the neuroimaging evidence in humans and non-human primates to demonstrate the involvement of the prefrontal cortex in emotional, cognitive, and behavioral alterations in drug addiction, with particular attention to the impaired response inhibition and salience attribution (iRISA) framework. In support of iRISA, functional and structural neuroimaging studies document a role for the prefrontal cortex in assigning excessive salience to drug over non-drug-related processes with concomitant lapses in self-control, and deficits in reward-related decision-making and insight into illness. Importantly, converging insights from human and non-human primate studies suggest a causal relationship between drug addiction and prefrontal insult, indicating that chronic drug use causes the prefrontal cortex damage that underlies iRISA while changes with abstinence and recovery with treatment suggest plasticity of these same brain regions and functions. We further dissect the overlapping and distinct characteristics of drug classes, potential biomarkers that inform vulnerability and resilience, and advancements in cutting-edge psychological and neuromodulatory treatment strategies, providing a comprehensive landscape of the human and non-human primate drug addiction literature as it relates to the prefrontal cortex.
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15
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Goldwaser EL, Du X, Adhikari BM, Kvarta M, Chiappelli J, Hare S, Marshall W, Savransky A, Carino K, Bruce H, Acheson A, Kochunov P, Elliot Hong L. Role of White Matter Microstructure in Impulsive Behavior. J Neuropsychiatry Clin Neurosci 2022; 34:254-260. [PMID: 35040662 PMCID: PMC9289076 DOI: 10.1176/appi.neuropsych.21070167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Increased impulsivity is a hallmark trait of some neuropsychiatric illnesses, including addiction, traumatic brain injury, and externalizing disorders. The authors hypothesized that altered cerebral white matter microstructure may also underwrite normal individual variability in impulsive behaviors and tested this among healthy individuals. METHODS Impulsivity and diffusion tensor imaging (DTI) data were collected from 74 healthy adults (32 women; mean age=36.6 years [SD=13.6]). Impulsivity was evaluated using the Barratt Impulsiveness Scale-11, which provides a total score and scores for three subdomains: attentional, motor, and nonplanning impulsiveness. DTI was processed using the Enhancing Neuro Imaging Genetics Through Meta Analysis-DTI analysis pipeline to measure whole-brain and regional white matter fractional anisotropy (FA) values in 24 tracts. RESULTS Whole-brain total average FA was inversely correlated with motor impulsiveness (r=-0.32, p=0.007) and positively correlated with nonplanning impulsiveness (r=0.29, p=0.02); these correlations were significant after correction for multiple comparisons. Additional significant correlations were observed for motor impulsiveness and regional FA values for the corticospinal tract (r=-0.29, p=0.01) and for nonplanning impulsiveness and regional FA values for the superior fronto-occipital fasciculus (r=0.32, p=0.008). CONCLUSIONS These results provide initial evidence that the motor and nonplanning subdomains of impulsive behavior are linked to specific white matter microstructural connectivity, supporting the notion that impulsivity is in part a network-based construct involving white matter microstructural integrity among otherwise healthy populations.
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Affiliation(s)
- Eric L. Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bhim M. Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mark Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wyatt Marshall
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anya Savransky
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathleen Carino
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ashley Acheson
- Psychiatry and Behavioral Science, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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16
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Du Y, Yang W, Zhang J, Liu J. Changes in ALFF and ReHo values in methamphetamine abstinent individuals based on the Harvard-Oxford atlas: A longitudinal resting-state fMRI study. Addict Biol 2022; 27:e13080. [PMID: 34427375 PMCID: PMC9286454 DOI: 10.1111/adb.13080] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/24/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023]
Abstract
Methamphetamine (MA) abuse has become a global public health problem due to damage to various systems throughout the body, especially the central nervous system. However, the differences in resting‐state brain function between short‐term and long‐term abstinence, the pros and cons of treatments, and the relationship between resting‐state brain function and behavioral tests are unknown. Sixty‐three MA abstinent individuals were followed up for nearly 1 year and treated with three different methods. The amplitude of low‐frequency fluctuation (ALFF) and regional homogeneity (ReHo) based on the Harvard‐Oxford atlas (HOA) were measured by resting‐state functional magnetic resonance imaging (fMRI). Impulsivity was evaluated by the Barratt Impulsivity Scale‐11 (BIS‐11). Brain regions with significant increases in ALFF and ReHo values in the long‐term abstinent group compared to the short‐term abstinent group were around the right frontal pole (McKetin et al., 2012, https://doi.org/10.1111/j.1360-0443.2012.03933.x) and right middle frontal gyrus (Wang et al., 2015, https://doi.org/10.1371/journal.pone.0133431). There were no significant differences among the three groups that experienced long‐term abstinence. The changes in ALFF and ReHo in the right middle frontal gyrus were significantly associated with BIS total scores, BIS attention scores, and BIS nonplanning scores. The right middle frontal gyrus is a critical region in MA long‐term abstinent individuals exposed to therapeutic intervention, and this region may be useful, when combined with BIS‐11, as a potential biomarker to identify the effect of abstinence with therapeutic intervention in MA individuals.
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Affiliation(s)
- Yanyao Du
- Department of Radiology Second Xiangya Hospital of Central South University Changsha China
| | - Wenhan Yang
- Department of Radiology Second Xiangya Hospital of Central South University Changsha China
| | - Jun Zhang
- Department of Detoxification Treatment Technology Hunan Judicial Police Vocational College Changsha China
| | - Jun Liu
- Department of Radiology Second Xiangya Hospital of Central South University Changsha China
- Clinical Research Center for Medical Imaging in Hunan Province Changsha China
- Department of Radiology Quality Control Center Changsha China
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17
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Moulin V, Framorando D, Gasser J, Dan-Glauser E. The Link Between Cannabis Use and Violent Behavior in the Early Phase of Psychosis: The Potential Role of Impulsivity. Front Psychiatry 2022; 13:746287. [PMID: 35392388 PMCID: PMC8980530 DOI: 10.3389/fpsyt.2022.746287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Recently, the literature has shown that Cannabis Use (CU) was a risk factor for Violent Behavior (VB) in patients with psychosis, and those in the early phase of psychosis (EPP). These findings are relevant because of the high prevalence of CU in this EPP, and the potential for prevention during this phase of illness. However, there is still a lack of clear explanations, supported by empirical evidence, about what underlies the link between CU and VB against other. METHOD This viewpoint reviews the scientific literature on the link between CU and VB, and the involvement of impulsivity in this relationship. This last point will be addressed at clinical and neurobiological levels. RESULTS Recent studies confirmed that CU is particularly high in the EPP, and is a risk factor for VB in the EPP and schizophrenia. Studies have also shown that impulsivity is a risk factor for VB in psychosis, is associated with CU, and may mediate the link between CU and VB. Research suggests a neurobiological mechanism, as CU affects the structures and function of frontal areas, known to play a role in impulsive behavior. CONCLUSION Scientific evidence support the hypothesis of an involvement of impulsivity as a variable that could mediate the link between CU and aggression, particularly, when CU has an early onset. However, this hypothesis should be confirmed with longitudinal studies and by taking into account confounding factors. The studies highlight the relevance of early prevention in the EPP, in addition to interventions focusing on psychotic disorders.
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Affiliation(s)
- Valerie Moulin
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - David Framorando
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Jacques Gasser
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Elise Dan-Glauser
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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18
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Bukke VN, Archana M, Villani R, Serviddio G, Cassano T. Pharmacological and Toxicological Effects of Phytocannabinoids and Recreational Synthetic Cannabinoids: Increasing Risk of Public Health. Pharmaceuticals (Basel) 2021; 14:ph14100965. [PMID: 34681189 PMCID: PMC8541640 DOI: 10.3390/ph14100965] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023] Open
Abstract
Synthetic Cannabinoids (CBs) are a novel class of psychoactive substances that have rapidly evolved around the world with the addition of diverse structural modifications to existing molecules which produce new structural analogues that can be associated with serious adverse health effects. Synthetic CBs represent the largest class of drugs detected by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) with a total of 207 substances identified from 2008 to October 2020, and 9 compounds being reported for the first time. Synthetic CBs are sprayed on natural harmless herbs with an aim to mimic the euphoric effect of Cannabis. They are sold under different brand names including Black mamba, spice, K2, Bombay Blue, etc. As these synthetic CBs act as full agonists at the CB receptors, they are much more potent than natural Cannabis and have been increasingly associated with acute to chronic intoxications and death. Due to their potential toxicity and abuse, the US government has listed some synthetic CBs under schedule 1 classification. The present review aims to provide a focused overview of the literature concerning the development of synthetic CBs, their abuse, and potential toxicological effects including renal toxicity, respiratory depression, hyperemesis syndrome, cardiovascular effects, and a range of effects on brain function.
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19
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Millar SR, Mongan D, O’Dwyer C, Smyth BP, Perry IJ, Galvin B. Relationships between patterns of cannabis use, abuse and dependence and recent stimulant use: Evidence from two national surveys in Ireland. PLoS One 2021; 16:e0255745. [PMID: 34370775 PMCID: PMC8351952 DOI: 10.1371/journal.pone.0255745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background and objectives Epidemiological studies show that the use of cannabis is related to the use of other illicit drugs, including stimulants such as cocaine and ecstasy. However, few studies have examined how patterns of cannabis use relate to the use of stimulants. In this research we determined relationships between patterns of cannabis use and recent stimulant use, drawing on data from two large nationally representative surveys. We also explored how frequency of cannabis use relates to stimulant use and whether subjects with a cannabis use disorder (CUD)–defined as cannabis abuse or dependence–are more likely to be recent users of cocaine or ecstasy. Materials and methods We analysed data from Ireland’s 2010/11 and 2014/15 National Drug Prevalence Surveys,which recruited 5,134 and 7,005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported some past cannabis use. Multivariable logistic regression analysis was used to examine associations between patterns of cannabis use and recent stimulant use. Results Among survey participants who had used cannabis in the last month, 17.9% reported recent cocaine use, while almost one-quarter (23.6%) reported recent ecstasy use. There was a significant linear relationship between patterns of cannabis use and recent use of cocaine, ecstasy or any stimulant, with last month cannabis users displaying greater odds (OR = 12.03, 95% CI: 8.15–17.78) of having recent stimulant use compared to last year (OR = 4.48, 95% CI: 2.91–6.91) and former (reference) cannabis users. Greater frequency of cannabis use in the last 30 days was also significantly related to the use of stimulants. In addition, results demonstrated an association between CUD and recent use of cocaine or ecstasy (OR = 2.28, 95% CI: 1.55–3.35). Conclusions Findings from this study suggest a relationship between patterns and frequency of cannabis use and recent use of stimulants and an association between CUD and stimulant use. As the use of cannabis with stimulants may increase the risk of negative health consequences, education in community and medical settings about polydrug use and its increased risks may be warranted.
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Affiliation(s)
- Seán R. Millar
- Health Research Board, Dublin, Ireland
- School of Public Health, University College Cork, Cork, Ireland
- * E-mail:
| | | | | | - Bobby P. Smyth
- Department of Public Health & Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Ivan J. Perry
- School of Public Health, University College Cork, Cork, Ireland
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20
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Pan N, Wang S, Zhao Y, Lai H, Qin K, Li J, Biswal BB, Sweeney JA, Gong Q. Brain gray matter structures associated with trait impulsivity: A systematic review and voxel-based meta-analysis. Hum Brain Mapp 2021; 42:2214-2235. [PMID: 33599347 PMCID: PMC8046062 DOI: 10.1002/hbm.25361] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/27/2020] [Accepted: 01/22/2021] [Indexed: 02/05/2023] Open
Abstract
Trait impulsivity is a multifaceted personality characteristic that contributes to maladaptive life outcomes. Although a growing body of neuroimaging studies have investigated the structural correlates of trait impulsivity, the findings remain highly inconsistent and heterogeneous. Herein, we performed a systematic review to depict an integrated delineation of gray matter (GM) substrates of trait impulsivity and a meta-analysis to examine concurrence across previous whole-brain voxel-based morphometry studies. The systematic review summarized the diverse findings in GM morphometry in the past literature, and the quantitative meta-analysis revealed impulsivity-related volumetric GM alterations in prefrontal, temporal, and parietal cortices. In addition, we identified the modulatory effects of age and gender in impulsivity-GM volume associations. The present study advances understanding of brain GM morphometry features underlying trait impulsivity. The findings may have practical implications in the clinical diagnosis of and intervention for impulsivity-related disorders.
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Affiliation(s)
- Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional & Molecular Imaging Key Laboratory of Sichuan ProvinceWest China Hospital of Sichuan UniversityChengduChina
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional & Molecular Imaging Key Laboratory of Sichuan ProvinceWest China Hospital of Sichuan UniversityChengduChina
| | - Yajun Zhao
- School of Education and PsychologySouthwest Minzu UniversityChengduChina
| | - Han Lai
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional & Molecular Imaging Key Laboratory of Sichuan ProvinceWest China Hospital of Sichuan UniversityChengduChina
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional & Molecular Imaging Key Laboratory of Sichuan ProvinceWest China Hospital of Sichuan UniversityChengduChina
| | - Jingguang Li
- College of Teacher EducationDali UniversityDaliChina
| | - Bharat B. Biswal
- Department of Biomedical EngineeringNew Jersey Institute of TechnologyNewarkNew JerseyUSA
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of PsychiatryUniversity of CincinnatiCincinnatiOhioUSA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional & Molecular Imaging Key Laboratory of Sichuan ProvinceWest China Hospital of Sichuan UniversityChengduChina
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21
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Huber RS, McGlade EC, Legarreta M, Subramaniam P, Renshaw PF, Yurgelun-Todd DA. Cingulate white matter volume and associated cognitive and behavioral impulsivity in Veterans with a history of suicide behavior. J Affect Disord 2021; 281:117-124. [PMID: 33316716 DOI: 10.1016/j.jad.2020.11.126] [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: 09/25/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of death for military personnel and Veterans. Neuroimaging studies have revealed abnormalities in white matter tracts and brain connectivity in suicide behavior (SB); however, reports of alterations in white matter volume and its association with related behaviors are limited. The current study examined the relationship between cingulate white matter volume (WMV), impulsivity, and SB in Veterans. METHODS Fifty-two Veterans, ages 18 to 65, underwent magnetic resonance imaging on a 3T Siemens Verio scanner. Morphometric analysis of brain images was performed to evaluate differences in WMV in cingulate regions of interest. Participants completed the Columbia Suicide Severity Rating Scale to assess lifetime suicide behavior and the Barratt Impulsivity Scale (BIS) and the Continuous Performance Test (CPT) to assess impulsivity. RESULTS Twenty-nine Veterans had a history of suicidal ideation (SI) and 23 had a history of suicide attempts (SA). Controlling for age, sex, handedness and total white matter volume, reduced WMV was observed in the left rostral anterior cingulate cortex (rACC) in Veterans with SA relative to Veterans with SI, p = .008. Additionally, non-planning on the BIS was negatively correlated with left rACC WMV for Veterans with a history of SA, p = .04. Other subregions of the ACC WMV were negatively correlated with planning and attention impulsivity (BIS) and omission and commission errors (CPT) for attempters. CONCLUSIONS Reduction in rACC WMV in Veterans with SA was negatively correlated with nonplanning measures. These findings are consistent with ACC involvement in inhibitory processes and build on evidence that SB is associated with neurobiological abnormalities and suggest that white matter changes may be related to actual attempts.
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Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA.
| | - Erin C McGlade
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA; Veterans Affairs VISN 19 Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, UT, USA
| | - Margaret Legarreta
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA; Sheridan Veterans Affairs Health Care System, Sheridan, WY, USA
| | - Punitha Subramaniam
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA; Veterans Affairs VISN 19 Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, UT, USA
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, USA; Veterans Affairs VISN 19 Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, UT, USA
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22
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Towe SL, Meade CS, Cloak CC, Bell RP, Baptiste J, Chang L. Reciprocal Influences of HIV and Cannabinoids on the Brain and Cognitive Function. J Neuroimmune Pharmacol 2020; 15:765-779. [PMID: 32445005 PMCID: PMC7680275 DOI: 10.1007/s11481-020-09921-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/23/2020] [Indexed: 02/03/2023]
Abstract
Globally, cannabis is the most commonly used illicit drug, with disproportionately high use among persons with HIV. Despite advances in HIV care, nearly half of persons living with HIV continue to experience neurocognitive deficits or impairments that may have negative impacts on their daily function. Chronic cannabis use may play a role in the development or exacerbation of these impairments. Here we present a review summarizing existing research detailing the effect of cannabis use associated with the neuropathogenesis of HIV. We examine evidence for possible additive or synergistic effects of HIV infection and cannabis use on neuroHIV in both the preclinical and adult human literatures, including in vitro studies, animal models, clinical neuroimaging research, and studies examining the cognitive effects of cannabis. We discuss the limitations of existing research, including methodological challenges involved with clinical research with human subjects. We identify gaps in the field and propose critical research questions to advance our understanding of how cannabis use affects neuroHIV. Graphical Abstract.
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Affiliation(s)
- Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Christine C Cloak
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Room 1161, Baltimore, MD, 21201, USA
| | - Ryan P Bell
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Julian Baptiste
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Room 1161, Baltimore, MD, 21201, USA
| | - Linda Chang
- Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Room 1161, Baltimore, MD, 21201, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
- John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, 96813, USA.
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23
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Wiers CE, Cunningham SI, Tomasi DG, Ernst T, Chang L, Shokri-Kojori E, Wang GJ, Volkow ND. Elevated thalamic glutamate levels and reduced water diffusivity in alcohol use disorder: Association with impulsivity. Psychiatry Res Neuroimaging 2020; 305:111185. [PMID: 32957041 PMCID: PMC9347183 DOI: 10.1016/j.pscychresns.2020.111185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/31/2022]
Abstract
Alcohol induces neuroinflammation but its role in cognitive impairment and impulsivity in alcohol use disorder (AUD) has been poorly investigated. We used proton magnetic resonance spectroscopy to measure brain glutamate (Glu) levels and diffusion-weighted imaging to measure functional anisotropy (FA) in the thalamus and ventral anterior cingulate cortex (vACC) in 15 recently detoxified patients with AUD and 14 matched controls. Compared to controls, AUD patients showed higher Glu levels (p = 0.04) and lower FA in the thalamus (p = 0.04) but not in the vACC. In AUD, thalamic Glu levels (r = 0.62, p = 0.019) and FA (r=-0.55, p = 0.034) were associated with severity of drinking (drinks/week). Compared to controls, AUD patients showed higher scores on Conners' Adult ADHD Rating Scale for impulsivity (p = 0.03), which correlated with glutamate levels in the thalamus (r = 0.58, p = 0.03) and vACC (r = 0.55, p = 0.036). In a second cohort of AUD patients (n = 32), Glu in dorsal ACC (dACC) also correlated with Barrett Impulsiveness Scale total score (r = 0.43, p = 0.014). We interpret the elevated thalamic Glu levels and the parallel reduction in FA in AUD-which correlated with drinking severity-as possible evidence of neurotoxicity from neuroinflammation. The association of Glu with impulsivity suggests that neurotoxic effects of chronic alcohol exposure in the thalamus and dACC may contribute to impulsivity.
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Affiliation(s)
- Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
| | | | - Dardo G Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD. USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD. USA; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda, MD, USA.
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24
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Wallace AL, Maple KE, Barr AT, Lisdahl KM. BOLD responses to inhibition in cannabis-using adolescents and emerging adults after 2 weeks of monitored cannabis abstinence. Psychopharmacology (Berl) 2020; 237:3259-3268. [PMID: 32715317 PMCID: PMC7572837 DOI: 10.1007/s00213-020-05608-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Previous studies have suggested that chronic cannabis use has been associated with increased blood oxygen level-dependent (BOLD) response during a response inhibition task; however, these studies primarily included males. OBJECTIVES We investigated whether gender moderated the effects of cannabis use on BOLD response and behavioral performance during a Go-NoGo task in adolescents and young adults following 2 weeks of monitored abstinence. METHODS Participants included 77 16-26-year olds (MJ = 36, controls = 41). An emotion-based Go-NoGo task required participants to inhibit their response during a calm face. A whole-brain analysis looked at differences between cannabis group, gender, and their interaction. RESULTS Significant greater BOLD responses were observed in cannabis users compared with that in controls in the left frontal cortex, left cingulate cortex, and the left thalamus during correct response inhibitions; gender did not moderate these effects. CONCLUSION Supporting previous research, cannabis users showed greater BOLD responses in core areas associated with response inhibition during a Go-NoGo task, even after a minimum of 2 weeks of abstinence.
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Affiliation(s)
- Alexander L Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Kristin E Maple
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Alicia T Barr
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
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25
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Subramaniam P, Yurgelun-Todd D. Neural and behavioral correlates associated with adolescent marijuana use. CURRENT ADDICTION REPORTS 2020; 7:475-485. [PMID: 33777643 DOI: 10.1007/s40429-020-00335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose of Review Marijuana (MJ) is one of the most commonly used drugs among adolescents. Exposure to MJ during adolescence can lead to alterations in brain development, and, subsequently to the behavioral correlates regulated by the affected brain regions. In this review, we discuss findings from preclinical and human studies examining the relationship between adolescent MJ use and the neurobiological and behavioral correlates associated with it. Recent Findings Current findings indicate that adolescent MJ use is associated with alterations in brain structure and function, especially in regions that express high levels of the cannabinoid 1 receptor such as the prefrontal cortex, hippocampus, cerebellum and limbic regions. These alterations are correlated with changes in affective, cognitive and reward-seeking behavior. Furthermore, evidence suggests that exposure to MJ during adolescence can have long-lasting and pronounced neural and behavioral effects into adulthood. Summary The wide ranging neural and behavioral correlates associated with MJ use during adolescence highlight the need for further studies to better understand the potential risk factors and/or neurotoxic effects of adolescent MJ use.
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Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT.,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City VA Health Care System, Salt Lake City, UT, USA
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26
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Koc D, Besenek M, Ulas G, Ildız A, Yılmaz IT, Guleryuz H, Guney SA, Emiroglu NI. Investigation of structure-function correlation among the young offspring of patients with bipolar disorder. Psychiatry Res Neuroimaging 2020; 301:111103. [PMID: 32464339 DOI: 10.1016/j.pscychresns.2020.111103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/11/2020] [Accepted: 04/16/2020] [Indexed: 01/06/2023]
Abstract
Bipolar disorder (BD) has been associated with impaired executive functioning and integrity of fronto-limbic white matter tracts. The evaluation of these factors in young offspring of patients with BD (BDoff) as a high-risk group offers an opportunity to investigate factors that could predict vulnerability to the disorder. This study aims to examine the correlation between neurocognition and neuroimaging findings to evaluate the potential for these findings as biomarkers for the early recognition of BD. We enrolled BDoff (n = 16) who were aged between 12 and 18. Participants were assessed using clinical and neurocognitive tests. In addition, structural brain magnetic resonance and diffusion tensor imaging data were obtained. Mean fractional anisotropy (FA) and mean diffusivity (MD) values of the superior longitudinal fasciculus (SLF) and cingulum were extracted and correlations with neuropsychological data were analyzed. FA values in the SLF were negatively correlated with Stroop interference, the Wisconsin Card Sorting Test, and the Trail Making Test (B-A) scores. MD values in the cingulum were inversely correlated with the Child and Youth Resilience Measure and positively correlated with higher scores on the Barratt Impulsiveness Scale-Attentional. These findings provide a link between features of the brain and cognitive dysfunction in BDoff.
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Affiliation(s)
- Dogukan Koc
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey..
| | - Mert Besenek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Gozde Ulas
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Aysegul Ildız
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | | | - Handan Guleryuz
- Department of Radiodiagnostics, Dokuz Eylul University, Izmir, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, University of Health Sciences Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
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27
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Chye Y, Kirkham R, Lorenzetti V, McTavish E, Solowij N, Yücel M. Cannabis, Cannabinoids, and Brain Morphology: A Review of the Evidence. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:627-635. [PMID: 32948510 DOI: 10.1016/j.bpsc.2020.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Abstract
Cannabis and cannabinoid-based products are increasingly being accepted and commodified globally. Yet there is currently limited understanding of the effect of the varied cannabinoid compounds on the brain. Exogenous cannabinoids interact with the endogenous cannabinoid system that underpins vital functions in the brain and body, and they are thought to perturb key brain and cognitive function. However, much neuroimaging research has been confined to observational studies of cannabis users, without examining the specific role of the various cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, etc.). This review summarizes the brain structural imaging evidence to date associated with cannabis use, its major cannabinoids (e.g., Δ9-tetrahydrocannabinol, cannabidiol), and synthetic cannabinoid products that have emerged as recreational drugs. In doing so, we seek to highlight some of the key issues to consider in understanding cannabinoid-related brain effects, emphasizing the dual neurotoxic and neuroprotective role of cannabinoids, and the need to consider the distinct role of the varied cannabinoids in establishing their effect on the brain.
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Affiliation(s)
- Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Kirkham
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia; School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, New South Wales, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia.
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28
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Cabeen RP, Allman JM, Toga AW. THC Exposure is Reflected in the Microstructure of the Cerebral Cortex and Amygdala of Young Adults. Cereb Cortex 2020; 30:4949-4963. [PMID: 32377689 DOI: 10.1093/cercor/bhaa087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The endocannabinoid system serves a critical role in homeostatic regulation through its influence on processes underlying appetite, pain, reward, and stress, and cannabis has long been used for the related modulatory effects it provides through tetrahydrocannabinol (THC). We investigated how THC exposure relates to tissue microstructure of the cerebral cortex and subcortical nuclei using computational modeling of diffusion magnetic resonance imaging data in a large cohort of young adults from the Human Connectome Project. We report strong associations between biospecimen-defined THC exposure and microstructure parameters in discrete gray matter brain areas, including frontoinsular cortex, ventromedial prefrontal cortex, and the lateral amygdala subfields, with independent effects in behavioral measures of memory performance, negative intrusive thinking, and paternal substance abuse. These results shed new light on the relationship between THC exposure and microstructure variation in brain areas related to salience processing, emotion regulation, and decision making. The absence of effects in some other cannabinoid-receptor-rich brain areas prompts the consideration of cellular and molecular mechanisms that we discuss. Further studies are needed to characterize the nature of these effects across the lifespan and to investigate the mechanistic neurobiological factors connecting THC exposure and microstructural parameters.
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Affiliation(s)
- Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
| | - John M Allman
- Division of Biology, California Institute of Technology, Pasadena, CA 91125, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
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29
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Abstract
Given the aging Baby Boomer generation, changes in cannabis legislation, and the growing acknowledgment of cannabis for its therapeutic potential, it is predicted that cannabis use in the older population will escalate. It is, therefore, important to determine the interaction between the effects of cannabis and aging. The aim of this report is to describe the link between cannabis use and the aging brain. Our review of the literature found few and inconsistent empirical studies that directly address the impact of cannabis use on the aging brain. However, research focused on long-term cannabis use points toward cumulative effects on multimodal systems in the brain that are similarly affected during aging. Specifically, the effects of cannabis and aging converge on overlapping networks in the endocannabinoid, opioid, and dopamine systems that may affect functional decline particularly in the hippocampus and prefrontal cortex, which are critical areas for memory and executive functioning. To conclude, despite the limited current knowledge on the potential interactive effects between cannabis and aging, evidence from the literature suggests that cannabis and aging effects are concurrently present across several neurotransmitter systems. There is a great need for future research to directly test the interactions between cannabis and aging.
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Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Jennifer DiMuzio
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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30
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Abstract
Objective: Shifting policies and widespread acceptance of cannabis for medical and/or recreational purposes have fueled worries of increased cannabis initiation and use in adolescents. In particular, the adolescent period is thought to be associated with an increased susceptibility to the potential harms of repeated cannabis use, due to being a critical period for neuromaturational events in the brain. This review investigates the neuroimaging evidence of brain harms attributable to adolescent cannabis use. Methods: PubMed and Scopus searches were conducted for empirical articles that examined neuroimaging effects in both adolescent cannabis users and adult user studies that explored the effect of age at cannabis use onset on the brain. Results: We found 43 studies that examined brain effect (structural and functional magnetic resonance imaging) in adolescent cannabis users and 20 that examined the link between onset age of cannabis use and brain effects in adult users. Studies on adolescent cannabis users relative to nonusers mainly implicate frontal and parietal regions and associated brain activation in relation to inhibitory control, reward, and memory. However, studies in adults are more mixed, many of which did not observe an effect of onset age of cannabis use on brain imaging metrics. Conclusions: While there is some evidence of compromised frontoparietal structure and function in adolescent cannabis use, it remains unclear whether the observed effects are specifically attributable to adolescent onset of use or general cannabis use-related factors such as depressive symptoms. The relative contribution of adolescent onset of cannabis use and use chronicity will have to be more comprehensively examined in prospective, longitudinal studies with more rigorous measures of cannabis use (dosage, exposure, dependence, constituent compounds such as the relative cannabinoid levels).
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Affiliation(s)
- Yann Chye
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Erynn Christensen
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Murat Yücel
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
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31
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Huang S, Yang W, Luo J, Yan C, Liu J. White Matter Abnormalities Based on TBSS and Its Correlation With Impulsivity Behavior of Methamphetamine Addicts. Front Psychiatry 2020; 11:452. [PMID: 32528325 PMCID: PMC7253705 DOI: 10.3389/fpsyt.2020.00452] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Methamphetamine (MA) abuse is one of the most rapidly growing illicit drug problems worldwide. Impulsivity has been considered as a core impairment underpinning addictive behavior. Studies have demonstrated that MA addicts have white matter abnormalities based on ROIs. There are few studies on whole brain, and the association between whole brain tracts and impulsivity in MA dependence remain unclear. Tract-based spatial statistics (TBSS) was used to detect four DTI measures, and these were correlated with the Barratt Impulsivity Scale (BIS) to verify and expand the previous results. METHODS A total of 28 MA addicts and 22 healthy controls were recruited. MRI was performed to evaluate the brain structural changes, the BIS was used to evaluate impulsivity behavior, white matter differences were compared between MA addicts and healthy controls, and then determine correlation between diffusion parameters and BIS scores. RESULTS MA addicts had significantly lower FA, and higher AD, RD, and MD in a wide range of white matter, which mainly included: corona radiata, internal capsule, superior longitudinal fasciculus, external capsule, inferior fronto-occipital fascicules, posterior thalamic radiation, sagittal stratum, fornix and stria terminalis, cerebral peduncle, superior cerebellar peduncle, corpus callosum, and corticolspinal tract compared with controls. The MA group had significantly higher total score, attention and motor scores compared to healthy controls. Higher MD in the right corticospinal tract was significantly associated with higher total scores. CONCLUSION MA addicts exhibit a globally diminished white matter integrity. furthermore, they present with high levels of impulsivity, and this dysfunction is associated with MD in corticospinal tracts. Future studies on larger sample sizes, gender effects and longitudinal studies are needed.
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Affiliation(s)
- Sihong Huang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenhan Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Luo
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
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32
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Abstract
Eleven US States and the District of Columbia legally allow personal (i.e., recreational) cannabis use by adults, and an additional 22 states allow use of cannabis for medicinal purposes. Of these jurisdictions, only two do not have some form of legalized gambling available (https://www.casino.org/local/guide/). In contrast to this rapid increase in legally available marijuana is the limited knowledge about the intersection of cannabis use and gambling. This paper strives to define the current status of the relevant literatures and consider the implication for future gambling research. We describe the research literature on the prevalence of cannabis use and co-existing gambling problems and the effects of cannabis use on gambling-related cognitive functions and decision-making. We also discuss clinical considerations with treating problem gamblers with a cannabis use disorder. Finally, the potential implications for responsible gambling practices and policies and the most pressing gaps in the research literature are offered.
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Affiliation(s)
- Ken C Winters
- Oregon Research Institute (MN location), 1575 Northrop St., Falcon Heights, MN, 55108, USA.
| | - James P Whelan
- Department of Psychology, University of Memphis, 400 Innovation Drive, Memphis, TN, 38152-3032, USA
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33
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Archie SR, Cucullo L. Harmful Effects of Smoking Cannabis: A Cerebrovascular and Neurological Perspective. Front Pharmacol 2019; 10:1481. [PMID: 31920665 PMCID: PMC6915047 DOI: 10.3389/fphar.2019.01481] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/15/2019] [Indexed: 12/16/2022] Open
Abstract
Apart from being used as a medicine, cannabis or marijuana is the most widely abused recreational drug all over the world. The legalization and decriminalization of cannabis in Canada and various states of USA may be the underlying reason of the widespread popularity of it among young population. Various studies have reported about the relationship between cannabis use and different detrimental effects like cardiovascular, cerebrovascular, and neurological complications among different age groups. Specifically, the young population is getting adversely affected by this, harmful yet, readily accessible recreational drug. Although the mechanism behind cannabis mediated neurological and cerebrovascular complications has not been elucidated yet, the results of these studies have confirmed the association of these diseases with cannabis. Given the lack of comprehensive study relating these harmful complications with cannabis use, the aim of this narrative literature review article is to evaluate and summarize current studies on cannabis consumption and cerebrovascular/neurological diseases along with the leading toxicological mechanisms.
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Affiliation(s)
- Sabrina Rahman Archie
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, United States
| | - Luca Cucullo
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, United States.,Center for Blood Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX, United States
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34
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Abstract
As an increasing number of states legalize cannabis use for recreational and/or medical purposes, it is increasingly important to understand the neural and cognitive consequences of recreational cannabis use in adolescent consumers. Adolescence is marked by ongoing neuromaturational processes, making this a particularly vulnerable period, particularly regarding exposure to drugs, including cannabis. This review highlights evidence from studies documenting the neural impact of cannabis use in adolescence and explores mediating factors related to cannabis use.
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Affiliation(s)
- Yasmin Mashhoon
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, Mclean Hospital, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Kelly A Sagar
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Staci A Gruber
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA.
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35
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Lopez-Vergara HI, Jackson KM, Meshesha LZ, Metrik J. Dysregulation as a correlate of cannabis use and problem use. Addict Behav 2019; 95:138-144. [PMID: 30913511 DOI: 10.1016/j.addbeh.2019.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/19/2019] [Accepted: 03/17/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Cannabis users with a dysregulatory risk factor may be particularly vulnerable to engaging in more frequent and problematic cannabis use. Contemporary models of dysregulated behavior suggest that dysregulation emerges due to distinct mechanisms. The current study seeks to examine the dysregulatory correlates of cannabis involvement, including working memory capacity, delay discounting, impulsivity, and reward sensitivity. METHOD Participants were 104 non-treatment seeking frequent cannabis users (the average participant used cannabis 71% of the days/past 60 days [SD = 22%], with an average of two uses per day [SD = 1.2]). Mean age was 21.3 (SD = 4.3); 36.5% were female. Working memory was assessed via the Trail-Making Test-B and the Digit Span subtests of the WAIS-III, delay discounting was assessed via a computer-based task, trait impulsivity was self-reported via the Barratt Impulsiveness Scale, and reward sensitivity was self-reported via the Reward Dependence Scale and the Snaith-Hamilton Pleasure Scale. RESULTS Structural equation modeling estimated the associations between different facets of dysregulation and cannabis involvement. Results suggest that poor working memory capacity and high trait impulsivity were associated with both use and problem use. Greater delay discounting was associated with problem use, but not with frequency of use. Low reward sensitivity was associated with more frequent cannabis use, but not with problem use. CONCLUSIONS Results confirm that the dysregulatory correlates of cannabis involvement consist of multiple dimensions of functioning. Prospective studies that assess the multidimensional structure of dysregulation and cannabis involvement are needed in order to disaggregate the dysregulatory antecedents and consequences of cannabis involvement.
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Affiliation(s)
- Hector I Lopez-Vergara
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States of America
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States of America
| | - Lidia Z Meshesha
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States of America
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02903, United States of America; Providence VA Medical Center, Providence, RI 02908, United States of America.
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36
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Burggren AC, Shirazi A, Ginder N, London ED. Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:563-579. [PMID: 31365275 PMCID: PMC7027431 DOI: 10.1080/00952990.2019.1634086] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Background: Cannabis is the most widely used illicit substance worldwide, and legalization for recreational and medical purposes has substantially increased its availability and use in the United States.Objectives: Decades of research have suggested that recreational cannabis use confers risk for cognitive impairment across various domains, and structural and functional differences in the brain have been linked to early and heavy cannabis use.Methods: With substantial evidence for the role of the endocannabinoid system in neural development and understanding that brain development continues into early adulthood, the rising use of cannabis in adolescents and young adults raises major concerns. Yet some formulations of cannabinoid compounds are FDA-approved for medical uses, including applications in children.Results: Potential effects on the trajectory of brain morphology and cognition, therefore, should be considered. The goal of this review is to update and consolidate relevant findings in order to inform attitudes and public policy regarding the recreational and medical use of cannabis and cannabinoid compounds.Conclusions: The findings point to considerations for age limits and guidelines for use.
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Affiliation(s)
- Alison C Burggren
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Anaheed Shirazi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
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37
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Hampton WH, Hanik IM, Olson IR. Substance abuse and white matter: Findings, limitations, and future of diffusion tensor imaging research. Drug Alcohol Depend 2019; 197:288-298. [PMID: 30875650 PMCID: PMC6440853 DOI: 10.1016/j.drugalcdep.2019.02.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/14/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
Abstract
Individuals who abuse substances often differ from nonusers in their brain structure. Substance abuse and addiction is often associated with atrophy and pathology of grey matter, but much less is known about the role of white matter, which constitutes over half of human brain volume. Diffusion tensor imaging (DTI), a method for non-invasively estimating white matter, is increasingly being used to study addiction and substance abuse. Here we review recent DTI studies of major substances of abuse (alcohol, opiates, cocaine, cannabis, and nicotine substance abuse) to examine the relationship, specificity, causality, and permanence of substance-related differences in white matter microstructure. Across substance, users tended to exhibit differences in the microstructure of major fiber pathways, such as the corpus callosum. The direction of these differences, however, appeared substance-dependent. The subsample of longitudinal studies reviewed suggests that substance abuse may cause changes in white matter, though it is unclear to what extent such alterations are permanent. While collectively informative, some studies reviewed were limited by methodological and technical approach. We therefore also provide methodological guidance for future research using DTI to study substance abuse.
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Affiliation(s)
- William H Hampton
- Department of Psychology, College of Liberal Arts, Temple University, United States
| | - Italia M Hanik
- Department of Psychology, College of Liberal Arts, Temple University, United States
| | - Ingrid R Olson
- Department of Psychology, College of Liberal Arts, Temple University, United States.
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38
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Burggren AC, Siddarth P, Mahmood Z, London ED, Harrison TM, Merrill DA, Small GW, Bookheimer SY. Subregional Hippocampal Thickness Abnormalities in Older Adults with a History of Heavy Cannabis Use. Cannabis Cannabinoid Res 2018; 3:242-251. [PMID: 30547094 PMCID: PMC6290479 DOI: 10.1089/can.2018.0035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and Aims: Legalization of cannabis (CB) for both medicinal and, in some states, recreational use, has given rise to increasing usage rates across the country. Of particular concern are indications that frequent CB use may be selectively harmful to the developing adolescent brain compared with adult-onset usage. However, the long-term effects of heavy, adolescent CB use on brain structure and cognitive performance in late-life remain unknown. A critical brain region is the hippocampus (HC), where there is a striking intersection between high concentrations of cannabinoid 1 (CB1) receptors and age-related pathology. Design: We investigated whether older adults (average age=66.6+7.2 years old) with a history of early life CB use show morphological differences in hippocampal subregions compared with older, nonusers. Methods: We performed high-resolution magnetic resonance imaging combined with computational techniques to assess cortical thickness of the medial temporal lobe, neuropsychological testing, and extensive drug use histories on 50 subjects (24 formerly heavy cannabis users [CB+ group] abstinent for an average of 28.7 years, 26 nonusers [CB− group]). We investigated group differences in hippocampal subregions, controlling for age, sex, and intelligence (as measured by the Wechsler Test of Adult Reading), years of education, and cigarette use. Results: The CB+ subjects exhibited thinner cortices in subfields cornu ammonis 1 [CA1; F(1,42)=9.96, p=0.0003], and CA2, 3, and the dentate gyrus [CA23DG; F(1,42)=23.17, p<0.0001], and in the entire HC averaged over all subregions [F(1,42)=8.49, p=0.006]. Conclusions: Negative effects of chronic adolescent CB use on hippocampal structure are maintained well into late life. Because hippocampal cortical loss underlies and exacerbates age-related cognitive decline, these findings have profound implications for aging adults with a history of early life usage. Clinical Trial Registration: ClinicalTrials.gov # NCT01874886.
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Affiliation(s)
- Alison C Burggren
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Zanjbeel Mahmood
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California, Berkeley, California
| | - David A Merrill
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Gary W Small
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Susan Y Bookheimer
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
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39
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Schuster RM, Gilman J, Schoenfeld D, Evenden J, Hareli M, Ulysse C, Nip E, Hanly A, Zhang H, Evins AE. One Month of Cannabis Abstinence in Adolescents and Young Adults Is Associated With Improved Memory. J Clin Psychiatry 2018; 79:17m11977. [PMID: 30408351 PMCID: PMC6587572 DOI: 10.4088/jcp.17m11977] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/01/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Associations between adolescent cannabis use and poor neurocognitive functioning have been reported from cross-sectional studies that cannot determine causality. Prospective designs can assess whether extended cannabis abstinence has a beneficial effect on cognition. METHODS Eighty-eight adolescents and young adults (aged 16-25 years) who used cannabis regularly were recruited from the community and a local high school between July 2015 and December 2016. Participants were randomly assigned to 4 weeks of cannabis abstinence, verified by decreasing 11-nor-9-carboxy-∆⁹-tetrahydrocannabinol urine concentration (MJ-Abst; n = 62), or a monitoring control condition with no abstinence requirement (MJ-Mon; n = 26). Attention and memory were assessed at baseline and weekly for 4 weeks with the Cambridge Neuropsychological Test Automated Battery. RESULTS Among MJ-Abst participants, 55 (88.7%) met a priori criteria for biochemically confirmed 30-day continuous abstinence. There was an effect of abstinence on verbal memory (P = .002) that was consistent across 4 weeks of abstinence, with no time-by-abstinence interaction, and was driven by improved verbal learning in the first week of abstinence. MJ-Abst participants had better memory overall and at weeks 1, 2, 3 than MJ-Mon participants, and only MJ-Abst participants improved in memory from baseline to week 1. There was no effect of abstinence on attention: both groups improved similarly, consistent with a practice effect. CONCLUSIONS This study suggests that cannabis abstinence is associated with improvements in verbal learning that appear to occur largely in the first week following last use. Future studies are needed to determine whether the improvement in cognition with abstinence is associated with improvement in academic and other functional outcomes. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03276221.
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Affiliation(s)
- Randi Melissa Schuster
- Center for Addiction Medicine, Massachusetts General Hospital, 101 Merrimac St, Ste 320, Boston, MA 02114. .,Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jodi Gilman
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - David Schoenfeld
- Department of Biostatistics, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Maya Hareli
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Christine Ulysse
- Department of Biostatistics, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Emily Nip
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Ailish Hanly
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA;,University of Massachusetts Medical School, Worcester, MA
| | - Haiyue Zhang
- Department of Biostatistics, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - A. Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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40
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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41
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Prashad S, Dedrick ES, Filbey FM. Cannabis users exhibit increased cortical activation during resting state compared to non-users. Neuroimage 2018; 179:176-186. [PMID: 29894828 PMCID: PMC6693493 DOI: 10.1016/j.neuroimage.2018.06.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/18/2018] [Accepted: 06/08/2018] [Indexed: 12/16/2022] Open
Abstract
Studies have shown altered task-based brain functioning as a result of cannabis use. To date, however, whether similar alterations in baseline resting state and functional organization of neural activity are observable in cannabis users remains unknown. We characterized global resting state cortical activations and functional connectivity via electroencephalography (EEG) in cannabis users and related these activations to measures of cannabis use. Resting state EEG in the eyes closed condition was collected from age- and sex-matched cannabis users (N = 17; 6 females; mean age = 30.9 ± 7.4 years) and non-using controls (N = 21; 9 females; mean age = 33.1 ± 11.6 years). Power spectral density and spectral coherence were computed to determine differences in cortical activations and connectivity between the two groups in the delta (1-4Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13-30 Hz), and gamma (31-50 Hz) frequency bands. Cannabis users exhibited decreased delta and increased theta, beta, and gamma power compared to controls, suggesting increased cortical activation in resting state and a disinhibition of inhibitory functions that may interrupt cognitive processes. Cannabis users also exhibited increased interhemispheric and intrahemispheric coherence relative to controls, reduced mean network degree, and increased clustering coefficient in specific regions and frequencies. This increased cortical activity may indicate a loss of neural refinement and efficiency that may indicate a "noisy" brain. Lastly, measures related to cannabis use were correlated with spectral power and functional connectivity measures, indicating that specific electrophysiological signals are associated with cannabis use. These results suggest that there are differences in cortical activity and connectivity between cannabis users and non-using controls in the resting state that may be related to putative cognitive impairments and can inform effectiveness of intervention programs.
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Affiliation(s)
- Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Elizabeth S Dedrick
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
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42
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Sagar KA, Gruber SA. Marijuana matters: reviewing the impact of marijuana on cognition, brain structure and function, & exploring policy implications and barriers to research. Int Rev Psychiatry 2018; 30:251-267. [PMID: 29966459 PMCID: PMC6455965 DOI: 10.1080/09540261.2018.1460334] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The neurobiologic effects of cannabis, commonly referred to as 'marijuana' (MJ), have been studied for decades. The impact of recreational MJ use on cognition and measures of brain function and structure is outlined, and variables influencing study results are discussed, including age of the consumer, patterns of MJ use, variations in MJ potency, and the presence of additional cannabinoids. Although evidence suggests that chronic, heavy recreational MJ use is related to cognitive decrements and neural changes, particularly when use begins in adolescence, findings from studies of recreational MJ users may not be applicable to medical marijuana (MMJ) patients given differences in demographic variables, product selection, and reasons for use. Although additional research is needed to fully understand the impact of MJ and individual cannabinoids on the brain, current findings are beginning to inform public policy, including considerations for age limits, potential limits for some cannabinoids, and guidelines for use. However, barriers continue to impede researchers' ability to conduct studies that will guide policy change and provide vital information to consumers and patients regarding best practices and safest methods for use. The need for information is critical, as legalization of MJ for medical and recreational use is increasingly widespread.
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Affiliation(s)
- Kelly A. Sagar
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Boston University School of Medicine, 72 E Concord St Boston, MA, 02118
| | - Staci A. Gruber
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Corresponding Author Information Address: McLean Hospital, 115 Mill Street, Belmont, MA 02478, Telephone: 617-855-2762, Fax: 617-855-3713,
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43
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Choi NG, DiNitto DM, Marti CN. A longitudinal assessment of change in marijuana use with other substance use problems. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:642-652. [DOI: 10.1080/00952990.2018.1461879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Diana M. DiNitto
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
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44
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Mashhoon Y, Betts J, Farmer SL, Lukas SE. Early onset tobacco cigarette smokers exhibit deficits in response inhibition and sustained attention. Drug Alcohol Depend 2018; 184:48-56. [PMID: 29402679 PMCID: PMC5818311 DOI: 10.1016/j.drugalcdep.2017.11.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Initiation of cigarette smoking during adolescence coincides with structural and cognitive neuromaturation. Thus, early onset smokers (EOS; initiated <16 years old) may be at unique risk of altered development of executive function relative to late onset smokers (LOS; initiated >16 years old). This study quantified the effects of age of smoking onset on response impulsivity and inhibitory control using a novel smoking Go/NoGo task (Luijten et al., 2011). METHODS Nicotine deprived adult EOS (n = 10) and LOS (n = 10) and adult healthy non-smokers (HNS; n = 10) were shown smoking-related and neutral images with either a blue (Go) or yellow (NoGo) frame. Participants were instructed to respond to blue-framed Go trials quickly and accurately, and withhold responding for yellow-framed NoGo trials. RESULTS EOS made more Go response accuracy errors (p ≤ 0.02) and failed more frequently to inhibit responses to NoGo trials (p < 0.02) than LOS and HNS. EOS also made more errors in inhibiting responses to smoking-related (p ≤ 0.02) and neutral (p ≤ 0.02) NoGo trials. EOS reported greater baseline craving for cigarette smoking than LOS (p < 0.04), and craving was significantly associated with greater omission errors (p ≤ 0.04). CONCLUSIONS EOS exhibited greater difficulty than LOS in responding accurately to Go stimuli and withholding responses to both smoking and neutral NoGo stimuli, indicating greater response impulsivity, poor attention, and deficits in response inhibition. These findings suggest that EO smoking, in particular, contributes to diminished task-related attention and inhibitory control behaviors in adulthood and provide support for the tobacco-induced neurotoxicity of adolescent cognitive development (TINACD) theory (DeBry and Tiffany, 2008).
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Affiliation(s)
- Yasmin Mashhoon
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Jennifer Betts
- Behavioral Psychopharmacology Research Laboratory,McLean Imaging Center, McLean Hospital, Belmont, MA
| | - Stacey L Farmer
- Behavioral Psychopharmacology Research Laboratory,McLean Imaging Center, McLean Hospital, Belmont, MA
| | - Scott E Lukas
- Behavioral Psychopharmacology Research Laboratory,McLean Imaging Center, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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45
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Levar N, Francis AN, Smith MJ, Ho WC, Gilman JM. Verbal Memory Performance and Reduced Cortical Thickness of Brain Regions Along the Uncinate Fasciculus in Young Adult Cannabis Users. Cannabis Cannabinoid Res 2018; 3:56-65. [PMID: 29607411 PMCID: PMC5870060 DOI: 10.1089/can.2017.0030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction: Memory impairment is one of the most commonly reported effects of cannabis use, especially among those who initiate use earlier, perhaps due to the effects of delta-9- tetrahydrocannabinol on cannabinoid (CB1) receptors in the brain. Studies have increasingly investigated whether cannabis use is associated with impairments in verbal memory, and with alterations in brain structures underlying verbal memory. The uncinate fasciculus (UF), a long-range white matter tract, connects regions with densely localized CB1 receptors that are important in verbal memory. This study investigated the impact of cannabis use on UF structures and its association with memory performance in young adult cannabis users (CU) and non-using controls (CON). Materials and Methods: Nineteen CU and 22 CON completed a verbal memory task and a neuroimaging protocol, in which diffusion tensor imaging and structural scans were collected. We compared memory performance, diffusion and tractography measures of the UF, and cortical thickness of regions connected by the UF, between CU and CON. In regions showing a significant group effect, we also examined associations between verbal memory performance, cortical thickness, and age of onset of cannabis use. Results: Compared to non-users, CU had worse memory performance, decreased fiber bundle length in the UF, and decreased cortical thickness of brain regions along the UF such as the entorhinal cortex and fusiform gyrus. Verbal memory performance was significantly associated with age of onset of cannabis use, indicating that those who initiated cannabis use at an earlier age performed worse. Cortical thickness of the entorhinal cortex was significantly correlated with age of first use and memory performance. Conclusion: This study provides evidence that cannabis use, especially when initiated at a young age, may be associated with worse verbal memory and altered neural development along the UF. Reductions in cortical thickness in regions implicated in memory processes may underlie weaknesses in verbal memory performance.
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Affiliation(s)
- Nina Levar
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alan N Francis
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Matthew J Smith
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Wilson C Ho
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jodi M Gilman
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Naik S, Kolikonda M, Prabhu A, Lippmann S. MARIJUANA ON THE BRAIN- A CONCERN. INNOVATIONS IN CLINICAL NEUROSCIENCE 2018; 15:12. [PMID: 30023136 PMCID: PMC6042982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Shivani Naik
- Dr. Naik is a Research Scholar in the Department of Neurology
- Dr. Kolikonda is a Neurology Resident in the Department of Neurology
- Dr. Prabhu is a Research Scholar in the Department of Cardiology
- Dr. Lippmann is a Professor Emeritus in the Department of Psychiatry at University of Louisville, Louisville, Kentucky
| | - Murali Kolikonda
- Dr. Naik is a Research Scholar in the Department of Neurology
- Dr. Kolikonda is a Neurology Resident in the Department of Neurology
- Dr. Prabhu is a Research Scholar in the Department of Cardiology
- Dr. Lippmann is a Professor Emeritus in the Department of Psychiatry at University of Louisville, Louisville, Kentucky
| | - Angeline Prabhu
- Dr. Naik is a Research Scholar in the Department of Neurology
- Dr. Kolikonda is a Neurology Resident in the Department of Neurology
- Dr. Prabhu is a Research Scholar in the Department of Cardiology
- Dr. Lippmann is a Professor Emeritus in the Department of Psychiatry at University of Louisville, Louisville, Kentucky
| | - Steven Lippmann
- Dr. Naik is a Research Scholar in the Department of Neurology
- Dr. Kolikonda is a Neurology Resident in the Department of Neurology
- Dr. Prabhu is a Research Scholar in the Department of Cardiology
- Dr. Lippmann is a Professor Emeritus in the Department of Psychiatry at University of Louisville, Louisville, Kentucky
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Cannabis use patterns and motives: A comparison of younger, middle-aged, and older medical cannabis dispensary patients. Addict Behav 2017; 72:14-20. [PMID: 28340421 DOI: 10.1016/j.addbeh.2017.03.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/16/2017] [Accepted: 03/08/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Medical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan. METHODS The present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18-30, middle-aged: 31-50, and older: 51-72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses. RESULTS All three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults. CONCLUSIONS Findings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences.
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Prefrontal mechanisms of comorbidity from a transdiagnostic and ontogenic perspective. Dev Psychopathol 2017; 28:1147-1175. [PMID: 27739395 DOI: 10.1017/s0954579416000742] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Accumulating behavioral and genetic research suggests that most forms of psychopathology share common genetic and neural vulnerabilities and are manifestations of a relatively few core underlying processes. These findings support the view that comorbidity mostly arises, not from true co-occurrence of distinct disorders, but from the behavioral expression of shared vulnerability processes across the life span. The purpose of this review is to examine the role of the prefrontal cortex (PFC) in the shared vulnerability mechanisms underlying the clinical phenomena of comorbidity from a transdiagnostic and ontogenic perspective. In adopting this perspective, we suggest complex transactions between neurobiologically rooted vulnerabilities inherent in PFC circuitry and environmental factors (e.g., parenting, peers, stress, and substance use) across development converge on three key PFC-mediated processes: executive functioning, emotion regulation, and reward processing. We propose that individual differences and impairments in these PFC-mediated functions provide intermediate mechanisms for transdiagnostic symptoms and underlie behavioral tendencies that evoke and interact with environmental risk factors to further potentiate vulnerability.
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Nader DA, Sanchez ZM. Effects of regular cannabis use on neurocognition, brain structure, and function: a systematic review of findings in adults. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 44:4-18. [DOI: 10.1080/00952990.2017.1306746] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Danilo A. Nader
- Departmento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Zila M. Sanchez
- Departmento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, Brazil
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Global white matter microstructural abnormalities associated with addiction liability score in drug naïve youth. Brain Imaging Behav 2017; 12:274-283. [PMID: 28271440 DOI: 10.1007/s11682-017-9679-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abnormalities in brain white matter (WM) structure have been reported in youths having a family history of substance use disorders (SUDs). It was hypothesized that these abnormalities constitute features of the liability for SUDs transmitted across generations. The association between severity of intergenerational risk for SUD, measured by the Transmissible Liability Index (TLI), and white matter microstructure was examined. Diffusion tensor imaging (DTI) measured WM microstructure in forty-four drug-naïve 10-14 year-olds (N = 19 with parental SUD). Metrics of WM microstructure (i.e., fractional anisotropy, radial diffusivity, mean diffusivity and axial diffusivity) were quantified across the whole brain and in four tracts of interest: anterior corona radiata, superior and inferior longitudinal fasciculi and superior fronto-occipital fasciculi. The TLI was completed by the youths, their parents and, when available, their teachers. The relationship between WM structure and TLI score across the entire group was evaluated using linear multiple regression and between group comparisons were also examined. Fractional anisotropy and radial diffusivity in multiple tracts across the brain were significantly associated with TLI scores. Confirming and extending prior research, the findings indicate that global atypicality in WM tracts was linearly related to liability for eventual SUD development in drug naïve youths.
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