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Dagher M, Alayoubi M, Sigal GH, Cahill CM. Unveiling the link between chronic pain and misuse of opioids and cannabis. J Neural Transm (Vienna) 2024; 131:563-580. [PMID: 38570361 DOI: 10.1007/s00702-024-02765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
Over 50 million Americans endure chronic pain where many do not receive adequate treatment and self-medicate to manage their pain by taking substances like opioids and cannabis. Research has shown high comorbidity between chronic pain and substance use disorders (SUD) and these disorders share many common neurobiological underpinnings, including hypodopaminergic transmission. Drugs commonly used for self-medication such as opioids and cannabis relieve emotional, bothersome components of pain as well as negative emotional affect that perpetuates misuse and increases the risk of progressing towards drug abuse. However, the causal effect between chronic pain and the development of SUDs has not been clearly established. In this review, we discuss evidence that affirms the proposition that chronic pain is a risk factor for the development of opioid and cannabis use disorders by outlining the clinical evidence and detailing neurobiological mechanisms that link pain and drug misuse. Central to the link between chronic pain and opioid and cannabis misuse is hypodopaminergic transmission and the modulation of dopamine signaling in the mesolimbic pathway by opioids and cannabis. Moreover, we discuss the role of kappa opioid receptor activation and neuroinflammation in the context of dopamine transmission, their contribution to opioid and cannabis withdrawal, along with potential new treatments.
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Affiliation(s)
- Merel Dagher
- MacDonald Research Laboratory Building, Department of Psychiatry and Biobehavioral Sciences, Shirley and Stefan Hatos Center for Neuropharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 675 Charles E Young Drive South, Office 2774, Los Angeles, CA, 90095, USA
| | - Myra Alayoubi
- MacDonald Research Laboratory Building, Department of Psychiatry and Biobehavioral Sciences, Shirley and Stefan Hatos Center for Neuropharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 675 Charles E Young Drive South, Office 2774, Los Angeles, CA, 90095, USA
- Neuroscience Interdepartmental Program, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Gabriella H Sigal
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Catherine M Cahill
- MacDonald Research Laboratory Building, Department of Psychiatry and Biobehavioral Sciences, Shirley and Stefan Hatos Center for Neuropharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 675 Charles E Young Drive South, Office 2774, Los Angeles, CA, 90095, USA.
- Neuroscience Interdepartmental Program, University of California Los Angeles, Los Angeles, CA, 90095, USA.
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2
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Kuang FW, Farrukh MJ. Assessing the preparedness and future-readiness of Malaysian community pharmacists in Klang Valley regarding the use of medical marijuana. BMC Health Serv Res 2024; 24:524. [PMID: 38664704 PMCID: PMC11044563 DOI: 10.1186/s12913-024-11008-w] [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] [Received: 12/26/2023] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND This study investigated community pharmacists' level of knowledge and attitude towards medical marijuana and its association with sociodemographic characteristics. METHODS A cross-sectional study was conducted from 21 February 2022 to 15 November 2022. Community pharmacists working in Klang Valley were given a self-administered questionnaire. This survey instrument facilitated the collection of information about their sociodemographic attributes, training background, and knowledge and attitude concerning medical marijuana. Through rigorous analysis of the accumulated data, discernible factors correlating with the levels of knowledge and attitudes surrounding medical marijuana were identified. RESULTS The majority (n=149, 53.8%) of participants had low knowledge of medical marijuana. Participants with lower knowledge of medical marijuana tend to have a negative attitude toward medical marijuana. Besides that, male participants showed higher knowledge of medical marijuana than female participants. Furthermore, it was found that atheists had the most negative attitude among other religions toward medical marijuana. CONCLUSION Most community pharmacists in Malaysia lack sufficient knowledge about medical marijuana. This indicates that Malaysian pharmacists are not future-ready and need to equip themselves with adequate knowledge of the indications and adverse effects of medical marijuana if it is to be legalised one day. Thus, there is a need for improved training and education of pharmacists around cannabis-based medicines.
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Affiliation(s)
- Fu Wai Kuang
- Faculty of Pharmaceutical Sciences, UCSI University, Cheras, 56000, Kuala Lumpur, Malaysia
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3
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Temourian AA, Halliday DM, Yan Y, Chan-Golston AM, Song AV. Marijuana and E-cigarette Initiation Among Adolescents: A Survival Analysis. J Adolesc Health 2024; 74:747-754. [PMID: 38085208 DOI: 10.1016/j.jadohealth.2023.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/27/2023] [Accepted: 11/10/2023] [Indexed: 03/24/2024]
Abstract
PURPOSE Prior literature suggests marijuana and e-cigarette initiation among adolescents is surpassing combustible cigarette uptake. Marijuana and nicotine co-use is also a concern as these products grow in popularity. Initiation trajectories for marijuana and e-cigarette products are not well understood, let alone how the use of one product may impact initiation susceptibility for the other. METHODS We used national longitudinal data from the Population Assessment of Tobacco and Health study from 2013 to 2018. Eighth graders in Wave 1 made up the analytic sample (N = 2,270). We employed discrete time survival analyses to determine the likelihood of initiating marijuana and e-cigarettes between Waves 2 and 5. We used survival analyses to estimate the relationships between prior cigarette and marijuana use and subsequent e-cigarette initiation, as well as prior cigarette and e-cigarette use and subsequent marijuana initiation. RESULTS Previous marijuana initiation was associated with later e-cigarette initiation (odds ratio = 6.88, 95% confidence interval [4.89, 9.67]). Previous e-cigarette initiation was associated with later marijuana initiation (odds ratio = 9.28, 95% confidence interval [6.86, 12.56]). By wave 5, adolescents were more than 42% likely to initiate marijuana and e-cigarettes. DISCUSSION Susceptibility to marijuana and e-cigarette products starts as early as eighth grade and increases over time. The use of one product is significantly related to later initiation for the other. Rather than addressing marijuana and nicotine as separate concerns, interventions may benefit by recognizing the closely related nature of these products.
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Affiliation(s)
- Allison A Temourian
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, California; Nicotine and Cannabis Policy Center, Health Sciences Research Institute, University of California, Merced, California
| | - Deanna M Halliday
- Center for Tobacco Control Research and Education, University of California, San Francisco, California
| | - Yueqi Yan
- Biostatistics and Data Support Center, Health Sciences Research Institute, University of California, Merced, California
| | - Alec M Chan-Golston
- Department of Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, California; Biostatistics and Data Support Center, Health Sciences Research Institute, University of California, Merced, California
| | - Anna V Song
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, California; Nicotine and Cannabis Policy Center, Health Sciences Research Institute, University of California, Merced, California.
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Reisdorph N, Doenges K, Levens C, Manke J, Armstrong M, Smith H, Quinn K, Radcliffe R, Reisdorph R, Saba L, Kuhn KA. Oral Cannabis consumption and intraperitoneal THC:CBD dosing results in changes in brain and plasma neurochemicals and endocannabinoids in mice. J Cannabis Res 2024; 6:10. [PMID: 38429800 PMCID: PMC10908076 DOI: 10.1186/s42238-024-00219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND While the use of orally consumed Cannabis, cannabidiol (CBD) and tetrahydrocannabinol (THC) containing products, i.e. "edibles", has expanded, the health consequences are still largely unknown. This study examines the effects of oral consumption of whole Cannabis and a complex Cannabis extract on neurochemicals, endocannabinoids (eCB), and physiological parameters (body temperature, heart rate) in mice. METHODS In this pilot study, C57BL/6 J mice were treated with one of the following every other day for 2 weeks: a complex Cannabis extract by gavage, whole Cannabis mixed with nutritional gel through free feeding, or purified THC/CBD by intraperitoneal (i.p.) injection. Treatments were conducted at 4 doses ranging from 0-100 mg/kg/day of CBD with THC levels of ≤ 1.2 mg/kg/day for free feeding and gavage and 10 mg/kg/day for i.p. Body temperature and heart rate were monitored using surgically implanted telemetry devices. Levels of neurochemicals, eCB, THC, CBD, and 11-OH-THC were measured using mass spectrometry 48 h after the final treatment. Statistical comparisons were conducted using ANOVA and t-tests. RESULTS Differences were found between neurochemicals in the brains and plasma of mice treated by i.p. (e.g. dopamine, p < 0.01), gavage (e.g., phenylalanine, p < 0.05) and in mice receiving whole Cannabis (e.g., 3,4-dihydroxyphenylacetic DOPAC p < 0.05). Tryptophan trended downward or was significantly decreased in the brain and/or plasma of all mice receiving Cannabis or purified CBD/THC, regardless of dose, compared to controls. Levels of the eCB, arachidonoyl glycerol (2-AG) were decreased in mice receiving lowest doses of a complex Cannabis extract by gavage, but were higher in mice receiving highest doses compared to controls (p < 0.05). Plasma and brain levels of THC and 11-OH-THC were higher in mice receiving 1:1 THC:CBD by i.p. compared to those receiving 1:5 or 1:10 THC:CBD. Nominal changes in body temperature and heart rate following acute and repeated exposures were seen to some degree in all treatments. CONCLUSIONS Changes to neurochemicals and eCBs were apparent at all doses regardless of treatment type. Levels of neurochemicals seemed to vary based on the presence of a complex Cannabis extract, suggesting a non-linear response between THC and neurochemicals following repeated oral dosing.
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Affiliation(s)
- Nichole Reisdorph
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Katrina Doenges
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Cassandra Levens
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jon Manke
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Michael Armstrong
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Harry Smith
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kevin Quinn
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Richard Radcliffe
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Richard Reisdorph
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Laura Saba
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kristine A Kuhn
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
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Shah K, Farwa UE, Vanaparti A, Patel S, Kanumuri M, Vashishth O, Hossain N, Dahiya R, Banala M, Enamorado FRP, Patel AS, Nadeem H, Kanani R, Desai HD, Sharma KH, Tripathi S. Global epidemiology of cannabis use disorders and its trend from 1990 to 2019: Benchmarking analysis of the global burden of disease study. J Family Med Prim Care 2024; 13:881-889. [PMID: 38736814 PMCID: PMC11086777 DOI: 10.4103/jfmpc.jfmpc_824_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/16/2023] [Accepted: 08/01/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Cannabis is one of the most widely used psychoactive substances globally, with an increasing trend in its legalization for both medical and recreational purposes in various countries. While cannabis offers potential therapeutic benefits, its regular use can lead to the development of Cannabis Use Disorders (CUDs). Understanding the epidemiology of CUDs is crucial in assessing the public health burden associated with cannabis use. Methods Epidemiological parameters of CUDs were assessed using the Global Burden of Disease (GBD) methodology across different age-groups, years, sexes, and locations worldwide from 1990-2019. Results Globally, for both sexes combined, prevalent cases of CUDs increased steadily from 17.1 million(95%UI=12.7-22.8million) in 1990 to 23.8-million(95%UI=17.8-30.9 million) in 2019. All age-adjusted highest number of incidence observed in High-Income-North-America(HINA)(121/100,000), followed by Australasia(100/100,000), Oceania(83.97/100,000), Tropical Latin America(69.59/100,000). Globally, age-standardized disability-adjusted life years rate(ASDR) observed higher in HINA, followed by Australasia, and Western-Europe. In male, all-age incidence counts increased from 1.7 million(95%UI=1.3-2.4million) in 1990 to 2.4 million(95%UI=1.8-3.2 million) in 2019. The highest annual percentage of change in age-standardized incidence rate(ASIR) was found in East-Asia (22%) followed by Middle-East and North-Africa(MENA)(15%). The age group of 15-24 years exhibited the highest burden of CUDs. Conclusion The widespread occurrence of CUDs on a global scale poses a substantial challenge to public health. Understanding the impact of CUDs and implementing evidence-based interventions is crucial in mitigating the associated individual, societal, and economic burdens. Continued research, collaboration, and knowledge dissemination are essential to inform policies, prevention efforts, and treatment strategies aimed at addressing CUDs on a global-scale.
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Affiliation(s)
- Kinjal Shah
- Department of Public Health Administration, Rutgers University, Edward J. Bloustein School of Planning and Public Policy, New Jersey, United States of America
| | - Umm E. Farwa
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ankitha Vanaparti
- Department of Internal Medicine, Kakatiya Medical College, Hyderabad, Telangana, India
| | - Savan Patel
- Department of Internal Medicine, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Manisha Kanumuri
- Department of Psychiatry, Mediciti Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Oshin Vashishth
- Department of Internal Medicine, St. Martinus University, Willemstad, Curaçao
| | - Nadia Hossain
- Department of Internal Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Roopali Dahiya
- Department of Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, Delhi, India
| | - Mallareddy Banala
- Department of Internal Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India
| | | | - Abhiraj S. Patel
- Department of Internal Medicine, Our Lady of Fatima University College of Medicine, Valenzuela, Philippines
| | - Huzaifa Nadeem
- Department of Psychiatry, CMH Lahore Medical College, Combined Military Hospital, Lahore, Pakistan
| | - Ravi Kanani
- Department of Research Wing, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
| | - Hardik D. Desai
- Department of Research Wing, Gujarat Adani Institute of Medical Sciences, Affiliated to K.S.K.V University, Bhuj, Gujarat, India
| | - Kamal H. Sharma
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India
| | - Sharanya Tripathi
- Department of Internal Medicine, G.M.E.R.S Medical College, M.S. University, Gotri, Vadodara, Gujarat, India
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Weinstein AM. A brain imaging study of dopamine receptor D 2 availability in cannabis dependent users after recovery from cannabis-induced psychosis. Front Psychiatry 2023; 14:1230760. [PMID: 37965367 PMCID: PMC10641483 DOI: 10.3389/fpsyt.2023.1230760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
There is increased risk of psychosis associated with cannabis use disorder and the interaction of THC with dopamine neurotransmission is complex. It is important to investigate the recovery from cannabis-induced psychosis and its effects on the brain's dopamine neurotransmission. This study was to evaluate dopamine receptor D2 availability in the striatum (caudate/putamen) in recently abstinent cannabis dependent users after recovery from psychosis in comparison with abstinent MDMA "ecstasy" abusers and healthy control participants. Participants were eight abstinent ex cannabis-dependent users who were treated for cannabis-induced psychosis with anti-psychotic medication and psychosocial support for 4 months in an inpatient treatment center for drug users. They were compared with nine abstinent ex MDMA "ecstasy" abusers who received medication and psycho-social treatment for 4 months at the same treatment facility and eight healthy control participants. All participants were scanned with bolus and constant infusion of [123I] Iodobenzamide (IBZM) in Single Photon Computed Tomography (SPECT). Cannabis abstinent users who were treated for cannabis-induced psychotic episodes showed no difference in dopamine D2 receptor availability in the caudate compared with abstinent MDMA "ecstasy" abusers and healthy control participants. This finding indicates minimal effects of cannabis-induced psychosis on dopamine reward mechanisms. There is evidence for reduced D2 receptor availability measures in the right putamen (uncorrected) which may indicate a residual effect of anti-psychotic medication.
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Affiliation(s)
- Aviv M. Weinstein
- Department of Psychology and Behavioral Science, Ariel University, Ariel, Israel
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Reece AS, Hulse GK. Perturbation of 3D nuclear architecture, epigenomic aging and dysregulation, and cannabinoid synaptopathy reconfigures conceptualization of cannabinoid pathophysiology: part 2-Metabolome, immunome, synaptome. Front Psychiatry 2023; 14:1182536. [PMID: 37854446 PMCID: PMC10579598 DOI: 10.3389/fpsyt.2023.1182536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
The second part of this paper builds upon and expands the epigenomic-aging perspective presented in Part 1 to describe the metabolomic and immunomic bases of the epigenomic-aging changes and then considers in some detail the application of these insights to neurotoxicity, neuronal epigenotoxicity, and synaptopathy. Cannabinoids are well-known to have bidirectional immunomodulatory activities on numerous parts of the immune system. Immune perturbations are well-known to impact the aging process, the epigenome, and intermediate metabolism. Cannabinoids also impact metabolism via many pathways. Metabolism directly impacts immune, genetic, and epigenetic processes. Synaptic activity, synaptic pruning, and, thus, the sculpting of neural circuits are based upon metabolic, immune, and epigenomic networks at the synapse, around the synapse, and in the cell body. Many neuropsychiatric disorders including depression, anxiety, schizophrenia, bipolar affective disorder, and autistic spectrum disorder have been linked with cannabis. Therefore, it is important to consider these features and their complex interrelationships in reaching a comprehensive understanding of cannabinoid dependence. Together these findings indicate that cannabinoid perturbations of the immunome and metabolome are important to consider alongside the well-recognized genomic and epigenomic perturbations and it is important to understand their interdependence and interconnectedness in reaching a comprehensive appreciation of the true nature of cannabinoid pathophysiology. For these reasons, a comprehensive appreciation of cannabinoid pathophysiology necessitates a coordinated multiomics investigation of cannabinoid genome-epigenome-transcriptome-metabolome-immunome, chromatin conformation, and 3D nuclear architecture which therefore form the proper mechanistic underpinning for major new and concerning epidemiological findings relating to cannabis exposure.
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Affiliation(s)
- Albert Stuart Reece
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Gary Kenneth Hulse
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Reece AS, Hulse GK. Perturbation of 3D nuclear architecture, epigenomic dysregulation and aging, and cannabinoid synaptopathy reconfigures conceptualization of cannabinoid pathophysiology: part 1-aging and epigenomics. Front Psychiatry 2023; 14:1182535. [PMID: 37732074 PMCID: PMC10507876 DOI: 10.3389/fpsyt.2023.1182535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
Much recent attention has been directed toward the spatial organization of the cell nucleus and the manner in which three-dimensional topologically associated domains and transcription factories are epigenetically coordinated to precisely bring enhancers into close proximity with promoters to control gene expression. Twenty lines of evidence robustly implicate cannabinoid exposure with accelerated organismal and cellular aging. Aging has recently been shown to be caused by increased DNA breaks. These breaks rearrange and maldistribute the epigenomic machinery to weaken and reverse cellular differentiation, cause genome-wide DNA demethylation, reduce gene transcription, and lead to the inhibition of developmental pathways, which contribute to the progressive loss of function and chronic immune stimulation that characterize cellular aging. Both cell lineage-defining superenhancers and the superanchors that control them are weakened. Cannabis exposure phenocopies the elements of this process and reproduces DNA and chromatin breakages, reduces the DNA, RNA protein and histone synthesis, interferes with the epigenomic machinery controlling both DNA and histone modifications, induces general DNA hypomethylation, and epigenomically disrupts both the critical boundary elements and the cohesin motors that create chromatin loops. This pattern of widespread interference with developmental programs and relative cellular dedifferentiation (which is pro-oncogenic) is reinforced by cannabinoid impairment of intermediate metabolism (which locks in the stem cell-like hyper-replicative state) and cannabinoid immune stimulation (which perpetuates and increases aging and senescence programs, DNA damage, DNA hypomethylation, genomic instability, and oncogenesis), which together account for the diverse pattern of teratologic and carcinogenic outcomes reported in recent large epidemiologic studies in Europe, the USA, and elsewhere. It also accounts for the prominent aging phenotype observed clinically in long-term cannabis use disorder and the 20 characteristics of aging that it manifests. Increasing daily cannabis use, increasing use in pregnancy, and exponential dose-response effects heighten the epidemiologic and clinical urgency of these findings. Together, these findings indicate that cannabinoid genotoxicity and epigenotoxicity are prominent features of cannabis dependence and strongly indicate coordinated multiomics investigations of cannabinoid genome-epigenome-transcriptome-metabolome, chromatin conformation, and 3D nuclear architecture. Considering the well-established exponential dose-response relationships, the diversity of cannabinoids, and the multigenerational nature of the implications, great caution is warranted in community cannabinoid penetration.
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Affiliation(s)
- Albert Stuart Reece
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Gary Kenneth Hulse
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Di Raddo ME, Milenkovic M, Sivasubramanian M, Hasbi A, Bergman J, Withey S, Madras BK, George SR. Δ9-Tetrahydrocannabinol does not upregulate an aversive dopamine receptor mechanism in adolescent brain unlike in adults. CURRENT RESEARCH IN NEUROBIOLOGY 2023; 5:100107. [PMID: 38020805 PMCID: PMC10663137 DOI: 10.1016/j.crneur.2023.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/05/2023] [Accepted: 08/18/2023] [Indexed: 12/01/2023] Open
Abstract
Earlier age of cannabis usage poses higher risk of Cannabis Use Disorder and adverse consequences, such as addiction, anxiety, dysphoria, psychosis, largely attributed to its principal psychoactive component, Δ9-tetrahydrocannabinol (THC) and altered dopaminergic function. As dopamine D1-D2 receptor heteromer activation causes anxiety and anhedonia, this signaling complex was postulated to contribute to THC-induced affective symptoms. To investigate this, we administered THC repeatedly to adolescent monkeys and adolescent or adult rats. Drug-naïve adolescent rat had lower striatal densities of D1-D2 heteromer compared to adult rat. Repeated administration of THC to adolescent rat or adolescent monkey did not alter D1-D2 heteromer expression in nucleus accumbens or dorsal striatum but upregulated it in adult rat. Behaviourally, THC-treated adult, but not adolescent rat manifested anxiety and anhedonia-like behaviour, with elevated composite negative emotionality scores that correlated with striatal D1-D2 density. THC modified downstream markers of D1-D2 activation in adult, but not adolescent striatum. THC administered with cannabidiol did not alter D1-D2 expression. In adult rat, co-administration of CB1 receptor (CB1R) inverse agonist with THC attenuated D1-D2 upregulation, implicating cannabinoids in the regulation of striatal D1-D2 heteromer expression. THC exposure revealed an adaptable age-specific, anxiogenic, anti-reward mechanism operant in adult striatum but deficient in adolescent rat and monkey striatum that may confer increased sensitivity to THC reward in adolescence while limiting its negative effects, thus promoting continued use and increasing vulnerability to long-term adverse cannabis effects.
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Affiliation(s)
- Marie-Eve Di Raddo
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada M5S 1A8
| | - Marija Milenkovic
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada M5S 1A8
| | | | - Ahmed Hasbi
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada M5S 1A8
| | - Jack Bergman
- McLean Hospital, Belmont MA & Department of Psychiatry, Harvard Medical School, Boston, MA, 02478, United States
| | - Sarah Withey
- McLean Hospital, Belmont MA & Department of Psychiatry, Harvard Medical School, Boston, MA, 02478, United States
| | - Bertha K. Madras
- McLean Hospital, Belmont MA & Department of Psychiatry, Harvard Medical School, Boston, MA, 02478, United States
| | - Susan R. George
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada M5S 1A8
- Department of Medicine, University of Toronto, Toronto, Canada M5S 1A8
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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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11
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Gasparyan A, Maldonado Sanchez D, Navarrete F, Sion A, Navarro D, García-Gutiérrez MS, Rubio Valladolid G, Jurado Barba R, Manzanares J. Cognitive Alterations in Addictive Disorders: A Translational Approach. Biomedicines 2023; 11:1796. [PMID: 37509436 PMCID: PMC10376598 DOI: 10.3390/biomedicines11071796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 07/30/2023] Open
Abstract
The cognitive decline in people with substance use disorders is well known and can be found during both the dependence and drug abstinence phases. At the clinical level, cognitive decline impairs the response to addiction treatment and increases dropout rates. It can be irreversible, even after the end of drug abuse consumption. Improving our understanding of the molecular and cellular alterations associated with cognitive decline could be essential to developing specific therapeutic strategies for its treatment. Developing animal models to simulate drug abuse-induced learning and memory alterations is critical to continue exploring this clinical situation. The main aim of this review is to summarize the most recent evidence on cognitive impairment and the associated biological markers in patients addicted to some of the most consumed drugs of abuse and in animal models simulating this clinical situation. The available information suggests the need to develop more studies to further explore the molecular alterations associated with cognitive impairment, with the ultimate goal of developing new potential therapeutic strategies.
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Affiliation(s)
- Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | | | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Ana Sion
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Faculty of Psychology, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Gabriel Rubio Valladolid
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Department of Psychiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rosa Jurado Barba
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Faculty of Health, Universidad Camilo José Cela, 28001 Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
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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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13
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Barbuti M, Maiello M, Spera V, Pallucchini A, Brancati GE, Maremmani AGI, Perugi G, Maremmani I. Challenges of Treating ADHD with Comorbid Substance Use Disorder: Considerations for the Clinician. J Clin Med 2023; 12:jcm12093096. [PMID: 37176536 PMCID: PMC10179386 DOI: 10.3390/jcm12093096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Adults with attention deficit/hyperactivity disorder (ADHD) often present psychiatric comorbidities and, in particular, substance use disorder (SUD). ADHD-SUD comorbidity is characterized by greater severity of both disorders, earlier age of onset, higher likelihood of polydrug-abuse and suicidal behaviors, more hospitalizations, and lower treatment adherence. At the present stage, research focused on the pharmacological management of ADHD with comorbid SUD in both adolescents and adults is still lacking. Furthermore, while the short-term effects of stimulants are well studied, less is known about the chronic effects of these drugs on dopamine signaling. Current available evidence is consistent in reporting that high doses of stimulant medications in ADHD-SUD subjects have a mild to moderate efficacy on ADHD symptoms. Some data suggest that pharmacological treatment with stimulants may be beneficial for both ADHD symptoms and comorbid cocaine or amphetamine use. However, in the long run, stimulant medications may have a potential risk for misuse. For the absence of potential misuse, atomoxetine is often recommended for ADHD with comorbid cocaine or amphetamine use disorder. However, its efficacy in reducing addictive behavior is not demonstrated. In subjects with other subtypes of SUD, both atomoxetine and stimulant drugs seem to have scarce impact on addictive behavior, despite the improvement in ADHD symptomatology. In this population, ADHD treatment should be combined with SUD-specific strategies.
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Affiliation(s)
- Margherita Barbuti
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Marco Maiello
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Vincenza Spera
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Alessandro Pallucchini
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Giulio E Brancati
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Angelo G I Maremmani
- Section of Psychiatry, Department of Psychiatry and Addictions, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Via Aurelia 335, 55041 Lido di Camaiore, Italy
| | - Giulio Perugi
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
| | - Icro Maremmani
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
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14
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Xu H, Owens MM, Farncombe T, Noseworthy M, MacKillop J. Molecular brain differences and cannabis involvement: A systematic review of positron emission tomography studies. J Psychiatr Res 2023; 162:44-56. [PMID: 37088043 DOI: 10.1016/j.jpsychires.2023.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND An increasing number of studies have used positron emission tomography (PET) to investigate molecular neurobiological differences in individuals who use cannabis. This study aimed to systematically review PET imaging research in individuals who use cannabis or have cannabis use disorder (CUD). METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, a comprehensive systematic review was undertaken using the PubMed, Scopus, PsycINFO and Web of Science databases. RESULTS In total, 20 studies were identified and grouped into three themes: (1) studies of the dopamine system primarily found that cannabis use was associated with abnormal striatal dopamine synthesis capacity, which was in turn correlated with clinical symptoms; (2) studies of the endocannabinoid system found that cannabis use and CUD are associated with lower cannabinoid receptor type 1 availability and global reductions in fatty acid amide hydrolase binding; (3) studies of brain metabolism found that individuals who use cannabis exhibit lower normalized glucose metabolism in both cortical and subcortical brain regions, and reduced cerebral blood flow in the lateral prefrontal cortex during experimental tasks. Heterogeneity across studies prevented meta-analysis. CONCLUSION Existing PET imaging research reveals substantive molecular differences in cannabis users in the dopamine and endocannabinoid systems, and in global brain metabolism, although the heterogeneity of designs and approaches is very high, and whether these differences are causal versus consequential is largely unclear.
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Affiliation(s)
- Hui Xu
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, McMaster University, 100 West 5th Street, Hamilton, L8P 3R2, ON, Canada
| | - Max M Owens
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, McMaster University, 100 West 5th Street, Hamilton, L8P 3R2, ON, Canada
| | - Troy Farncombe
- Department of Radiology, McMaster University, 1280 Main St W, Hamilton, L8S 4L8, ON, Canada
| | - Michael Noseworthy
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, L8S 4L8, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, McMaster University, 100 West 5th Street, Hamilton, L8P 3R2, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, St. Joseph's Healthcare Hamilton, McMaster University, 100 West 5th Street, Hamilton, L8P 3R2, ON, Canada.
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15
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Hámori G, File B, Fiáth R, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Adolescent ADHD and electrophysiological reward responsiveness: A machine learning approach to evaluate classification accuracy and prognosis. Psychiatry Res 2023; 323:115139. [PMID: 36921508 DOI: 10.1016/j.psychres.2023.115139] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/12/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
We evaluated event-related potential (ERP) indices of reinforcement sensitivity as ADHD biomarkers by examining, in N=306 adolescents (Mage=15.78, SD=1.08), the extent to which ERP amplitude and latency variables measuring reward anticipation and response (1) differentiate, in age- and sex-matched subsamples, (i) youth with vs. without ADHD, (ii) youth at-risk for vs. not at-risk for ADHD, and, in the with ADHD subsample, (iii) youth with the inattentive vs. the hyperactive/impulsive (H/I) and combined presentations. We further examined the extent to which ERP variables (2) predict, in the ADHD subsample, substance use (i) concurrently and (ii) prospectively at 18-month follow-up. Linear support vector machine analyses indicated ERPs weakly differentiate youth with/without (65%) - and at-risk for/not at-risk for (63%) - ADHD but better differentiate ADHD presentations (78%). Regression analyses showed in adolescents with ADHD, ERPs explain a considerable proportion of variance (50%) in concurrent alcohol use and, controlling for concurrent marijuana and tobacco use, explain a considerable proportion of variance (87 and 87%) in, and predict later marijuana and tobacco use. Findings are consistent with the dual-pathway model of ADHD. Results also highlight limitations of a dichotomous, syndromic classification and indicate differences in neural reinforcement sensitivity are a promising ADHD prognostic biomarker.
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Affiliation(s)
- György Hámori
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest H-1111, Hungary
| | - Bálint File
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary; Theoretical Neuroscience and Complex Systems Research Group, Wigner Research Centre for Physics, Konkoly-Tege Miklós út 29-33, Budapest 1121, Hungary
| | - Richárd Fiáth
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Bea Pászthy
- Department of Paediatrics, Semmelweis University, Faculty of Medicine, Bókay János u. 53-54, Budapest 1083, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Faculty of Medicine, Balassa u. 6, Budapest 1083, Hungary
| | - István Ulbert
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary.
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Abstract
Cannabis exerts an indirect effect on dopamine (DA) output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure, and thus may be associated with aberrant effort-based decision making. The "amotivation syndrome" hypothesis suggests that regular cannabis use results in impaired capacity for goal-directed behavior. However, investigations of this hypothesis have used divergent methodology and have not controlled for key confounding variables. The present study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25; 68% meeting criteria for Cannabis Use Disorder) and noncannabis using (n = 22) students completed the Effort Expenditure for Rewards Task (EEfRT). In generalized estimating equation models, reward magnitude, reward probability, and expected value predicted greater likelihood of selecting a high-effort trial. Furthermore, past-month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a high-effort trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, distress tolerance, income, and delay discounting. The results provide preliminary evidence suggesting that college students who use cannabis are more likely to expend effort to obtain reward, even after controlling for the magnitude of the reward and the probability of reward receipt. Thus, these results do not support the amotivational syndrome hypothesis. Future research with a larger sample is required to evaluate possible associations between cannabis use and patterns of real-world effortful behavior over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Cannabis use in Attention - Deficit/Hyperactivity Disorder (ADHD): A scoping review. J Psychiatr Res 2023; 157:239-256. [PMID: 36508935 DOI: 10.1016/j.jpsychires.2022.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Treatments for Adult ADHD include stimulants, two non-stimulant medications, as well as cognitive-behavioral therapy (CBT). These pharmacological agents are often associated with side effects, contributing to poor treatment adherence. Patients with ADHD have regularly stated that cannabis has helped improve their ADHD symptoms; however, scientific literature describing the effects of cannabis on symptoms of ADHD is scarce. METHODS We systematically searched MEDLINE, EMBASE, EMCARE, PsycINFO, Web of Science, Cochrane Library, and Clinicaltrials.gov. The searches included all publications in English up to June 27, 2022. We included both experimental and observational studies that assessed the effect of cannabis on ADHD symptomatology and neuropsychiatric outcomes. To synthesize our current understanding of the potential effects of cannabis use on ADHD symptoms and pathophysiology, and the effects of ADHD on cannabis use, data was extracted from each study regarding the characteristics of its population, methods used to assess both cannabis consumption and ADHD symptoms, and key findings. RESULTS Our scoping review included a total of 39 studies. Only one study employed a randomized and placebo-controlled design to directly measure the effect of cannabis on ADHD, and no significant effect was observed for the study's primary outcome, the QbTest (Est = -0.17, 95% CI -0.40 to 0.07, p = 0.16). Most of the literature consists of cross-sectional studies that evaluate the association between ADHD severity and cannabis use. 15 studies addressed the neuropsychiatric effects of cannabis on ADHD by employing either a battery of neuropsychiatric tests or neuroimaging. The concentration and amount of THC and CBD used were not well measured in most of the studies. Although some studies indicated that cannabis improved ADHD symptoms, most studies indicated it worsened or had no effect on ADHD symptoms. CONCLUSIONS Given the current evidence, cannabis is not recommended for people with ADHD. Limitations of the literature include the absence of objective measurements for cannabis exposure and ADHD symptoms, heterogenous definitions, oversampling, and small sample sizes.
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Preston TJ, Albanese BJ, Schmidt NB, Macatee RJ. Impact of acute stress on neural indices of positive and negative reinforcement processing in cannabis users. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:1036-1047. [PMID: 35696184 PMCID: PMC9745563 DOI: 10.1037/adb0000846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Chronic cannabis use is maintained in part through dysregulated stress and reward response systems. Specifically, stress-related negative affect is thought to act as a salient motivator for chronic substance use. Models of addiction posit that the transition from positive to negative reinforcement motives for substance use is a key mechanism of disordered use. However, research in substance-using samples has not assessed stress-related neural processing of both positive and negative reinforcement. METHOD Therefore, the present study utilized laboratory stress induction to examine how stress affects the reward positivity, an event-related potential sensitive to both positive (RewP) and negative (relief-RewP) reinforcement, in 87 cannabis users (58.10% female, Mage = 19.40) varying in cannabis use disorder (CUD) severity and, as part of larger study aims, history of traumatic brain injury (TBI). We predicted greater CUD severity would be associated with a blunted RewP and enhanced relief-RewP, particularly after stress induction, independent of TBI status. RESULTS Findings indicated that CUD severity was not associated with RewP/relief-RewP amplitude regardless of acute stress. Exploratory analyses revealed, however, that among those with history of TBI +, CUD severity was associated with greater stress-elicited blunting of the RewP and enhancement of the relief-RewP. CONCLUSION Although initial findings contradict current allostatic models of addiction, exploratory findings suggest that history of TBI, and potentially other confounding variables related to increased risk of TBI experience, may influence the extent to which stressful experiences modulate the neurophysiology of both positive and negative reinforcement reward processing in CUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Cannabis smoking increases the risk of suicide ideation and suicide attempt in young individuals of 11-21 years: A systematic review and meta-analysis. J Psychiatr Res 2022; 153:90-98. [PMID: 35810604 DOI: 10.1016/j.jpsychires.2022.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/20/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cannabis is the most frequently consumed drug around the world. Its use has been associated with increased suicide behaviors; nonetheless, the association of cannabis smoking and suicide behaviors in adolescents has not yet been established. The aim of this systematic review and meta-analysis was to evaluate the risk of suicide attempt, suicidal ideation or suicide planning in individuals of 11-21 years of age who smoke cannabis. METHODS We performed an online searched using PubMed, EBSCO and Science Direct databases, up to July 2021. We calculated odds ratio with 95% confidence intervals to evaluate the association between suicide attempt, suicidal ideation or suicide planning and cannabis smoking in individuals of 11-21 years of age. RESULTS Twenty studies reported suicide attempts in 34,859 young individuals, suicidal ideation in 26, 937 individuals, and suicide planning in 9054 young individuals. We found an increased risk of suicide attempt in cannabis smokers than in non-cannabis users (OR: 2.33; 95% CI: 1.78-3.05; Z p value; <0.0001; I2 = 97.12%), as well as a significant association between cannabis smoking and suicidal ideation (OR: 2.04; 95%CI: 1.64-2.53; Z p value: <0.001; I2: 94.88) and suicide planning (OR: 1.674; 95% CI: 1.554-1.804; Z p value: 0.000; I2: 92.609). Subgroup analyses showed that American teens have an increased risk of suicidal ideation; the meta-regression analysis revealed that age was negatively associated with the risk of suicide attempt. CONCLUSIONS This meta-analysis shows that cannabis smoking increased the risk of suicide attempt, suicidal ideation and suicide planning in young individuals of 11-21 years of age. The high risk of suicide behaviors could vary depending on the population studied; therefore, more studies are necessary to corroborate the risk of presenting suicide behaviors in individuals of 11-21 years of age who smoke cannabis.
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Chmielowiec J, Chmielowiec K, Masiak J, Śmiarowska M, Strońska-Pluta A, Dziedziejko V, Grzywacz A. Association between Polymorphism rs1799732 of DRD2 Dopamine Receptor Gene and Personality Traits among Cannabis Dependency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10915. [PMID: 36078646 PMCID: PMC9518330 DOI: 10.3390/ijerph191710915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Compared to other addictive substances, patients with cannabis addiction are significantly outnumbered by those who report dependence on other, more addictive substances. Unfortunately, most cannabis addiction goes untreated, and among those who choose treatment, the requirements are much higher for adolescents and young adults. THE AIM OF THE STUDY To examine the relationship of cannabinoid dependency in the genetic context-the association between the rs1799732 polymorphism of the DRD2 gene and psychological traits and anxiety. METHODS The study group consisted of 515 male volunteers. Of these, 214 patients were diagnosed with cannabis addiction and 301 were non-addicted. Patients were diagnosed with NEO Five-Factor Personality Inventory (NEO-FFI), and State-Trait Anxiety Inventory (STAI) questionnaires. The interactions between personality traits and polymorphisms in the DRD2 rs1799732 gene were investigated in a group of cannabis-addicted patients and non-addicted controls using the real-time PCR method. RESULTS Compared to the control group, the case group obtained significantly higher scores on the STAI State, STAI Trait, Neuroticism and Openness scales, as well as lower scores on the Extraversion, Agreeableness, and Conscientiousness scales. There was no statistically significant difference between addicts and the control group in the frequency of genotypes, but there was a statistically significant difference between addicts and the control group in the frequency of the DRD2 allele rs179973. The multivariate ANOVA analysis showed a statistically significant influence of the DRD2 rs1799732 genotype on the NEO-FFI agreeableness scale and a statistically significant effect of addiction to cannabinoids or its absence on the NEO-FFI agreeableness scale score. CONCLUSIONS Studying homogeneous subgroups-as in our study-seems reasonable, particularly when combined with genetic determinants and psychological traits. In multigenic and multifactorial entities, such a strategy has a future.
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Affiliation(s)
- Jolanta Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Gora, 28 Zyty St., 65-046 Zielona Gora, Poland
| | - Krzysztof Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Gora, 28 Zyty St., 65-046 Zielona Gora, Poland
| | - Jolanta Masiak
- Second Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska St., 20-059 Lublin, Poland
| | - Małgorzata Śmiarowska
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Aleksandra Strońska-Pluta
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, 11 Chlapowskiego St., 70-204 Szczecin, Poland
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, 11 Chlapowskiego St., 70-204 Szczecin, Poland
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A possible anti-anxiety effect of appetitive aggression and a possible link to the work of Donald Winnicott. Scand J Child Adolesc Psychiatr Psychol 2022; 10:102-113. [PMID: 36133733 PMCID: PMC9454322 DOI: 10.2478/sjcapp-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Various pleasant sensations that give a particularly intense pleasure are able to improve anxiety. In the present study I consider the possibility that their anti-anxiety action depends on the strong pleasure they provide, and I propose a possible mechanism of this action. According to some studies, also appetitive aggression (an aggression that provokes a strong pleasure and that is performed only for the pleasure it provides) can improve anxiety, and in this article I consider the possibility that the pleasure of appetitive aggression is able to reduce anxiety by the same mechanism I have proposed for other intense pleasurable sensations. The aggression performed by a child against the mother or against a substitute for the mother in the first period of life (a period in which this aggression is not dangerous) is a recurring theme throughout the work of of Donald Winnicott. Winnicott stresses that this aggression is necessary for the normal development of the child, and that the child must be free to practise it. According to Winnicott, this aggression is highly pleasurable and is not a response to unpleasant or hostile external situations. For these characteristics it seems to correspond to appetitive aggression in the adult that has been found to be able to reduce anxiety. Consequently, aggression performed by the child in the first period of life may also relieve anxiety, in the same way that appetitive aggression helps against anxiety in the adult. In his writings, Winnicott returns several times to an unthinkable or archaic anxiety that children experience when they feel abandoned by their mother for a period that is too long for them, and all children, according to Winnicott, live on the brink of this anxiety. In this study I propose the hypothesis that aggression in the early period of life may be necessary for children because the intense pleasure it provides may help them against this continuously impending anxiety.
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Xu H, Li D, Yin B. Aberrant hippocampal shape development in young adults with heavy cannabis use: Evidence from a longitudinal study. J Psychiatr Res 2022; 152:343-351. [PMID: 35785577 DOI: 10.1016/j.jpsychires.2022.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
Abstract
Cannabis is one of the most commonly used illicit drugs globally. Mounting evidence indicates that cannabis use, particularly consumption during young adulthood, is related to adverse mental and behavioral outcomes and an increased risk of the onset and relapse of psychosis. However, the neuromechanism underpinnings of heavy cannabis use (HCU) in young adults remain largely unknown, and no study has yet investigated the development of hippocampal shape in young adults with HCU. Twenty young adults with HCU and 22 matched non-cannabis-use healthy controls (HCs) were enrolled. Neuroimaging scanning and clinical assessments for all participants were performed at baseline (BL) and 3-year follow-up (FU). The vertex-wise shape analysis was conducted to investigate aberrant hippocampal shape development in young adults with HCU. Aberrant shape development pattern of the hippocampus was observed in young adults with HCU. There was no significant difference in hippocampal shape between the groups at BL, but young adults with HCU at FU exhibited significant shape atrophy of the right dorsal anterior hippocampus related to HCs. In addition, there was a significantly lower growth rate of the right hippocampal shape. Furthermore, there were significant associations of heavy cannabis use, as indicated by the age at onset first and frequent cannabis use, with the growth rate of hippocampal shape in young adults with HCU. The aberrant hippocampal shape development may reflect the effect of heavy cannabis use on young adults and it may be a potential target for heavy cannabis use treatment for young adults.
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Affiliation(s)
- Hui Xu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada.
| | - Dandong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.
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Phillips JG, Ogeil RP. Remote detection of Cannabis-related impairments in performance? Psychopharmacology (Berl) 2022; 239:2527-2536. [PMID: 35451615 DOI: 10.1007/s00213-022-06145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE Researchers have traditionally studied the effects of psychoactive drugs such as Cannabis in controlled laboratory settings or relied on retrospective self-reports to measure impairment. However, advances in technology afford opportunities to conduct assessments remotely. OBJECTIVES We considered whether objective click-stream data (time and number of clicks spent on a webpage) during an online survey could supplement self-reports of substance use problems. METHODS The clickstream data of participants (n = 236) were examined as they completed an online study which included validated psychometric tests (Cannabis Use Disorders Identification Test-Revised, Grit-O, Kessler Psychological Distress Scale, and Brief Self Control Scale). Clickstream data were compared to self-reported Cannabis use. RESULTS People reporting Cannabis use within the last 4 weeks required more time and more clicks to complete the online survey, and this was specifically associated with reported frequency of use, duration of impairment, and problems with memory and concentration. Longer amounts of time and more clicks on the online questionnaire were associated with more recent Cannabis use rather than demographic factors or stimulant use. CONCLUSIONS These results imply clickstream data remotely detected indecision or other deficits associated with previous Cannabis use.
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Affiliation(s)
- James G Phillips
- Psychology Department, Auckland University of Technology, Akoranga Campus, Auckland, 0627, New Zealand.
| | - Rowan P Ogeil
- Eastern Health Clinical School, Monash University, Box Hill, Clayton, 3128, Australia.,Turning Point, Eastern Health, Fitzroy, 3065, Australia
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Kesner AJ, Mateo Y, Abrahao KP, Ramos-Maciel S, Pava MJ, Gracias AL, Paulsen RT, Carlson HB, Lovinger DM. Changes in striatal dopamine release, sleep, and behavior during spontaneous Δ-9-tetrahydrocannabinol abstinence in male and female mice. Neuropsychopharmacology 2022; 47:1537-1549. [PMID: 35478010 PMCID: PMC9205922 DOI: 10.1038/s41386-022-01326-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/16/2022] [Accepted: 04/11/2022] [Indexed: 11/09/2022]
Abstract
Withdrawal symptoms are observed upon cessation of cannabis use in humans. Although animal studies have examined withdrawal symptoms following exposure to delta-9-tetrahydrocannabinol (THC), difficulties in obtaining objective measures of spontaneous withdrawal using paradigms that mimic cessation of use in humans have slowed research. The neuromodulator dopamine (DA) is affected by chronic THC treatment and plays a role in many behaviors related to human THC withdrawal symptoms. These symptoms include sleep disturbances that often drive relapse, and emotional behaviors like irritability and anhedonia. We examined THC withdrawal-induced changes in striatal DA release and the extent to which sleep disruption and behavioral maladaptation manifest during abstinence in a mouse model of chronic THC exposure. Using a THC treatment regimen known to produce tolerance, we measured electrically elicited DA release in acute brain slices from different striatal subregions during early and late THC abstinence. Long-term polysomnographic recordings from mice were used to assess vigilance state and sleep architecture before, during, and after THC treatment. We additionally assessed how behaviors that model human withdrawal symptoms are altered by chronic THC treatment in early and late abstinence. We detected altered striatal DA release, sleep disturbances that mimic clinical observations, and behavioral maladaptation in mice following tolerance to THC. Altered striatal DA release, sleep, and affect-related behaviors associated with spontaneous THC abstinence were more consistently observed in male mice. These findings provide a foundation for preclinical study of directly translatable non-precipitated THC withdrawal symptoms and the neural mechanisms that affect them.
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Affiliation(s)
- Andrew J. Kesner
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA ,grid.94365.3d0000 0001 2297 5165Center on Compulsive Behaviors, Intramural Research Program, NIH, Bethesda, MD USA
| | - Yolanda Mateo
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
| | - Karina P. Abrahao
- grid.411249.b0000 0001 0514 7202Departamento de Psicobiologia, Universidade Federal de São Paulo, Campus São Paulo, São Paulo, SP Brazil
| | - Stephanie Ramos-Maciel
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
| | | | - Alexa L. Gracias
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
| | - Riley T. Paulsen
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
| | - Hartley B. Carlson
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
| | - David M. Lovinger
- grid.94365.3d0000 0001 2297 5165National Institute on Alcohol Abuse and Alcoholism, Intramural Research Program, NIH, Bethesda, MD USA
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Differences in Inhibitory Control and Resting Brain Metabolism between Older Chronic Users of Tetrahydrocannabinol (THC) or Cannabidiol (CBD)—A Pilot Study. Brain Sci 2022; 12:brainsci12070819. [PMID: 35884627 PMCID: PMC9312972 DOI: 10.3390/brainsci12070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Δ9-Tetrahydrocannabinol is the main psychoactive component of cannabis and cannabidiol is purportedly responsible for many of the medicinal benefits. The effects of Δ9-tetrahydrocannabinol and cannabidiol in younger populations have been well studied; however, motor function, cognitive function, and cerebral glucose metabolism in older adults have not been extensively researched. The purpose of this study was to assess differences in cognitive function, motor function, and cerebral glucose metabolism (assessed via [18F]-fluorodeoxyglucose positron emission tomography) in older adults chronically using Δ9-tetrahydrocannabinol, cannabidiol, and non-using controls. Eight Δ9-tetrahydrocannabinol users (59.3 ± 5.7 years), five cannabidiol users (54.6 ± 2.1 years), and 16 non-users (58.2 ± 16.9 years) participated. Subjects underwent resting scans and performed cognitive testing (reaction time, Flanker Inhibitory Control and Attention Test), motor testing (hand/arm function, gait), and balance testing. Δ9-tetrahydrocannabinol users performed worse than both cannabidiol users and non-users on the Flanker Test but were similar on all other cognitive and motor tasks. Δ9-tetrahydrocannabinol users also had lower global metabolism and relative hypermetabolism in the bilateral amygdala, cerebellum, and brainstem. Chronic use of Δ9-tetrahydrocannabinol in older adults might negatively influence inhibitory control and alter brain activity. Future longitudinal studies with larger sample sizes investigating multiple Δ9-tetrahydrocannabinol:cannabidiol ratios on functional outcomes and cerebral glucose metabolism in older adults are necessary.
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Augustin SM, Lovinger DM. Synaptic changes induced by cannabinoid drugs and cannabis use disorder. Neurobiol Dis 2022; 167:105670. [DOI: 10.1016/j.nbd.2022.105670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022] Open
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Ahlers J, Baumgartner C, Augsburger M, Wenger A, Malischnig D, Boumparis N, Berger T, Stark L, Ebert DD, Haug S, Schaub MP. Cannabis Use in Adults Who Screen Positive for Attention Deficit/Hyperactivity Disorder: CANreduce 2.0 Randomized Controlled Trial Subgroup Analysis. J Med Internet Res 2022; 24:e30138. [PMID: 35442196 PMCID: PMC9069287 DOI: 10.2196/30138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/25/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy. Objective We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not. Methods We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety. Results Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, P<.001; without: mean 8.53, SD 9.4, P<.001) and severity of cannabis use (SDS: with: mean 3.57, SD 3.65, P<.001; without: mean 2.47, SD 3.39, P<.001; CUDIT: with: mean 6.38, SD 5.96, P<.001; without: mean 5.33, SD 6.05, P<.001), as well as anxiety (with: mean 4.31, SD 4.71, P<.001; without: mean 1.84, SD 4.22, P<.001) and depression (with: mean 10.25, SD 10.54; without: mean 4.39, SD 10.22, P<.001). Those who screened positive for attention deficit/hyperactivity disorder also reported significantly decreased attention deficit/hyperactivity disorder scores (mean 4.65, SD 4.44, P<.001). There were no significant differences in change in use (P=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=−0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=−0.09; P=.43). The same was true for the rate of adverse effects (P=.33). Conclusions Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program’s advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185
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Affiliation(s)
- Joachim Ahlers
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Christian Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Mareike Augsburger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Doris Malischnig
- Institute for Addiction Prevention, Office of Addiction and Drug Policy of Vienna, Vienna, Austria
| | - Nikolaos Boumparis
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lars Stark
- Arud Centre for Addiction Medicine, Zurich, Switzerland
| | - David D Ebert
- Clinical Department for Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
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Soto-Montenegro ML, García-Vázquez V, Lamanna-Rama N, López-Montoya G, Desco M, Ambrosio E. Neuroimaging reveals distinct brain glucose metabolism patterns associated with morphine consumption in Lewis and Fischer 344 rat strains. Sci Rep 2022; 12:4643. [PMID: 35301397 PMCID: PMC8931060 DOI: 10.1038/s41598-022-08698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/08/2022] [Indexed: 11/14/2022] Open
Abstract
Vulnerability to addiction may be given by the individual's risk of developing an addiction during their lifetime. A challenge in the neurobiology of drug addiction is understanding why some people become addicted to drugs. Here, we used positron emission tomography (PET) and statistical parametric mapping (SPM) to evaluate changes in brain glucose metabolism in response to chronic morphine self-administration (MSA) in two rat strains with different vulnerability to drug abuse, Lewis (LEW) and Fischer 344 (F344). Four groups of animals were trained to self-administer morphine or saline for 15 days. 2-deoxy-2-[18F]-fluoro-d-glucose (FDG)-PET studies were performed on the last day of MSA (acquisition phase) and after 15 days of withdrawal. PET data were analyzed using SPM12. LEW-animals self-administered more morphine injections per session than F344-animals. We found significant brain metabolic differences between LEW and F344 strains in the cortex, hypothalamus, brainstem, and cerebellum. In addition, the different brain metabolic patterns observed after the MSA study between these rat strains indicate differences in the efficiency of neural substrates to translate the drug effects, which could explain the differences in predisposition to morphine abuse between one individual and another. These findings have important implications for the use of these rat strains in translational morphine and opiate research.
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Affiliation(s)
- Mª Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. .,CIBER de Salud Mental (CIBERSAM), Madrid, Spain. .,Laboratorio de Imagen, Medicina Experimental, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | | | - Nicolás Lamanna-Rama
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Departamento de Bioingeniería E Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Gonzalo López-Montoya
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Departamento de Psicobiología, Facultad de Psicología, Universidad de Educación Nacional a Distancia (UNED), 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, Madrid, Spain. .,Centro Nacional de Investigaciones Cardiovasculares, CNIC, Madrid, Spain. .,Laboratorio de Imagen, Medicina Experimental, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | - Emilio Ambrosio
- Departamento de Psicobiología, Facultad de Psicología, Universidad de Educación Nacional a Distancia (UNED), Madrid, Spain. .,Laboratorio de Imagen, Medicina Experimental, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain.
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van Hooijdonk CF, Drukker M, van de Giessen E, Booij J, Selten JP, van Amelsvoort TA. Dopaminergic alterations in populations at increased risk for psychosis: a systematic review of imaging findings. Prog Neurobiol 2022; 213:102265. [DOI: 10.1016/j.pneurobio.2022.102265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
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D3 Receptors and PET Imaging. Curr Top Behav Neurosci 2022; 60:251-275. [PMID: 35711027 DOI: 10.1007/7854_2022_374] [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: 01/05/2023]
Abstract
This chapter encapsulates a short introduction to positron emission tomography (PET) imaging and the information gained by using this technology to detect changes of the dopamine 3 receptor (D3R) at the molecular level in vivo. We will discuss available D3R radiotracers, emphasizing [11C]PHNO. The focus, however, will be on PET findings in conditions including substance abuse, obesity, traumatic brain injury, schizophrenia, Parkinson's disease, and aging. Finally, there is a discussion about progress in producing next-generation selective D3R radiotracers.
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Abstract
BACKGROUND Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing. AIMS We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine. METHODS This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis RESULTS: There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC. CONCLUSIONS There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.
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Shokri-Kojori E, Naganawa M, Ramchandani VA, Wong DF, Wang GJ, Volkow ND. Brain opioid segments and striatal patterns of dopamine release induced by naloxone and morphine. Hum Brain Mapp 2021; 43:1419-1430. [PMID: 34873784 PMCID: PMC8837588 DOI: 10.1002/hbm.25733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
Opioid receptors are expressed throughout the brain and play a major role in regulating striatal dopamine (DA) release. Clinical studies have shown that naloxone (NAL, a nonspecific opioid antagonist) in individuals with opioid use disorder and morphine (MRP, a nonspecific opioid agonist) in healthy controls, resulted in DA release in the dorsal and ventral striatum, respectively. It is not known whether the underlying patterns of striatal DA release are associated with the striatal distribution of opioid receptors. We leveraged previously published PET datasets (collected in independent cohorts) to study the brain‐wide distribution of opioid receptors and to compare striatal opioid receptor availability with striatal DA release patterns. We identified three major gray matter segments based on availability maps of DA and opioid receptors: striatum, and primary and secondary opioid segments with high and intermediate opioid receptor availability, respectively. Patterns of DA release induced by NAL and MRP were inversely associated and correlated with kappa (NAL: r(68) = −0.81, MRP: r(68) = 0.54), and mu (NAL: r(68) = −0.62, MRP: r(68) = 0.46) opioid receptor availability. Kappa opioid receptor availability accounted for a unique part of variance in NAL‐ and MRP‐DA release patterns (ΔR2 >0.14, p <.0001). In sum, distributions of opioid receptors distinguished major cortical and subcortical regions. Patterns of NAL‐ and MRP‐induced DA release had inverse associations with striatal opioid receptor availability. Our approach provides a pattern‐based characterization of drug‐induced DA targets and is relevant for modeling the role of opioid receptors in modulating striatal DA release.
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Affiliation(s)
- Ehsan Shokri-Kojori
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Mika Naganawa
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Vijay A Ramchandani
- Human Psychopharmacology Laboratory, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Dean F Wong
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
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Datta S, Ramamurthy PC, Anand U, Singh S, Singh A, Dhanjal DS, Dhaka V, Kumar S, Kapoor D, Nandy S, Kumar M, Koshy EP, Dey A, Proćków J, Singh J. Wonder or evil?: Multifaceted health hazards and health benefits of Cannabis sativa and its phytochemicals. Saudi J Biol Sci 2021; 28:7290-7313. [PMID: 34867033 PMCID: PMC8626265 DOI: 10.1016/j.sjbs.2021.08.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
Cannabis sativa, widely known as 'Marijuana' poses a dilemma for being a blend of both good and bad medicinal effects. The historical use of Cannabis for both medicinal and recreational purposes suggests it to be a friendly plant. However, whether the misuse of Cannabis and the cannabinoids derived from it can hamper normal body physiology is a focus of ongoing research. On the one hand, there is enough evidence to suggest that misuse of marijuana can cause deleterious effects on various organs like the lungs, immune system, cardiovascular system, etc. and also influence fertility and cause teratogenic effects. However, on the other hand, marijuana has been found to offer a magical cure for anorexia, chronic pain, muscle spasticity, nausea, and disturbed sleep. Indeed, most recently, the United Nations has given its verdict in favour of Cannabis declaring it as a non-dangerous narcotic. This review provides insights into the various health effects of Cannabis and its specialized metabolites and indicates how wise steps can be taken to promote good use and prevent misuse of the metabolites derived from this plant.
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Affiliation(s)
- Shivika Datta
- Department of Zoology, Doaba College, Jalandhar, Punjab 144001, India
| | - Praveen C. Ramamurthy
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Uttpal Anand
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Simranjeet Singh
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Amritpal Singh
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College and Hospital, Amphala, Jammu 180012, India
| | - Daljeet Singh Dhanjal
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Vaishali Dhaka
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sanjay Kumar
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Miyagi 980-8577, Japan
| | - Dhriti Kapoor
- Department of Botany, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Samapika Nandy
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Manoj Kumar
- Department of Life Sciences, School of Natural Science, Central University of Jharkhand, Brambe, Ratu-Lohardaga Road Ranchi, Jharkhand 835205, India
| | - Eapen P. Koshy
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Kożuchowska 5b, 51-631 Wrocław, Poland
| | - Joginder Singh
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
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Calakos KC, Liu H, Lu Y, Anderson JM, Matuskey D, Nabulsi N, Ye Y, Skosnik PD, D'Souza DC, Morris ED, Cosgrove KP, Hillmer AT. Assessment of transient dopamine responses to smoked cannabis. Drug Alcohol Depend 2021; 227:108920. [PMID: 34399137 PMCID: PMC8464527 DOI: 10.1016/j.drugalcdep.2021.108920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/14/2021] [Accepted: 06/08/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Dopaminergic mechanisms that may underlie cannabis' reinforcing effects are not well elucidated in humans. This positron emission tomography (PET) imaging study used the dopamine D2/3 receptor antagonist [11C]raclopride and kinetic modelling testing for transient changes in radiotracer uptake to assess the striatal dopamine response to smoked cannabis in a preliminary sample. METHODS PET emission data were acquired from regular cannabis users (n = 14; 7 M/7 F; 19-32 years old) over 90 min immediately after [11C]raclopride administration (584 ± 95 MBq) as bolus followed by constant infusion (Kbol = 105 min). Participants smoked a cannabis cigarette, using a paced puff protocol, 35 min after scan start. Plasma concentrations of Δ9-THC and metabolites and ratings of subjective "high" were collected during imaging. Striatal dopamine responses were assessed voxelwise with a kinetic model testing for transient reductions in [11C]raclopride binding, linear-parametric neurotransmitter PET (lp-ntPET) (cerebellum as a reference region). RESULTS Cannabis smoking increased plasma Δ9-THC levels (peak: 0-10 min) and subjective high (peak: 0-30 min). Significant clusters (>16 voxels) modeled by transient reductions in [11C]raclopride binding were identified for all 12 analyzed scans. In total, 26 clusters of significant responses to cannabis were detected, of which 16 were located in the ventral striatum, including at least one ventral striatum cluster in 11 of the 12 analyzed scans. CONCLUSIONS These preliminary data support the sensitivity of [11C]raclopride PET with analysis of transient changes in radiotracer uptake to detect cannabis smoking-induced dopamine responses. This approach shows future promise to further elucidate roles of mesolimbic dopaminergic signaling in chronic cannabis use. ClinicalTrials.gov Identifier: NCT02817698.
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Affiliation(s)
- Katina C Calakos
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, 333 Cedar Street, New Haven, CT, 06510, United States.
| | - Heather Liu
- Department of Biomedical Engineering, Yale University, 17 Hillhouse Avenue, New Haven, CT, 06511, United States.
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States.
| | - Jon Mikael Anderson
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States.
| | - David Matuskey
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States; Department of Neurology, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06519, United States.
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States.
| | - Yunpeng Ye
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States.
| | - Patrick D Skosnik
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519, United States.
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519, United States.
| | - Evan D Morris
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, 333 Cedar Street, New Haven, CT, 06510, United States; Department of Biomedical Engineering, Yale University, 17 Hillhouse Avenue, New Haven, CT, 06511, United States; Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States.
| | - Kelly P Cosgrove
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, 333 Cedar Street, New Haven, CT, 06510, United States; Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Department of Neuroscience, Yale University, 333 Cedar Street, New Haven, CT, 06510, United States.
| | - Ansel T Hillmer
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, United States; Department of Biomedical Engineering, Yale University, 17 Hillhouse Avenue, New Haven, CT, 06511, United States; Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06519, United States; Yale PET Center, Yale University, 801 Howard Avenue, New Haven, CT, 06510, United States.
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Mecca CM, Chao D, Yu G, Feng Y, Segel I, Zhang Z, Rodriguez-Garcia DM, Pawela CP, Hillard CJ, Hogan QH, Pan B. Dynamic Change of Endocannabinoid Signaling in the Medial Prefrontal Cortex Controls the Development of Depression After Neuropathic Pain. J Neurosci 2021; 41:7492-7508. [PMID: 34244365 PMCID: PMC8412994 DOI: 10.1523/jneurosci.3135-20.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 01/15/2023] Open
Abstract
Many patients with chronic pain conditions suffer from depression. The mechanisms underlying pain-induced depression are still unclear. There are critical links of medial prefrontal cortex (mPFC) synaptic function to depression, with signaling through the endocannabinoid (eCB) system as an important contributor. We hypothesized that afferent noxious inputs after injury compromise activity-dependent eCB signaling in the mPFC, resulting in depression. Depression-like behaviors were tested in male and female rats with traumatic neuropathy [spared nerve injury (SNI)], and neuronal activity in the mPFC was monitored using the immediate early gene c-fos and in vivo electrophysiological recordings. mPFC eCB Concentrations were determined using mass spectrometry, and behavioral and electrophysiological experiments were used to evaluate the role of alterations in eCB signaling in depression after pain. SNI-induced pain induced the development of depression phenotypes in both male and female rats. Pyramidal neurons in mPFC showed increased excitability followed by reduced excitability in the onset and prolonged phases of pain, respectively. Concentrations of the eCBs, 2-arachidonoylglycerol (2-AG) in the mPFC, were elevated initially after SNI, and our results indicate that this resulted in a loss of CB1R function on GABAergic interneurons in the mPFC. These data suggest that excessive release of 2-AG as a result of noxious stimuli triggers use-dependent loss of function of eCB signaling leading to excessive GABA release in the mPFC, with the final result being behavioral depression.SIGNIFICANCE STATEMENT Pain has both somatosensory and affective components, so the complexity of mechanisms underlying chronic pain is best represented by a biopsychosocial model that includes widespread CNS dysfunction. Many patients with chronic pain conditions develop depression. The mechanism by which pain causes depression is unclear. Although manipulation of the eCB signaling system as an avenue for providing analgesia per se has not shown much promise in previous studies. An important limitation of past research has been inadequate consideration of the dynamic nature of the connection between pain and depression as they develop. Here, we show that activity-dependent synthesis of eCBs during the initial onset of persistent pain is the critical link leading to depression when pain is persistent.
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Affiliation(s)
- Christina M Mecca
- Departments of Anesthesiology
- Cell Biology, Neurobiology, and Anatomy
| | | | | | | | | | | | | | - Christopher P Pawela
- Departments of Anesthesiology
- Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Cecilia J Hillard
- Pharmacology and Toxicology
- Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Quinn H Hogan
- Departments of Anesthesiology
- Cell Biology, Neurobiology, and Anatomy
- Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Bin Pan
- Departments of Anesthesiology
- Cell Biology, Neurobiology, and Anatomy
- Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
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36
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Pocuca N, Walter TJ, Minassian A, Young JW, Geyer MA, Perry W. The Effects of Cannabis Use on Cognitive Function in Healthy Aging: A Systematic Scoping Review. Arch Clin Neuropsychol 2021; 36:673-685. [PMID: 33159510 DOI: 10.1093/arclin/acaa105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Older adults (≥50 years) represent the fastest-growing population of people who use cannabis, potentially due to the increasing promotion of cannabis as medicine by dispensaries and cannabis websites. Given healthy aging and cannabis use are both associated with cognitive decline, it is important to establish the effects of cannabis on cognition in healthy aging. OBJECTIVE This systematic scoping review used preferred reporting items for systematic reviews and meta-analyses guidelines to critically examine the extent of literature on this topic and highlight areas for future research. METHOD A search of six databases (PubMed, EMBASE, PsycINFO, Web of Science, Family and Society Studies Worldwide, and CINAHL) for articles published by September 2019, yielded 1,014 unique results. RESULTS Six articles reported findings for older populations (three human and three rodent studies), highlighting the paucity of research in this area. Human studies revealed largely null results, likely due to several methodological limitations. Better-controlled rodent studies indicate that the relationship between ∆9-tetrahydrocannabinol (THC) and cognitive function in healthy aging depends on age and level of THC exposure. Extremely low doses of THC improved cognition in very old rodents. Somewhat higher chronic doses improved cognition in moderately aged rodents. No studies examined the effects of cannabidiol (CBD) or high-CBD cannabis on cognition. CONCLUSIONS This systematic scoping review provides crucial, timely direction for future research on this emerging issue. Future research that combines neuroimaging and cognitive assessment would serve to advance understanding of the effects of age and quantity of THC and CBD on cognition in healthy aging.
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Affiliation(s)
- Nina Pocuca
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - T Jordan Walter
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Center for Stress and Mental Health, Veteran's Administration San Diego Hospital, San Diego, CA, USA
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - William Perry
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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37
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Zhang R, Manza P, Tomasi D, Kim SW, Shokri-Kojori E, Demiral SB, Kroll DS, Feldman DE, McPherson KL, Biesecker CL, Wang GJ, Volkow ND. Dopamine D1 and D2 receptors are distinctly associated with rest-activity rhythms and drug reward. J Clin Invest 2021; 131:e149722. [PMID: 34264865 DOI: 10.1172/jci149722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Certain components of rest-activity rhythms such as greater eveningness (delayed phase), physical inactivity (blunted amplitude) and shift work (irregularity) are associated with increased risk for drug use. Dopaminergic (DA) signaling has been hypothesized to mediate the associations, though clinical evidence is lacking. METHODS We examined associations between rhythm components and striatal D1 (D1R) and D2/3 receptor (D2/3R) availability in 32 healthy adults (12 female, age: 42.40±12.22) and its relationship to drug reward. Rest-activity rhythms were assessed by one-week actigraphy combined with self-reports. [11C]NNC112 and [11C]raclopride Positron Emission Tomography (PET) scans were conducted to measure D1R and D2/3R availability, respectively. Additionally, self-reported drug-rewarding effects of 60 mg oral methylphenidate were assessed. RESULTS We found that delayed rhythm was associated with higher D1R availability in caudate, which was not attributable to sleep loss or 'social jet lag', whereas physical inactivity was associated with higher D2/3R availability in nucleus accumbens (NAc). Delayed rest-activity rhythm, higher caudate D1R and NAc D2/3R availability were associated with greater sensitivity to the rewarding effects of methylphenidate. CONCLUSION These findings reveal specific components of rest-activity rhythms associated with striatal D1R, D2/3R availability and drug-rewarding effects. Personalized interventions that target rest-activity rhythms may help prevent and treat substance use disorders. TRIAL REGISTRATION ClinicalTrials.gov: NCT03190954FUNDING. This work was accomplished with support from the National Institute on Alcohol Abuse and Alcoholism (ZIAAA000550).
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Affiliation(s)
- Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Sung Won Kim
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Ehsan Shokri-Kojori
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Sukru B Demiral
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Danielle S Kroll
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Dana E Feldman
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Katherine L McPherson
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Catherine L Biesecker
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Nora D Volkow
- National Institute on Drug Abuse, NIH, Bethesda, United States of America
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38
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Evidence Lacking for Cannabis Users Slacking: A Longitudinal Analysis of Escalating Cannabis Use and Motivation among Adolescents. J Int Neuropsychol Soc 2021; 27:637-647. [PMID: 34261556 PMCID: PMC8289119 DOI: 10.1017/s135561772000096x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Reduced motivation is often noted as a consequence of cannabis use. However, previous work has yielded mixed results and focused largely on adults. To address these limitations, this study examined longitudinal associations between cannabis use and self-reported motivation in a large adolescent sample. METHOD Participants were 401 adolescents aged 14-17 at baseline who completed five bi-annual assessments. We assessed motivation at three timepoints using two self-report questionnaires: the Apathy Evaluation Scale and the Motivation and Engagement Scale (disengagement, persistence, planning, self-efficacy, and valuing school subscales). Controlling for relevant covariates, we used latent growth curve modeling to characterize patterns of cannabis use and motivation over time, examining bidirectional influences between these processes. RESULTS On average, adolescent cannabis use frequency increased significantly over time. The disengagement and planning facets of motivation also increased significantly over time, whereas other aspects of motivation remained stable. At baseline, greater cannabis use was associated with greater disengagement, lower planning, and lower valuing of school. Greater baseline cannabis use also predicted lesser increases in disengagement over time. After controlling for the effect of sex, age, depression, and use of alcohol and nicotine, only the baseline association between cannabis use and valuing school remained significant. CONCLUSIONS Our results do not support a prospective link between cannabis use and reduced motivation among adolescents. Although most observed associations were accounted for by covariates, greater cannabis use was cross-sectionally associated with lower perceived value of school, which may contribute to poorer educational and later life outcomes.
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Kesner AJ, Lovinger DM. Cannabis use, abuse, and withdrawal: Cannabinergic mechanisms, clinical, and preclinical findings. J Neurochem 2021; 157:1674-1696. [PMID: 33891706 PMCID: PMC9291571 DOI: 10.1111/jnc.15369] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
Cannabis sativa is the most widely used illicit drug in the world. Its main psychoactive component is delta‐9‐tetrahydrocannabinol (THC), one of over 100 phytocannabinoid compounds produced by the cannabis plant. THC is the primary compound that drives cannabis abuse potential and is also used and prescribed medically for therapeutic qualities. Despite its therapeutic potential, a significant subpopulation of frequent cannabis or THC users will develop a drug use syndrome termed cannabis use disorder. Individuals suffering from cannabis use disorder exhibit many of the hallmarks of classical addictions including cravings, tolerance, and withdrawal symptoms. Currently, there are no efficacious treatments for cannabis use disorder or withdrawal symptoms. This makes both clinical and preclinical research on the neurobiological mechanisms of these syndromes ever more pertinent. Indeed, basic research using animal models has provided valuable evidence of the neural molecular and cellular actions of cannabis that mediate its behavioral effects. One of the main components being central action on the cannabinoid type‐one receptor and downstream intracellular signaling related to the endogenous cannabinoid system. Back‐translational studies have provided insight linking preclinical basic and behavioral biology research to better understand symptoms observed at the clinical level. This narrative review aims to summarize major research elucidating the molecular, cellular, and behavioral manifestations of cannabis/THC use that play a role in cannabis use disorder and withdrawal.
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Affiliation(s)
- Andrew J Kesner
- Laboratory for Integrative Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD, USA
| | - David M Lovinger
- Laboratory for Integrative Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD, USA
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40
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Hoffman AF, Hwang EK, Lupica CR. Impairment of Synaptic Plasticity by Cannabis, Δ 9-THC, and Synthetic Cannabinoids. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a039743. [PMID: 32341064 PMCID: PMC8091957 DOI: 10.1101/cshperspect.a039743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The ability of neurons to dynamically and flexibly encode synaptic inputs via short- and long-term plasticity is critical to an organism's ability to learn and adapt to the environment. Whereas synaptic plasticity may be encoded by pre- or postsynaptic mechanisms, current evidence suggests that optimization of learning requires both forms of plasticity. Endogenous cannabinoids (eCBs) play critical roles in modulating synaptic transmission via activation of cannabinoid CB1 receptors (CB1Rs) in many central nervous system (CNS) regions, and the eCB system has been implicated, either directly or indirectly, in several forms of synaptic plasticity. Because of this, perturbations within the eCB signaling system can lead to impairments in a variety of learned behaviors. One agent of altered eCB signaling is exposure to "exogenous cannabinoids" such as the primary psychoactive constituent of cannabis, Δ9-THC, or illicit synthetic cannabinoids that in many cases have higher potency and efficacy than Δ9-THC. Thus, by targeting the eCB system, these agonists can produce widespread impairment of synaptic plasticity by disrupting ongoing eCB function. Here, we review studies in which Δ9-THC and synthetic cannabinoids impair synaptic plasticity in a variety of neuronal circuits and examine evidence that this contributes to their well-documented ability to disrupt cognition and behavior.
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Affiliation(s)
- Alexander F Hoffman
- Electrophysiology Research Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA
| | - Eun-Kyung Hwang
- Electrophysiology Research Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA
| | - Carl R Lupica
- Electrophysiology Research Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland 21224, USA
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Does Cannabis, Cocaine and Alcohol Use Impact Differently on Adult Attention Deficit/Hyperactivity Disorder Clinical Picture? J Clin Med 2021; 10:jcm10071481. [PMID: 33918432 PMCID: PMC8038274 DOI: 10.3390/jcm10071481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
While the association between adult Attention Deficit/Hyperactivity Disorder (A-ADHD) and Substance Use Disorders (SUDs) has been widely explored, less attention has been dedicated to the various substance use variants. In a previous paper, we identified two variants: type 1 (use of stimulants/alcohol) and type 2 (use of cannabinoids). In this study, we compared demographic, clinical and symptomatologic features between Dual Disorder A-ADHD (DD/A-ADHD) patients according to our substance use typology, and A-ADHD without DD (NDD/A-ADHD) ones. NDD patients were more frequently diagnosed as belonging to inattentive ADHD subtype compared with type 1 DD/A-ADHD patients, but not with respect to type 2 DD/ADHD. NDD/A-ADHD patients showed less severe symptoms of hyperactivity/impulsivity than DD/A-ADHD type 1, but not type 2. Type 1 and type 2 patients shared the feature of displaying higher impulsiveness than NDD/A-ADHD ones. General psychopathology scores were more severe in type 2 DD/ADHD patients, whereas type 1 patients showed greater similarity to NDD/A-ADHD. Legal problems were more strongly represented in type 1 than in type 2 patients or NDD/A-ADHD ones. Our results suggest that type 1 and type 2 substance use differ in their effects on A-ADHD patients-an outcome that brings with it different likely implications in dealing with the diagnostic and therapeutic processes.
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Blum K, Khalsa J, Cadet JL, Baron D, Bowirrat A, Boyett B, Lott L, Brewer R, Gondré-Lewis M, Bunt G, Kazmi S, Gold MS. Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis. Front Psychiatry 2021; 12:623403. [PMID: 33868044 PMCID: PMC8044913 DOI: 10.3389/fpsyt.2021.623403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/05/2021] [Indexed: 02/01/2023] Open
Abstract
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, United States
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
- Department of Psychiatry, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, United States
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, United States
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - David Baron
- Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Brent Boyett
- Bradford Health Services, Madison, AL, United States
| | - Lisa Lott
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Raymond Brewer
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Marjorie Gondré-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, United States
| | - Gregory Bunt
- Good Samaritan/Day Top Treatment Center, and NYU School of Medicine, New York, NY, United States
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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43
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Rinehart L, Spencer S. Which came first: Cannabis use or deficits in impulse control? Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110066. [PMID: 32795592 PMCID: PMC7750254 DOI: 10.1016/j.pnpbp.2020.110066] [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: 04/30/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/16/2022]
Abstract
Impulse control deficits are often found to co-occur with substance use disorders (SUDs). On the one hand, it is well known that chronic intake of drugs of abuse remodels the brain with significant consequences for a range of cognitive behaviors. On the other hand, individual variation in impulse control may contribute to differences in susceptibility to SUDs. Both of these relationships have been described, thus leading to a "chicken or the egg" debate which remains to be fully resolved. Does impulsivity precede drug use or does it manifest as a function of problematic drug usage? The link between impulsivity and SUDs has been most strongly established for cocaine and alcohol use disorders using both preclinical models and clinical data. Much less is known about the potential link between impulsivity and cannabis use disorder (CUD) or the directionality of this relationship. The initiation of cannabis use occurs most often during adolescence prior to the brain's maturation, which is recognized as a critical period of development. The long-term effects of chronic cannabis use on the brain and behavior have started to be explored. In this review we will summarize these observations, especially as they pertain to the relationship between impulsivity and CUD, from both a psychological and biological perspective. We will discuss impulsivity as a multi-dimensional construct and attempt to reconcile the results obtained across modalities. Finally, we will discuss possible avenues for future research with emerging longitudinal data.
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Affiliation(s)
- Linda Rinehart
- University of Minnesota, Department of Psychiatry and Behavioral Sciences
| | - Sade Spencer
- University of Minnesota, Department of Pharmacology, Minneapolis, MN, USA.
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44
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Abstract
Cannabis use disorder (CUD) is an underappreciated risk of using cannabis that affects ~10% of the 193 million cannabis users worldwide. The individual and public health burdens are less than those of other forms of drug use, but CUD accounts for a substantial proportion of persons seeking treatment for drug use disorders owing to the high global prevalence of cannabis use. Cognitive behavioural therapy, motivational enhancement therapy and contingency management can substantially reduce cannabis use and cannabis-related problems, but enduring abstinence is not a common outcome. No pharmacotherapies have been approved for cannabis use or CUD, although a number of drug classes (such as cannabinoid agonists) have shown promise and require more rigorous evaluation. Treatment of cannabis use and CUD is often complicated by comorbid mental health and other substance use disorders. The legalization of non-medical cannabis use in some high-income countries may increase the prevalence of CUD by making more potent cannabis products more readily available at a lower price. States that legalize medical and non-medical cannabis use should inform users about the risks of CUD and provide information on how to obtain assistance if they develop cannabis-related mental and/or physical health problems.
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45
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Blum K, Cadet JL, Gold MS. Psychostimulant use disorder emphasizing methamphetamine and the opioid -dopamine connection: Digging out of a hypodopaminergic ditch. J Neurol Sci 2021; 420:117252. [PMID: 33279726 DOI: 10.1016/j.jns.2020.117252] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Approved food and drug administration (FDA) medications to treat Psychostimulant Use Disorder (PUD) are needed. Both acute and chronic neurological deficits related to the neurophysiological effects of these powerfully addictive drugs can cause stroke and alterations in mood and cognition. OBJECTIVE This article presents a brief review of the psychiatric and neurobiological sequelae of methamphetamine use disorder, some known neurogenetic associations impacted by psychostimulants, and explores treatment modalities and outcomes. HYPOTHESIS The authors propose that gentle D2 receptor stimulation accomplished via some treatment modalities can induce dopamine release, causing alteration of D2-directed mRNA and thus enhanced function of D2 receptors in the human. This proliferation of D2 receptors, in turn, will induce the attenuation of craving behavior, especially in genetically compromised high-risk populations. DISCUSSION A better understanding of the involvement of molecular neurogenetic opioid, mesolimbic dopamine, and psychostimulant connections in "wanting" supports this hypothesis. While both scientific and, clinical professionals search for an FDA approved treatment for PUD the induction of dopamine homeostasis, via activation of the brain reward circuitry, offers treatment for underlying neurotransmitter functional deficits, potential prophylaxis, and support for recovery efforts. CONCLUSION Dopamine regulation may help people dig out of their hypodopaminergia ditch.
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Affiliation(s)
- Kenneth Blum
- Graduate College, Western University Health Sciences, Pomona, CA, Baltimore, MD, United States of America.
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, United States of America
| | - Mark S Gold
- Department of Psychiatry, Washington University, St Louis, MO, United States of America.
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46
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Vaseghi S, Nasehi M, Zarrindast MR. How do stupendous cannabinoids modulate memory processing via affecting neurotransmitter systems? Neurosci Biobehav Rev 2020; 120:173-221. [PMID: 33171142 DOI: 10.1016/j.neubiorev.2020.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 12/27/2022]
Abstract
In the present study, we wanted to review the role of cannabinoids in learning and memory in animal models, with respect to their interaction effects with six principal neurotransmitters involved in learning and memory including dopamine, glutamate, GABA (γ-aminobutyric acid), serotonin, acetylcholine, and noradrenaline. Cannabinoids induce a wide-range of unpredictable effects on cognitive functions, while their mechanisms are not fully understood. Cannabinoids in different brain regions and in interaction with different neurotransmitters, show diverse responses. Previous findings have shown that cannabinoids agonists and antagonists induce various unpredictable effects such as similar effect, paradoxical effect, or dualistic effect. It should not be forgotten that brain neurotransmitter systems can also play unpredictable roles in mediating cognitive functions. Thus, we aimed to review and discuss the effect of cannabinoids in interaction with neurotransmitters on learning and memory. In addition, we mentioned to the type of interactions between cannabinoids and neurotransmitter systems. We suggested that investigating the type of interactions is a critical neuropharmacological issue that should be considered in future studies.
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Affiliation(s)
- Salar Vaseghi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohammad-Reza Zarrindast
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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47
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The associations of comorbid substance use disorders and psychiatric conditions with adolescent brain structure and function: A review. J Neurol Sci 2020; 418:117099. [DOI: 10.1016/j.jns.2020.117099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 12/30/2022]
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48
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Ramirez V, Wiers CE, Wang GJ, Volkow ND. Personality traits in substance use disorders and obesity when compared to healthy controls. Addiction 2020; 115:2130-2139. [PMID: 32350970 DOI: 10.1111/add.15062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/23/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Although personality traits are implicated in substance use disorders (SUDs) and obesity, differences and similarities between them have not been assessed. Our main aim was to compare personality traits between people with different SUDs, obese people and healthy controls. DESIGN This was a secondary analysis of personality scores obtained from participants in neuroimaging studies from Brookhaven National Laboratory and the Laboratory of Neuroimaging, National Institutes of Health. SETTING United States. PARTICIPANTS/CASES Individuals with obesity (OB) n = 41, alcohol use disorder (AUD) n = 39, marijuana use disorder (MUD) n = 24, cocaine use disorder (CUD) n = 100, and healthy controls (HC) n = 117 (237 males and 84 females). MEASUREMENTS The Multidimensional Personality Questionnaire, which characterizes positive emotionality (PEM), negative emotionality (NEM) and constraint (CON) traits. Adjusted covariates included cigarette smoking status, age, gender and body mass index (BMI). FINDINGS Multivariate analysis of covariance showed a main group effect (i.e. OB, AUD, MUD, CUD and HC) only on NEM (P < 0.0001, η2 = 0.17) and CON (P = 0.005, η2 = 0.12). Specifically, NEM was higher in AUD (P < 0.0001, d = 10.4), CUD (P < 0.0001, d = 8.2) and MUD (P = 0.001, d = 9.2), but not in OB (P > 0.05, d = 2.8) relative to HC. CUD showed lower CON (P = 0.015, d = 5.4) and PEM (P = 0.018, d = 4.8) than HC; however, these differences were not significant in the other groups. NEM and CON were negatively correlated for groups combined (r = -0.26, P < 0.0001), and separately for OB (r = -0.49, P = 0.001) and CUD (r = -0.22, P = 0.03). Cigarette smoking status did not influence group differences in NEM, PEM or CON. CONCLUSIONS Compared with healthy controls, people with substance use disorders appear to show higher negative emotionality, and people with cocaine use disorders appear to show lower positive emotionality and constraint traits. Similar findings were not found among people with obesity.
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Affiliation(s)
- Veronica Ramirez
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, 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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49
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Schifani C, Pruessner J, Tseng H, Rao N, Tagore A, Wilson AA, Houle S, Rusjan PM, Mizrahi R. Stress-induced cortical dopamine response is altered in subjects at clinical high risk for psychosis using cannabis. Addict Biol 2020; 25:e12812. [PMID: 31389139 DOI: 10.1111/adb.12812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/10/2019] [Accepted: 06/26/2019] [Indexed: 01/01/2023]
Abstract
Stress and cannabis use are risk factors for the development of psychosis. We have previously shown that subjects at clinical high risk for psychosis (CHR) exhibit a higher striatal dopamine response to stress compared with healthy volunteers (HV), with chronic cannabis use blunting this response. However, it is unknown if this abnormal dopamine response extends to the prefrontal cortex (PFC). Here, we investigated dorsolateral PFC (dlPFC) and medial PFC (mPFC) dopamine release using [11 C]FLB457 positron emission tomography (PET) and a validated stress task. Thirty-three participants completed two PET scans (14 CHR without cannabis use, eight CHR regular cannabis users [CHR-CUs] and 11 HV) while performing a Sensory Motor Control Task (control scan) and the Montreal Imaging Stress Task (stress scan). Stress-induced dopamine release (ΔBPND ) was defined as percent change in D2/3 receptor binding potential between both scans using a novel correction for injected mass of [11 C]FLB457. ΔBPND was significantly different between groups in mPFC (F(2,30) = 5.40, .010), with CHR-CUs exhibiting lower ΔBPND compared with CHR (.008). Similarly, salivary cortisol response (ΔAUCI ) was significantly lower in CHR-CU compared with CHR (F(2,29) = 5.08, .013; post hoc .018) and positively associated with ΔBPND . Furthermore, CHR-CUs had higher attenuated psychotic symptoms than CHR following the stress task, which were negatively associated with ΔBPND . Length of cannabis use was negatively associated with ΔBPND in mPFC when controlling for current cannabis use. Given the global trend to legalize cannabis, this study is important as it highlights the effects of regular cannabis use on cortical dopamine function in high-risk youth.
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Affiliation(s)
- Christin Schifani
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Jens Pruessner
- Departments of Psychology, Psychiatry, Neurology and Neurosurgery, Douglas Institute McGill University Montreal Quebec Canada
- Department of Psychology University of Constance Constance Germany
| | - Huai‐Hsuan Tseng
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Naren Rao
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Abanti Tagore
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
| | - Alan A. Wilson
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Sylvain Houle
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Pablo M. Rusjan
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Romina Mizrahi
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
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50
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Yoo HB, Moya BE, Filbey FM. Dynamic functional connectivity between nucleus accumbens and the central executive network relates to chronic cannabis use. Hum Brain Mapp 2020; 41:3637-3654. [PMID: 32432821 PMCID: PMC7416060 DOI: 10.1002/hbm.25036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/13/2020] [Accepted: 05/05/2020] [Indexed: 01/05/2023] Open
Abstract
The neural mechanisms of drug cue‐reactivity regarding the temporal fluctuations of functional connectivity, namely the dynamic connectivity, are sparsely studied. Quantifying the task‐modulated variability in dynamic functional connectivity at cue exposure can aid the understanding. We analyzed changes in dynamic connectivity in 54 adult cannabis users and 90 controls during a cannabis cue exposure task. The variability was measured as standard deviation in the (a) connectivity weights of the default mode, the central executive, and the salience networks and two reward loci (amygdalae and nuclei accumbens); and (b) topological indexes of the whole brain (global efficiency, modularity and network resilience). These were compared for the main effects of task conditions and the group (users vs. controls), and correlated with pre‐ and during‐scan subjective craving. The variability of connectivity weights between the central executive network and nuclei accumbens was increased in users throughout the cue exposure task, and, was positively correlated with during‐scan craving for cannabis. The variability of modularity was not different by groups, but positively correlated with prescan craving. The variability of dynamic connectivity during cannabis cue exposure task between the central executive network and the nuclei accumbens, and, the level of modularity, seem to relate to the neural underpinning of cannabis use and the subjective craving.
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Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, TX, USA.,Department of Neurological Surgery, University of Texas Southwestern, Dallas, TX, USA
| | - Blake Edward Moya
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, TX, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, TX, USA
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