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Cooke JT, Schmidt AT, Garos S, Littlefield AK. The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes. Arch Clin Neuropsychol 2023; 38:1068-1081. [PMID: 37001549 DOI: 10.1093/arclin/acad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.
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Affiliation(s)
- Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
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2
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Hodges CB, Steinberg JL, Zuniga EA, Ma L, Bjork JM, Moeller FG. Chronic Cocaine Use and White Matter Coherence: A Diffusion Tensor Imaging Study. J Stud Alcohol Drugs 2023; 84:585-597. [PMID: 36971714 PMCID: PMC10488304 DOI: 10.15288/jsad.21-00410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/09/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Chronic substance use and its effects on brain function and structure has long been of interest to clinicians and researchers. Prior cross-sectional comparisons of diffusion tensor imaging (DTI) metrics have suggested deleterious effects of chronic substance use (i.e., cocaine use) on white matter coherence. However, it is unclear how these effects may replicate across geographic regions when examined with similar technologies. In this study, we sought to conduct a replication of previous work in this area and determine whether there are any patterns of persistent differences in white matter microstructure between individuals with a history of cocaine use disorder (CocUD, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and healthy controls. METHOD A total of 46 participants (21 healthy controls, 25 chronic cocaine users) were recruited from the Richmond, Virginia metropolitan area. Information regarding past and current substance use was collected from all participants. Participants also completed structural and DTI scans. RESULTS Consistent with previous DTI studies, significant differences were found between fractional anisotropy (FA) and axial diffusivity (AD) CocUD and controls, with CocUD showing lower FA and AD in the right inferior and superior longitudinal fasciculus, the genu, body, and splenium of the corpus callosum, and the anterior, posterior, and superior corona radiata, among several other regions. These differences were not significant for other diffusivity metrics. Lifetime alcohol consumption was greater in the CocUD group, but lifetime alcohol consumption did not show a significant linear relationship with any of the DTI metrics in within-group regression analyses. CONCLUSIONS These data align with previously reported declines in white matter coherence in chronic cocaine users. However, it is less clear whether comorbid alcohol consumption results in an additive deleterious effect on white matter microstructure.
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Affiliation(s)
- Cooper B. Hodges
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Joel L. Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
| | - Edward A. Zuniga
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - James M. Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - F. Gerard Moeller
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
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3
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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4
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Hiebler-Ragger M, Perchtold-Stefan CM, Unterrainer HF, Fuchshuber J, Koschutnig K, Nausner L, Kapfhammer HP, Papousek I, Weiss EM, Fink A. Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use: an fMRI study. Brain Imaging Behav 2021; 15:2187-2198. [PMID: 33222012 PMCID: PMC8413209 DOI: 10.1007/s11682-020-00414-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 01/19/2023]
Abstract
Insecure attachment, impaired personality structure and impaired emotion regulation figure prominently in substance use disorders. While negative emotions can trigger drug-use and relapse, cognitive reappraisal may reduce emotional strain by promoting changes in perspective. In the present study, we explored behavioral and neural correlates of cognitive reappraisal in poly-drug use disorder by testing individuals' capability to generate cognitive reappraisals for aversive events (Reappraisal Inventiveness Test). 18 inpatients with poly-drug use disorder and 16 controls completed the Adult Attachment Scale, the Emotion Regulation Questionnaire, the Brief Symptom Inventory, the Wonderlic Personnel Test, and the Operationalized Psychodynamic Diagnosis Structure Questionnaire, as well as two versions of the Reappraisal Inventiveness Test (during fMRI and outside the lab). Compared to controls, polydrug inpatients reported impaired personality structure, attachment and emotion regulation abilities. In the Reappraisal Inventiveness Test, poly-drug inpatients were less flexible and fluent in generating reappraisals for anger-eliciting situations. Corresponding to previous brain imaging evidence, cognitive reappraisal efforts of both groups were reflected in activation of left frontal regions, particularly left superior and middle frontal gyri and left supplemental motor areas. However, no group differences in neural activation patterns emerged. This suggests that despite cognitive reappraisal impairments on a behavioral level, neural reflections of these deficits in poly-drug use disorder might be more complex.
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Affiliation(s)
- M. Hiebler-Ragger
- University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria ,Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Simmeringer Hauptstraße 101, 1110 Vienna, Austria
| | | | - H. F. Unterrainer
- University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria ,Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Simmeringer Hauptstraße 101, 1110 Vienna, Austria ,Department of Religious Studies, University of Vienna, Schenkenstraße 8-10, 1010 Vienna, Austria
| | - J. Fuchshuber
- University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria ,Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Simmeringer Hauptstraße 101, 1110 Vienna, Austria
| | - K. Koschutnig
- Institute of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - L. Nausner
- Fachsektion Integrative Gestalttherapie, Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Vienna, Austria
| | - H. P. Kapfhammer
- University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria ,Department of Medical Psychology and Psychotherapy, Medical University of Graz, Auenbruggerplatz 43, 8036, Graz, Austria
| | - I. Papousek
- Institute of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - E. M. Weiss
- Institute of Psychology, University of Innsbruck, Innrain 52f, 6020 Innsbruck, Austria
| | - A. Fink
- Institute of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
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5
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Alcohol. Alcohol 2021. [DOI: 10.1016/b978-0-12-816793-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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6
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Cardenas-Iniguez C, Moore TM, Kaczkurkin AN, Meyer FAC, Satterthwaite TD, Fair DA, White T, Blok E, Applegate B, Thompson LM, Rosenberg MD, Hedeker D, Berman MG, Lahey BB. Direct and Indirect Associations of Widespread Individual Differences in Brain White Matter Microstructure With Executive Functioning and General and Specific Dimensions of Psychopathology in Children. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 7:362-375. [PMID: 33518499 DOI: 10.1016/j.bpsc.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Executive functions (EFs) are important partly because they are associated with risk for psychopathology and substance use problems. Because EFs have been linked to white matter microstructure, we tested the prediction that fractional anisotropy (FA) and mean diffusivity (MD) in white matter tracts are associated with EFs and dimensions of psychopathology in children younger than the age of widespread psychoactive substance use. METHODS Parent symptom ratings, EF test scores, and diffusion tensor parameters from 8588 9- to 10-year-olds in the ABCD Study (Adolescent Brain Cognitive Development Study) were used. RESULTS A latent factor derived from EF test scores was significantly associated with specific conduct problems and attention-deficit/hyperactivity disorder problems, with dimensions defined in a bifactor model. Furthermore, EFs were associated with FA and MD in 16 of 17 bilateral white matter tracts (range: β = .05; SE = .17; through β = -.31; SE = .06). Neither FA nor MD was directly associated with psychopathology, but there were significant indirect associations via EFs of both FA (range: β = .01; SE = .01; through β = -.09; SE = .02) and MD (range: β = .01; SE = .01; through β = .09; SE = .02) with both specific conduct problems and attention-deficit/hyperactivity disorder in all tracts except the forceps minor. CONCLUSIONS EFs in children are inversely associated with diffusion tensor imaging measures in nearly all tracts throughout the brain. Furthermore, variance in diffusion tensor measures that is shared with EFs is indirectly shared with attention-deficit/hyperactivity disorder and conduct problems.
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Affiliation(s)
- Carlos Cardenas-Iniguez
- Department of Psychology, Division of the Social Sciences, University of Chicago, Chicago, Illinois
| | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Antonia N Kaczkurkin
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee
| | - Francisco A C Meyer
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee
| | - Theodore D Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Damien A Fair
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Tonya White
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elisabet Blok
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Brooks Applegate
- Department of Educational Leadership, Research and Technology, College of Education and Human Development, Western Michigan University, Kalamazoo, Michigan
| | - Lauren M Thompson
- Department of Public Health Sciences, Division of the Biological Sciences, University of Chicago, Chicago, Illinois
| | - Monica D Rosenberg
- Department of Psychology, Division of the Social Sciences, University of Chicago, Chicago, Illinois
| | - Donald Hedeker
- Department of Public Health Sciences, Division of the Biological Sciences, University of Chicago, Chicago, Illinois
| | - Marc G Berman
- Department of Psychology, Division of the Social Sciences, University of Chicago, Chicago, Illinois
| | - Benjamin B Lahey
- Department of Public Health Sciences, Division of the Biological Sciences, University of Chicago, Chicago, Illinois.
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7
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Dahlgren MK, Sagar KA, Smith RT, Lambros AM, Kuppe MK, Gruber SA. Recreational cannabis use impairs driving performance in the absence of acute intoxication. Drug Alcohol Depend 2020; 208:107771. [PMID: 31952821 PMCID: PMC9036916 DOI: 10.1016/j.drugalcdep.2019.107771] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Across the nation, growing numbers of individuals are exploring the use of cannabis for medical or recreational purposes, and the proportion of cannabis-positive drivers involved in fatal crashes increased from 8 percent in 2013 to 17 percent in 2014, raising concerns about the impact of cannabis use on driving. Previous studies have demonstrated that cannabis use is associated with impaired driving performance, but thus far, research has primarily focused on the effects of acute intoxication. METHODS The current study assessed the potential impact of cannabis use on driving performance using a customized driving simulator in non-intoxicated, heavy, recreational cannabis users and healthy controls (HCs) without a history of cannabis use. RESULTS Overall, cannabis users demonstrated impaired driving relative to HC participants with increased accidents, speed, and lateral movement, and reduced rule-following. Interestingly, however, when cannabis users were divided into groups based on age of onset of regular cannabis use, significant driving impairment was detected and completely localized to those with early onset (onset before age 16) relative to the late onset group (onset ≥16 years old). Further, covariate analyses suggest that impulsivity had a significant impact on performance differences. CONCLUSIONS Chronic, heavy, recreational cannabis use was associated with worse driving performance in non-intoxicated drivers, and earlier onset of use was associated with greater impairment. These results may be related to other factors associated with early exposure such as increased impulsivity.
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Affiliation(s)
- M. Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kelly A. Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rosemary T. Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Ashley M. Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Madeline K. Kuppe
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Staci A. Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Corresponding author at: Cognitive and Clinical Neuroimaging Core, McLean Hospital, 115 Mill Street, Belmont, 021478, MA USA. (S.A. Gruber)
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8
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Wade NE, Thomas AM, Gruber SA, Tapert SF, Filbey FM, Lisdahl KM. Binge and Cannabis Co-Use Episodes in Relation to White Matter Integrity in Emerging Adults. Cannabis Cannabinoid Res 2020; 5:62-72. [PMID: 32322677 DOI: 10.1089/can.2018.0062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Growing evidence suggests that cannabis and alcohol (and especially binge alcohol drinking) use independently alters neural structure and functioning, particularly during sensitive developmental time periods (e.g., emerging adulthood). However, few studies have investigated the effects of same-day use of these two substances. Here, white matter (WM) integrity was investigated in relation to binge alcohol drinking, cannabis, and same-day binge and cannabis co-use in adolescents and emerging adults. Methods: FreeSurfer's TRACULA was used to assess WM in emerging adults (n=75; 16-26 years old). Timeline Followback calculated past month cannabis use, binge episodes, and same-day cannabis and binge drinking co-use. Multiple regressions investigated WM by past month cannabis, binge, and co-use. Results: Results revealed co-use episodes were related to lower fractional anisotropy (FA), an overall measure of neuronal integrity, in three tracts (left inferior longitudinal fasciculus [ILF], p=0.02; right anterior thalamic radiation [ATR], p=0.01; and left cingulum cingulate gyrus [CCG], p=0.01); and lower axial diffusivity in left ILF (p=0.03). Cannabis use was significantly related to greater FA in left ILF (p=0.005), left ATR (p=0.02), right ATR (p=0.05), left CCG (p=0.006), right CCG (p=0.03), and right superior longitudinal fasciculus parietal (p=0.03). Binge episodes related to greater FA in right ATR (p=0.03). Conclusions: These findings suggest that co-use was associated with lower WM integrity across frontolimbic tracts. In addition, greater FA was related to greater cannabis use across several tracts and binge alcohol use in one tract. Co-users also appeared to be more severe substance users. Future research should investigate the potential independent and interactive effects of these substances on pre-clinical and clinical levels.
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Affiliation(s)
- Natasha E Wade
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Alicia M Thomas
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Staci A Gruber
- Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Francesca M Filbey
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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9
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Shen Q, Heikkinen N, Kärkkäinen O, Gröhn H, Könönen M, Liu Y, Kaarre O, Zhang Z, Tan C, Tolmunen T, Vanninen R. Effects of long-term adolescent alcohol consumption on white matter integrity and their correlations with metabolic alterations. Psychiatry Res Neuroimaging 2019; 294:111003. [PMID: 31726326 DOI: 10.1016/j.pscychresns.2019.111003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 12/28/2022]
Abstract
Alcohol-related white matter (WM) microstructural changes have not been fully elucidated in adolescents. We aimed to investigate influences of subclinical alcohol use during adolescence on WM microstructure and to characterize those with serum metabolic alterations. 35 moderate-to-heavy drinkers (15 males, 20 females) and 27 controls (12 males, 15 females) were selected based on their ten-year Alcohol Use Disorders Identification Test scores measured at three time points. Magnetic resonance imaging was conducted at endpoint time. Whole brain analysis of fractional anisotropy (FA) was performed. Diffusivity indices in the significant regions were computed for between-group comparisons and correlation analyses with serum metabolite concentrations. Decreased FA was found in moderate-to-heavy drinking men in anterior corpus callosum, superior/anterior corona radiata and right inferior fronto-occipital fasciculus, accompanied by increased radial diffusivity and a smaller area of reduced axial diffusivity, which correlated with serum metabolites playing roles in energy metabolism, myelination and axonal degeneration. No significant difference in FA was detected between female or mixed-gender moderate-to-heavy drinking subjects and controls, supporting gender differences in the relationship between adolescent alcohol use and neurodevelopmental trajectories. Future researches with longitudinal imaging data are warranted for comprehensive evaluation on potentially reversible effects of alcohol use over adolescent brain.
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Affiliation(s)
- Qin Shen
- Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, China; Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Noora Heikkinen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Doctoral Programme of Clinical Research, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Olli Kärkkäinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Finland; School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Heidi Gröhn
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mervi Könönen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Yawu Liu
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Department of Neurology, University of Kuopio, Kuopio, Finland
| | - Outi Kaarre
- Doctoral Programme of Clinical Research, School of Medicine, University of Eastern Finland, Kuopio, Finland; Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Zishu Zhang
- Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Changlian Tan
- Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Tommi Tolmunen
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; Department of Psychiatry, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Radiology, School of Medicine, University of Eastern Finland, Kuopio, Finland.
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10
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Abstract
As an increasing number of states legalize cannabis use for recreational and/or medical purposes, it is increasingly important to understand the neural and cognitive consequences of recreational cannabis use in adolescent consumers. Adolescence is marked by ongoing neuromaturational processes, making this a particularly vulnerable period, particularly regarding exposure to drugs, including cannabis. This review highlights evidence from studies documenting the neural impact of cannabis use in adolescence and explores mediating factors related to cannabis use.
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Affiliation(s)
- Yasmin Mashhoon
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, Mclean Hospital, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Kelly A Sagar
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA
| | - Staci A Gruber
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA; Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA; Marijuana Investigations for Neuroscientific Discovery, McLean Hospital, McLean Imaging Center, 115 Mill Street, Mailstop 204, Belmont, MA 02478, USA.
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11
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Hiebler-Ragger M, Unterrainer HF. The Role of Attachment in Poly-Drug Use Disorder: An Overview of the Literature, Recent Findings and Clinical Implications. Front Psychiatry 2019; 10:579. [PMID: 31507461 PMCID: PMC6720034 DOI: 10.3389/fpsyt.2019.00579] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Substance use disorders (SUDs) represent a worldwide epidemic with extensive costs to the individual and to society. Occasionally described as an attachment disorder, they have been linked to various impairments in self-regulation and social functioning. However, while there have been significant advances in the development and validation of treatment strategies for SUD in recent years, the components of these treatment approaches have yet to be fully explored. The characteristics of polydrug use disorder (PUD) especially need to be addressed in more detail, as this diagnosis is highly common in individuals seeking treatment, while simultaneously being associated with poor treatment success. Aim and Scope: This review aims at further exploring the relevance of attachment in PUD and its treatment. To this end, this review provides a concise summary of relevant theories on the development and treatment of SUD in general, including related parameters of attachment, emotion regulation, and neuroscience. Furthermore, several studies focused specifically on PUD are described in more detail. These studies explored the connections between attachment, personality structure, primary and higher emotions (including spirituality), as well as structural and functional neural parameters in inpatients with PUD as well as in healthy controls. Most notably, the described studies highlight that insecure attachment and impairments in personality structure are present in inpatients with PUD. In addition, these characteristics are paralleled by extensive impairments in white matter integrity, especially in tracts connected to facets of emotion regulation. Conclusions: Based on our findings, we emphasize conceptualization of PUD as an Attachment Disorder, on a behavioral as well as on a neural level. Furthermore, we point out the importance of an integrated bio-psycho-social approach in this research area. Consequently, future studies might more closely focus on the influence of attachment-based interventions on emotion regulation abilities as well as a potentially related neuroplasticity. Neuroplastic changes, which are still rather unexplored, might represent important parameters for the assessment of treatment outcomes especially in long-term SUD treatment.
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Affiliation(s)
- Michaela Hiebler-Ragger
- Department for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
- Center for Integrative Addiction Research (CIAR), Gruener Kreis Society, Vienna, Austria
| | - Human-Friedrich Unterrainer
- Department for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
- Center for Integrative Addiction Research (CIAR), Gruener Kreis Society, Vienna, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
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12
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Abstract
INTRODUCTION The addictive disorder is a multifactorial pathology variable in its manifestations, environmental, developmental, inheritable, neurobiological, and behavioral. METHODS Synthesis of recent data from the literature. RESULTS/DISCUSSION Addiction is a pathology affecting decision-making, the emotional balance, the voluntary control of behaviour, not only in cases of psychoactive products use but also in behavioural dependencies. The social environment, developmental stages, and genetic factors are closely related to the vulnerability to addiction. In this article, after reviewing risk factors and neurobiology data, we will use cannabis, synthetic cannabinoids and cocaine as an example of substance use disorder.
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13
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Unterrainer HF, Hiebler-Ragger M, Koschutnig K, Fuchshuber J, Ragger K, Perchtold CM, Papousek I, Weiss EM, Fink A. Brain Structure Alterations in Poly-Drug Use: Reduced Cortical Thickness and White Matter Impairments in Regions Associated With Affective, Cognitive, and Motor Functions. Front Psychiatry 2019; 10:667. [PMID: 31616326 PMCID: PMC6763614 DOI: 10.3389/fpsyt.2019.00667] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/19/2019] [Indexed: 12/21/2022] Open
Abstract
Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.
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Affiliation(s)
- Human F Unterrainer
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria.,Institute for Religious Studies, University of Vienna, Vienna, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Klemens Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Ilona Papousek
- Institute of Psychology, University of Graz, Graz, Austria
| | | | - Andreas Fink
- Institute of Psychology, University of Graz, Graz, Austria
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14
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Sagar KA, Gruber SA. Marijuana matters: reviewing the impact of marijuana on cognition, brain structure and function, & exploring policy implications and barriers to research. Int Rev Psychiatry 2018; 30:251-267. [PMID: 29966459 PMCID: PMC6455965 DOI: 10.1080/09540261.2018.1460334] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The neurobiologic effects of cannabis, commonly referred to as 'marijuana' (MJ), have been studied for decades. The impact of recreational MJ use on cognition and measures of brain function and structure is outlined, and variables influencing study results are discussed, including age of the consumer, patterns of MJ use, variations in MJ potency, and the presence of additional cannabinoids. Although evidence suggests that chronic, heavy recreational MJ use is related to cognitive decrements and neural changes, particularly when use begins in adolescence, findings from studies of recreational MJ users may not be applicable to medical marijuana (MMJ) patients given differences in demographic variables, product selection, and reasons for use. Although additional research is needed to fully understand the impact of MJ and individual cannabinoids on the brain, current findings are beginning to inform public policy, including considerations for age limits, potential limits for some cannabinoids, and guidelines for use. However, barriers continue to impede researchers' ability to conduct studies that will guide policy change and provide vital information to consumers and patients regarding best practices and safest methods for use. The need for information is critical, as legalization of MJ for medical and recreational use is increasingly widespread.
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Affiliation(s)
- Kelly A. Sagar
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Boston University School of Medicine, 72 E Concord St Boston, MA, 02118
| | - Staci A. Gruber
- McLean Hospital, Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, 115 Mill St, Belmont, MA, 02478,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02115,Corresponding Author Information Address: McLean Hospital, 115 Mill Street, Belmont, MA 02478, Telephone: 617-855-2762, Fax: 617-855-3713,
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15
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Gruber SA, Sagar KA, Dahlgren MK, Gonenc A, Smith RT, Lambros AM, Cabrera KB, Lukas SE. The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment. Front Pharmacol 2018; 8:983. [PMID: 29387010 PMCID: PMC5776082 DOI: 10.3389/fphar.2017.00983] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/22/2017] [Indexed: 11/22/2022] Open
Abstract
The vast majority of states have enacted full or partial medical marijuana (MMJ) programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT) while undergoing functional magnetic resonance imaging (fMRI). We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ) use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it compares to recreational MJ use.
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Affiliation(s)
- Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Mary K Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychology, Tufts University, Medford, MA, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Rosemary T Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Ashley M Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Korine B Cabrera
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Scott E Lukas
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States.,Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
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16
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Clark DB, Chung T, Martin CS, Hasler BP, Fitzgerald DH, Luna B, Brown SA, Tapert SF, Brumback T, Cummins K, Pfefferbaum A, Sullivan EV, Pohl KM, Colrain IM, Baker FC, De Bellis MD, Nooner KB, Nagel BJ. Adolescent Executive Dysfunction in Daily Life: Relationships to Risks, Brain Structure and Substance Use. Front Behav Neurosci 2017; 11:223. [PMID: 29180956 PMCID: PMC5694208 DOI: 10.3389/fnbeh.2017.00223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/24/2017] [Indexed: 01/13/2023] Open
Abstract
During adolescence, problems reflecting cognitive, behavioral and affective dysregulation, such as inattention and emotional dyscontrol, have been observed to be associated with substance use disorder (SUD) risks and outcomes. Prior studies have typically been with small samples, and have typically not included comprehensive measurement of executive dysfunction domains. The relationships of executive dysfunction in daily life with performance based testing of cognitive skills and structural brain characteristics, thought to be the basis for executive functioning, have not been definitively determined. The aims of this study were to determine the relationships between executive dysfunction in daily life, measured by the Behavior Rating Inventory of Executive Function (BRIEF), cognitive skills and structural brain characteristics, and SUD risks, including a global SUD risk indicator, sleep quality, and risky alcohol and cannabis use. In addition to bivariate relationships, multivariate models were tested. The subjects (n = 817; ages 12 through 21) were participants in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The results indicated that executive dysfunction was significantly related to SUD risks, poor sleep quality, risky alcohol use and cannabis use, and was not significantly related to cognitive skills or structural brain characteristics. In multivariate models, the relationship between poor sleep quality and risky substance use was mediated by executive dysfunction. While these cross-sectional relationships need to be further examined in longitudinal analyses, the results suggest that poor sleep quality and executive dysfunction may be viable preventive intervention targets to reduce adolescent substance use.
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Affiliation(s)
- Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tammy Chung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Christopher S Martin
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Douglas H Fitzgerald
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sandra A Brown
- Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Susan F Tapert
- Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Ty Brumback
- Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Kevin Cummins
- Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Adolf Pfefferbaum
- Center for Health Sciences, SRI International, Menlo Park, CA, United States.,Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Kilian M Pohl
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | | | - Kate B Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, United States
| | - Bonnie J Nagel
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
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17
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Unterrainer HF, Hiebler M, Ragger K, Froehlich L, Koschutnig K, Schoeggl H, Kapfhammer HP, Papousek I, Weiss EM, Fink A. White matter integrity in polydrug users in relation to attachment and personality: a controlled diffusion tensor imaging study. Brain Imaging Behav 2017; 10:1096-1107. [PMID: 26542619 DOI: 10.1007/s11682-015-9475-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relationship between substance use disorders (SUD) and brain deficits has been studied extensively. However, there is still a lack of research focusing on the structural neural connectivity in long-term polydrug use disorder (PUD). Since a deficiency in white matter integrity has been reported as being related to various parameters of increased psychopathology, it might be considered an aggravating factor in the treatment of SUD. In this study we compared two groups of PUD inpatients (abstinent: n = 18, in maintenance treatment: n = 15) to healthy controls (n = 16) with respect to neural connectivity in white matter, and their relation to behavioral parameters of personality factors/organization and attachment styles. Diffusion Tensor Imaging was used to investigate white matter structure. Compared with healthy controls, the PUD patients showed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) mainly in the superior fasciculus longitudinalis and the superior corona radiata. These findings suggest diminished neural connectivity as a result of myelin pathology in PUD patients. In line with our assumptions, we observed FA in the biggest cluster as negatively correlated with anxious attachment (r = 0.36, p < 0.05), personality dysfunctioning (r = -0.41; p < 0.01) as well positively correlated with personality factors Openness (r = 0.34; p < 0.05) and Agreeableness (r = 0.28; p < 0.05). Correspondingly these findings were inversely mirrored by RD. Further research employing enhanced samples and addressing longitudinally neuronal plastic effects of SUD treatment in relation to changes in personality and attachment is recommended.
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Affiliation(s)
- H F Unterrainer
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria. .,Center for Integrative Addiction Research (Grüner Kreis Society), Vienna, Austria. .,University Clinic of Psychiatry, Medical University, Graz, Austria. .,Karl-Franzens-University Graz, Universitätsplatz 2, 8010, Graz, Austria.
| | - M Hiebler
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - K Ragger
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - L Froehlich
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - K Koschutnig
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - H Schoeggl
- University Clinic of Psychiatry, Medical University, Graz, Austria
| | - H P Kapfhammer
- University Clinic of Psychiatry, Medical University, Graz, Austria
| | - I Papousek
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - E M Weiss
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
| | - A Fink
- University of Graz, Institute of Psychology, BioTechMed-Graz, Graz, Austria
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18
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Hogue A, Henderson CE, Schmidt AT. Multidimensional Predictors of Treatment Outcome in Usual Care for Adolescent Conduct Problems and Substance Use. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 44:380-394. [PMID: 26884380 PMCID: PMC4987263 DOI: 10.1007/s10488-016-0724-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This study investigated baseline client characteristics that predicted long-term treatment outcomes among adolescents referred from school and community sources and enrolled in usual care for conduct and substance use problems. Predictor effects for multiple demographic (age, sex, race/ethnicity), clinical (baseline symptom severity, comorbidity, family discord), and developmental psychopathology (behavioral dysregulation, depression, peer delinquency) characteristics were examined. Participants were 205 adolescents (52 % male; mean age 15.7 years) from diverse backgrounds (59 % Hispanic American, 21 % African American, 15 % multiracial, 6 % other) residing in a large inner-city area. As expected, characteristics from all three predictor categories were related to various aspects of change in externalizing problems, delinquent acts, and substance use at one-year follow-up. The strongest predictive effect was found for baseline symptom severity: Youth with greater severity showed greater clinical gains. Higher levels of co-occurring developmental psychopathology characteristics likewise predicted better outcomes. Exploratory analyses showed that change over time in developmental psychopathology characteristics (peer delinquency, depression) was related to change in delinquent acts and substance use. Implications for serving multiproblem adolescents and tailoring treatment plans in routine care are discussed.
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Affiliation(s)
- Aaron Hogue
- The National Center on Addiction and Substance Abuse, 633 Third Avenue, 19th floor, New York, NY, 10017, USA.
| | - Craig E Henderson
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | - Adam T Schmidt
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
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19
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Unterrainer HF, Hiebler-Ragger M, Koschutnig K, Fuchshuber J, Tscheschner S, Url M, Wagner-Skacel J, Reininghaus EZ, Papousek I, Weiss EM, Fink A. Addiction as an Attachment Disorder: White Matter Impairment Is Linked to Increased Negative Affective States in Poly-Drug Use. Front Hum Neurosci 2017; 11:208. [PMID: 28503141 PMCID: PMC5408064 DOI: 10.3389/fnhum.2017.00208] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/10/2017] [Indexed: 01/19/2023] Open
Abstract
Substance use disorders (SUD) have been shown to be linked to various neuronal and behavioral impairments. In this study, we investigate whether there is a connection between the integrity of white matter (WM) and attachment styles as well as different affective states including spirituality in a group of patients diagnosed for poly-drug use disorder (PUD) in comparison to non-clinical controls. A total sample of 59 right-handed men, comprising the groups of patients with PUD (n = 19), recreational drug-using individuals (RUC; n = 20) as well as non-drug using controls were recruited (NUC; n = 20). For the behavioral assessment, we applied the Adult Attachment-Scale, the Affective Neuroscience Personality-Scale (short version) and the Multidimensional Inventory for Religious/Spiritual Well-Being. Diffusion Tensor Imaging was used to investigate differences in WM neural connectivity. Analyses revealed decreased Fractional Anisotropy and decreased Mean Diffusivity in PUD patients as compared to RUC and NUC. No differences were found between RUC and NUC. Additional ROI analyses suggested that WM impairment in the superior longitudinal fasciculus (SLF) and the superior corona radiata (SCR) was linked to more insecure attachment as well as to more negative affectivity. No substantial correlation was observed with spirituality. These findings are mainly limited by the cross-sectional design of the study. However, our preliminary results support the idea of addiction as an attachment disorder, both at neuronal and behavioral levels. Further research might be focused on the changes of insecure attachment patterns in SUD treatment and their correlation with changes in the brain.
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Affiliation(s)
- Human-Friedrich Unterrainer
- Institute of Psychology, University of GrazGraz, Austria.,Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | | | - Jürgen Fuchshuber
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria.,Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | | | - Maria Url
- Center for Integrative Addiction Research, Grüner Kreis SocietyVienna, Austria
| | - Jolana Wagner-Skacel
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria.,Department of Medical Psychology and Psychotherapy, Medical University GrazGraz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University GrazGraz, Austria
| | - Ilona Papousek
- Institute of Psychology, University of GrazGraz, Austria
| | | | - Andreas Fink
- Institute of Psychology, University of GrazGraz, Austria
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20
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Warren CM, Riggs NR, Pentz MA. Longitudinal relationships of sleep and inhibitory control deficits to early adolescent cigarette and alcohol use. J Adolesc 2017; 57:31-41. [PMID: 28334632 DOI: 10.1016/j.adolescence.2017.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 01/07/2023]
Abstract
Research in older adolescents suggests insufficient sleep may increase substance use initiation risk. This study tested whether sleep duration and dysregulation of sleep-wake patterns in late-elementary school youth were prospectively associated with cigarette and alcohol use initiation and how sleep-related changes in inhibitory control mediate these relationships. Average sleep duration at 4th grade predicted 6th grade cigarette but not alcohol use, however indirect effects were identified through 5th grade inhibitory control to both cigarette and alcohol use. Indirect effects were also identified through inhibitory control for relationships between 4th grade weekend bed-time delay and 6th grade cigarette or alcohol use, and for relationships between 4th grade weekend wake-time delay and 6th grade cigarette or alcohol use. Reductions in nightly sleep increased risk of cigarette use. Findings suggest a pathway linking both reduced sleep duration and greater weekend shifting of sleep patterns to future substance use through sleep-related inhibitory control deficits.
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Affiliation(s)
- Christopher M Warren
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, USA.
| | - Nathaniel R Riggs
- Colorado State University, College of Health and Human Sciences, Department of Human Development & Family Studies, USA.
| | - Mary Ann Pentz
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, USA.
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21
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Gruber SA, Sagar KA. Marijuana on the Mind? The Impact of Marijuana on Cognition, Brain Structure, and Brain Function, and Related Public Policy Implications. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2372732216684851] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although marijuana (MJ) has been used for thousands of years, the public’s opinion of MJ has shifted drastically over the past century, leaving many wondering about its potential risks and benefits. This article summarizes research detailing the impact of recreational MJ and related variables (frequency, magnitude, potency, and mode of MJ use) on cognition, brain structure, and brain function. MJ use, particularly at young ages, has been reported to undermine cognition, as well as alter brain structure and function. Furthermore, we discuss how data from recreational MJ studies, as well as more recent medical marijuana (MMJ) research findings, relate to legalization efforts. Considerations for policymakers, such as age limits, guidelines for safe use, and the therapeutic potential of certain constituents of MJ (i.e., cannabidiol), are also outlined. In recent years, policy has outpaced science; important areas in need of further research are noted.
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Affiliation(s)
- Staci A. Gruber
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kelly A. Sagar
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
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22
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Suryadevara U, Bruijnzeel DM, Nuthi M, Jagnarine DA, Tandon R, Bruijnzeel AW. Pros and Cons of Medical Cannabis use by People with Chronic Brain Disorders. Curr Neuropharmacol 2017; 15:800-814. [PMID: 27804883 PMCID: PMC5652027 DOI: 10.2174/1570159x14666161101095325] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/26/2016] [Accepted: 10/28/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cannabis is the most widely used illicit drug in the world and there is growing concern about the mental health effects of cannabis use. These concerns are at least partly due to the strong increase in recreational and medical cannabis use and the rise in tetrahydrocannabinol (THC) levels. Cannabis is widely used to self-medicate by older people and people with brain disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer's disease (AD), Parkinson's disease (PD), bipolar disorder, and schizophrenia. OBJECTIVE This review provides an overview of the perceived benefits and adverse mental health effects of cannabis use in people with ALS, MS, AD, PD, bipolar disorder, and schizophrenia. RESULTS The reviewed studies indicate that cannabis use diminishes some symptoms associated with these disorders. Cannabis use decreases pain and spasticity in people with MS, decreases tremor, rigidity, and pain in people with PD, and improves the quality of life of ALS patients by improving appetite, and decreasing pain and spasticity. Cannabis use is more common among people with schizophrenia than healthy controls. Cannabis use is a risk factor for schizophrenia which increases positive symptoms in schizophrenia patients and diminishes negative symptoms. Cannabis use worsens bipolar disorder and there is no evidence that bipolar patients derive any benefit from cannabis. In late stage Alzheimer's patients, cannabis products may improve food intake, sleep quality, and diminish agitation. CONCLUSION Cannabis use diminishes some of the adverse effects of neurological and psychiatric disorders. However, chronic cannabis use may lead to cognitive impairments and dependence.
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Affiliation(s)
- Uma Suryadevara
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | | | - Meena Nuthi
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | | | - Rajiv Tandon
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Adriaan W. Bruijnzeel
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, Florida, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
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Long EC, Lönn SL, Ji J, Lichtenstein P, Sundquist J, Sundquist K, Kendler KS. Resilience and Risk for Alcohol Use Disorders: A Swedish Twin Study. Alcohol Clin Exp Res 2016; 41:149-155. [PMID: 27918840 DOI: 10.1111/acer.13274] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 10/12/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Resilience has been shown to be protective against alcohol use disorders (AUDs), but the magnitude and nature of the relationship between these 2 phenotypes are not clear. The aim of this study was to examine the strength of this relationship and the degree to which it results from common genetic or common environmental influences. METHODS Resilience was assessed on a 9-point scale during a personal interview in 1,653,721 Swedish men aged 17 to 25 years. AUD was identified based on Swedish medical, legal, and pharmacy registries. The magnitude of the relationship between resilience and AUD was examined using logistic regression. The extent to which the relationship arises from common genetic or common environmental factors was examined using a bivariate Cholesky decomposition model. RESULTS The 5 single items that comprised the resilience assessment (social maturity, interest, psychological energy, home environment, and emotional control) all reduced risk for subsequent AUD, with social maturity showing the strongest effect. The linear effect by logistic regression showed that a 1-point increase on the resilience scale was associated with a 29% decrease in odds of AUD. The Cholesky decomposition model demonstrated that the resilience-AUD relationship was largely attributable to overlapping genetic and shared environmental factors (57 and 36%, respectively). CONCLUSIONS Resilience is strongly associated with a reduction in risk for AUD. This relationship appears to be the result of overlapping genetic and shared environmental influences that impact resilience and risk of AUD, rather than a directly causal relationship.
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Affiliation(s)
- Elizabeth C Long
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia
| | - Sara L Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jianguang Ji
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia.,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia.,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
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Brook JS, Zhang C, Leukefeld CG, Brook DW. Marijuana use from adolescence to adulthood: developmental trajectories and their outcomes. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1405-1415. [PMID: 27168181 PMCID: PMC5050063 DOI: 10.1007/s00127-016-1229-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 04/26/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The study assesses the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, children living at home, and spouse/partner marijuana use at age 43. METHOD This study used a longitudinal design. The sample participants (N = 548) were first studied at mean age 14 and last studied at mean age 43. RESULTS Six trajectories of marijuana use were identified: chronic/heavy users (3.6 %), increasing users (5.1 %), chronic/occasional users (20 %), decreasers (14.3 %), quitters (22.5 %), and nonusers/experimenters (34.5 %). With three exceptions, as compared with being a nonuser/experimenter, a higher probability of belonging to the chronic/heavy, the increasing, or the chronic/occasional user trajectory group was significantly associated with a greater likelihood of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, not having children who lived at home, and having a spouse/partner who used marijuana at early midlife. In addition, compared with being a quitter, a higher probability of belonging to the chronic/heavy user trajectory group was significantly associated with a higher likelihood of unconventional behavior, sensation seeking, emotional dysregulation, alcohol dependence/abuse, and spouse/partner marijuana use. Implications for intervention are presented. CONCLUSIONS Trajectories of marijuana use, especially chronic/heavy use, increasing use, and chronic/occasional use, are associated with unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, having children who lived at home, and spouse/partner marijuana use at age 43. The importance of the findings for prevention and treatment programs are discussed.
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Affiliation(s)
- Judith S. Brook
- Department of Psychiatry, New York University School of Medicine, New York, New York,Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, 15 Floor, New York, NY 10016,Reprints and correspondence should be addressed to Dr. Judith S. Brook, Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, 15 Floor, New York, NY 10016;
| | - Chenshu Zhang
- Department of Psychiatry, New York University School of Medicine, New York, New York,Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, 15 Floor, New York, NY 10016
| | - Carl G. Leukefeld
- Department of Behavioral Sciences, University of Kentucky, Lexington, KY
| | - David W. Brook
- Department of Psychiatry, New York University School of Medicine, New York, New York,Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, 15 Floor, New York, NY 10016
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25
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Silveri MM, Dager AD, Cohen-Gilbert JE, Sneider JT. Neurobiological signatures associated with alcohol and drug use in the human adolescent brain. Neurosci Biobehav Rev 2016; 70:244-259. [PMID: 27377691 DOI: 10.1016/j.neubiorev.2016.06.042] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/17/2016] [Accepted: 06/30/2016] [Indexed: 01/02/2023]
Abstract
Magnetic resonance (MR) techniques provide opportunities to non-invasively characterize neurobiological milestones of adolescent brain development. Juxtaposed to the critical finalization of brain development is initiation of alcohol and substance use, and increased frequency and quantity of use, patterns that can lead to abuse and addiction. This review provides a comprehensive overview of existing MR studies of adolescent alcohol and drug users. The most common alterations reported across substance used and MR modalities are in the frontal lobe (63% of published studies). This is not surprising, given that this is the last region to reach neurobiological adulthood. Comparatively, evidence is less consistent regarding alterations in regions that mature earlier (e.g., amygdala, hippocampus), however newer techniques now permit investigations beyond regional approaches that are uncovering network-level vulnerabilities. Regardless of whether neurobiological signatures exist prior to the initiation of use, this body of work provides important direction for ongoing prospective investigations of adolescent brain development, and the significant impact of alcohol and substance use on the brain during the second decade of life.
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Affiliation(s)
- Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Alecia D Dager
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Julia E Cohen-Gilbert
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer T Sneider
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Zhai ZW, Pajtek S, Luna B, Geier CF, Ridenour TA, Clark DB. Reward-Modulated Response Inhibition, Cognitive Shifting, and the Orbital Frontal Cortex in Early Adolescence. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2015; 25:753-764. [PMID: 26755891 PMCID: PMC4705559 DOI: 10.1111/jora.12168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Immaturities in cognitive shifting are associated with adolescent risk behaviors. The orbital frontal cortex (OFC) regulates reward processing and response inhibition. This study tested the relationship between cognitive shifting, OFC activity, and reward-modulated response inhibition in young adolescents. An fMRI antisaccade (AS) paradigm examined the effects of reward conditions on inhibitory response and OFC processing. A validated self-report inventory assessed cognitive shifting. Compared to neutral, reward trials showed better AS performance and increased OFC activation. Cognitive shifting positively associated with AS performance in reward and neutral trials. Poorer cognitive shifting predicted greater OFC activation. Results indicate lower OFC efficiency, as greater activation to achieve correct performance, underlies cognitive shifting problems. These neurocognitive impairments are relevant for understanding adolescent risk behaviors.
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Affiliation(s)
- Zu Wei Zhai
- University of Pittsburgh School of Pharmacy, Parkvale Annex, Suite 203, 3520 Forbes Avenue, Pittsburgh, PA 15213
| | - Stefan Pajtek
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Beatriz Luna
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Charles F Geier
- Pennsylvania State University, 120-B Henderson South, University Park, PA 16802
| | - Ty A Ridenour
- University of Pittsburgh School of Pharmacy, Parkvale Annex, Suite 203, 3520 Forbes Avenue, Pittsburgh, PA 15213
| | - Duncan B Clark
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
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27
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Long EC, Hill J, Luna B, Verhulst B, Clark DB. Disruptive behavior disorders and indicators of disinhibition in adolescents: The BRIEF-SR, anti-saccade task, and D-KEFS color-word interference test. J Adolesc 2015; 44:182-90. [PMID: 26277405 PMCID: PMC4632655 DOI: 10.1016/j.adolescence.2015.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/02/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
Disinhibition contributes to the development of disruptive behavior disorders (DBD) in adolescents. Self-reports and behavioral tasks are commonly used to assess disinhibition, each with their unique strengths and limitations. Accordingly, it is important to identify which measure, or combination thereof, is the most effective in predicting DBD symptoms. This study assessed the relationship between DBD (symptoms of ADHD/ODD/CD) and two behavioral disinhibition tasks: the anti-saccade task and the D-KEFS color-word interference test, as well as a self-report measure (the BRIEF-SR). The results indicated that the BRIEF-Inhibit scale accounted for the majority of the variance in the DBD sum score. The anti-saccade task and color-word interference test were also significantly associated with an increase in the number of DBD symptoms endorsed. These behavioral tasks accounted for 9% additional variance than the self-report alone. Therefore, combining self-report measures with behavioral disinhibition tasks may provide the most thorough assessment of adolescent DBD.
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Affiliation(s)
- E C Long
- Behavioral Sciences Department, New Mexico Highlands University, Las Vegas, NM, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
| | - J Hill
- Behavioral Sciences Department, New Mexico Highlands University, Las Vegas, NM, USA.
| | - B Luna
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - B Verhulst
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
| | - D B Clark
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Hasler BP, Soehner AM, Clark DB. Sleep and circadian contributions to adolescent alcohol use disorder. Alcohol 2015; 49:377-87. [PMID: 25442171 DOI: 10.1016/j.alcohol.2014.06.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/27/2014] [Accepted: 06/30/2014] [Indexed: 11/16/2022]
Abstract
Adolescence is a time of marked changes across sleep, circadian rhythms, brain function, and alcohol use. Starting at puberty, adolescents' endogenous circadian rhythms and preferred sleep times shift later, often leading to a mismatch with the schedules imposed by secondary education. This mismatch induces circadian misalignment and sleep loss, which have been associated with affect dysregulation, increased drug and alcohol use, and other risk-taking behaviors in adolescents and adults. In parallel to developmental changes in sleep, adolescent brains are undergoing structural and functional changes in the circuits subserving the pursuit and processing of rewards. These developmental changes in reward processing likely contribute to the initiation of alcohol use during adolescence. Abundant evidence indicates that sleep and circadian rhythms modulate reward function, suggesting that adolescent sleep and circadian disturbance may contribute to altered reward function, and in turn, alcohol involvement. In this review, we summarize the relevant evidence and propose that these parallel developmental changes in sleep, circadian rhythms, and neural processing of reward interact to increase risk for alcohol use disorder (AUD).
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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Regional brain activation supporting cognitive control in the context of reward is associated with treated adolescents' marijuana problem severity at follow-up: A preliminary study. Dev Cogn Neurosci 2015; 16:93-100. [PMID: 26026506 PMCID: PMC4644722 DOI: 10.1016/j.dcn.2015.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 05/05/2015] [Accepted: 05/07/2015] [Indexed: 11/29/2022] Open
Abstract
Activation during rewarded antisaccade task correlated with later marijuana severity. Antisaccade behavioral performance was not associated with treatment outcome. Preliminary results suggest a brain-based correlate of treatment outcome in youth.
This preliminary study examined the extent to which regional brain activation during a reward cue antisaccade (AS) task was associated with 6-month treatment outcome in adolescent substance users. Antisaccade performance provides a sensitive measure of executive function and cognitive control, and generally improves with reward cues. We hypothesized that when preparing to execute an AS, greater activation in regions associated with cognitive and oculomotor control supporting AS, particularly during reward cue trials, would be associated with lower substance use severity at 6-month follow-up. Adolescents (n = 14, ages 14–18) recruited from community-based outpatient treatment completed an fMRI reward cue AS task (reward and neutral conditions), and provided follow-up data. Results indicated that AS errors decreased in reward, compared to neutral, trials. AS behavioral performance, however, was not associated with treatment outcome. As hypothesized, activation in regions of interest (ROIs) associated with cognitive (e.g., ventrolateral prefrontal cortex) and oculomotor control (e.g., supplementary eye field) during reward trials were inversely correlated with marijuana problem severity at 6-months. ROI activation during neutral trials was not associated with outcomes. Results support the role of motivational (reward cue) factors to enhance cognitive control processes, and suggest a potential brain-based correlate of youth treatment outcome.
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Chung T, Ferrell R, Clark DB. Indirect association of DAT1 genotype with executive function through white matter volume in orbitofrontal cortex. Psychiatry Res 2015; 232:76-83. [PMID: 25704259 PMCID: PMC4404197 DOI: 10.1016/j.pscychresns.2015.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/03/2014] [Accepted: 01/26/2015] [Indexed: 01/14/2023]
Abstract
The dopamine transporter (DAT1) gene has been associated with impulsivity and executive functioning. Further, DAT1 has been associated with brain structural characteristics and resting state connectivity. This study tested an indirect effect model in which DAT1 genotype (9-repeat (9R) carriers vs 10-repeat (10R) homozygotes) is linked to phenotypes representing impulsivity and executive function (planning behavior) through effects on white matter (WM) volumes in prefrontal cortex (PFC), particularly orbitofrontal cortex (OFC). Adolescents (ages 14-18, n=38) were recruited from substance use treatment (n=22) and the community (n=16) to increase phenotype variation. Results indicated that DAT1 10/10 genotype was associated with lower WM volume in the PFC, specifically the left OFC. Further, lower WM volume in the left OFC predicted more difficulties in self-reported planning behavior, but not impulsivity. Indirect effect analysis indicated that lower WM volume in the left OFC mediated the association between DAT1 10/10 genotype and difficulties in planning behavior. Results suggest a brain structural mechanism, involving lower WM volume in the left OFC, as a link in the association between DAT1 genotype and a specific aspect of executive function. Genetic effects on regional WM volume that are linked to behavioral outcomes could ultimately inform the development of tailored interventions that address an individual׳s unique risk factors.
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Affiliation(s)
- Tammy Chung
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Robert Ferrell
- Department of Human Genetics, University of Pittsburgh Pittsburgh, Pennsylvania, USA
| | - Duncan B. Clark
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania, USA
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Shollenbarger SG, Price J, Wieser J, Lisdahl K. Poorer frontolimbic white matter integrity is associated with chronic cannabis use, FAAH genotype, and increased depressive and apathy symptoms in adolescents and young adults. NEUROIMAGE-CLINICAL 2015; 8:117-25. [PMID: 26106535 PMCID: PMC4473294 DOI: 10.1016/j.nicl.2015.03.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/17/2015] [Accepted: 03/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The heaviest period of cannabis use coincides with ongoing white matter (WM) maturation. Further, cannabis-related changes may be moderated by FAAH genotype (rs324420). We examined the association between cannabis use and FAAH genotype on frontolimbic WM integrity in adolescents and emerging adults. We then tested whether observed WM abnormalities were linked with depressive or apathy symptoms. METHODS Participants included 37 cannabis users and 37 healthy controls (33 female; ages 18-25). Multiple regressions examined the independent and interactive effects of variables on WM integrity. RESULTS Regular cannabis users demonstrated reduced WM integrity in the bilateral uncinate fasciculus (UNC) (MD, right: p = .009 and left: p = .009; FA, right: p = .04 and left: p = .03) and forceps minor (fMinor) (MD, p = .03) compared to healthy controls. Marginally reduced WM integrity in the cannabis users was found in the left anterior thalamic radiation (ATR) (FA, p = .08). Cannabis group ∗ FAAH genotype interaction predicted WM integrity in bilateral ATR (FA, right: p = .05 and left: p = .001) and fMinor (FA, p = .02). In cannabis users, poorer WM integrity was correlated with increased symptoms of depression and apathy in bilateral ATR and UNC. CONCLUSIONS Consistent with prior findings, cannabis use was associated with reduced frontolimbic WM integrity. WM integrity was also moderated by FAAH genotype, in that cannabis-using FAAH C/C carriers and A carrying controls had reduced WM integrity compared to control C/C carriers. Observed frontolimbic white matter abnormalities were linked with increased depressive and apathy symptoms in the cannabis users.
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Affiliation(s)
- Skyler G Shollenbarger
- Department of Psychology, University of Wisconsin-Milwaukee, Garland Hall Rm 224, 2441 East Hartford Ave, Milwaukee, WI 53211, USA
| | - Jenessa Price
- McLean Hospital, Harvard Medical School, 115 Mill St., Belmont, MA 02478, USA
| | - Jon Wieser
- Department of Psychology, University of Wisconsin-Milwaukee, Garland Hall Rm 224, 2441 East Hartford Ave, Milwaukee, WI 53211, USA
| | - Krista Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Garland Hall Rm 224, 2441 East Hartford Ave, Milwaukee, WI 53211, USA
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Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther 2014; 148:1-16. [PMID: 25460036 DOI: 10.1016/j.pharmthera.2014.11.009] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/14/2022]
Abstract
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Monash Clinical & Imaging Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Chung T, Clark DB. Insula white matter volume linked to binge drinking frequency through enhancement motives in treated adolescents. Alcohol Clin Exp Res 2014; 38:1932-40. [PMID: 24930680 DOI: 10.1111/acer.12461] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 04/02/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Given the insula's role in the representation of bodily states associated with hedonic (i.e., enhancement motives) and aversive (i.e., craving) aspects of substance use, this longitudinal study examined associations between insula structure (i.e., white matter [WM] and gray matter [GM] volume), enhancement motives for alcohol and cannabis use, craving for alcohol and marijuana, and alcohol and cannabis involvement in treated adolescents. Enhancement motives and craving, as conscious representations of bodily states associated with use, were hypothesized as mediators (i.e., linking mechanisms) of the association between insula volume and substance use. METHODS Adolescents (age 14 to 18, N = 30) recruited from substance use treatment reported on enhancement motives and obsession/craving for both alcohol and cannabis at baseline (near the start of treatment), and on alcohol and cannabis involvement (e.g., binge drinking, alcohol abuse/dependence symptom count) at baseline and over 1-year follow-up. Insula WM and GM volumes were determined using FreeSurfer. RESULTS Enhancement motives for drinking served as a link between left insula WM volume and frequency of binge drinking at baseline and 1-year follow-up. This novel finding is consistent with the insula's role in representing bodily states (e.g., "high" associated with binge drinking) that can motivate drinking behavior. Although right insula WM volume was positively correlated with obsession/craving for alcohol, and obsession/craving was positively correlated with alcohol outcomes, the indirect effect was not significant. Insula WM volume was not associated with cannabis-related variables. Insula GM volume was not associated with enhancement motives, obsession/craving, or alcohol involvement. CONCLUSIONS Enhancement motives for alcohol use, but not obsession/craving for alcohol, provided an important link between left insula WM volume and frequency of binge drinking in treated adolescents. Results are consistent with the insula's role in the processing of hedonic bodily states available to conscious awareness, particularly in the form of enhancement motives for alcohol use.
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Affiliation(s)
- Tammy Chung
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Lisdahl KM, Wright NE, Kirchner-Medina C, Maple KE, Shollenbarger S. Considering Cannabis: The Effects of Regular Cannabis Use on Neurocognition in Adolescents and Young Adults. CURRENT ADDICTION REPORTS 2014; 1:144-156. [PMID: 25013751 PMCID: PMC4084860 DOI: 10.1007/s40429-014-0019-6] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Thirty-six percent of high school seniors have used cannabis in the past year, and an alarming 6.5% smoked cannabis daily, up from 2.4% in 1993 (Johnston et al., 2013). Adolescents and emerging adults are undergoing significant neurodevelopment and animal studies suggest they may be particularly vulnerable to negative drug effects. In this review, we will provide a detailed overview of studies outlining the effects of regular (at least weekly) cannabis use on neurocognition, including studies outlining cognitive, structural and functional findings. We will also explore the public health impact of this research.
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Affiliation(s)
- Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Natasha E. Wright
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | | | - Kristin E. Maple
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
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Roth RM, Erdodi LA, McCulloch LJ, Isquith PK. Much ado about norming: the Behavior Rating Inventory of Executive Function. Child Neuropsychol 2014; 21:225-33. [PMID: 24650292 DOI: 10.1080/09297049.2014.897318] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Behavior Rating Inventory of Executive Function (BRIEF) is a rating scale designed to assess executive functions in everyday life that is widely used in school and clinical settings and in research studies. It has been recently suggested, however, that the limited geographic stratification of the standardization sample renders the measure overly sensitive. We evaluated this hypothesis by examining BRIEF scores across studies of typically developing children and adolescents. Thirty-nine studies were identified that included at least one of three possible index scores. Mean scores across studies were (a) within one to two T-score units from the standardization sample mean of 50, (b) tended to be slightly lower than 50, and (c) were unrelated to geographic location (US Census regions or internationally). These findings refute recent claims that the BRIEF is overly sensitive and further add to the large body of literature supporting the validity of the measure.
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Affiliation(s)
- Robert M Roth
- a Neuropsychology Program, Department of Psychiatry , Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire , USA
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Bernier D, Cookey J, McAllindon D, Bartha R, Hanstock CC, Newman AJ, Stewart SH, Tibbo PG. Multimodal neuroimaging of frontal white matter microstructure in early phase schizophrenia: the impact of early adolescent cannabis use. BMC Psychiatry 2013; 13:264. [PMID: 24131511 PMCID: PMC3852698 DOI: 10.1186/1471-244x-13-264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/14/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A disturbance in connectivity between different brain regions, rather than abnormalities within the separate regions themselves, could be responsible for the clinical symptoms and cognitive dysfunctions observed in schizophrenia. White matter, which comprises axons and their myelin sheaths, provides the physical foundation for functional connectivity in the brain. Myelin sheaths are located around the axons and provide insulation through the lipid membranes of oligodendrocytes. Empirical data suggests oligodendroglial dysfunction in schizophrenia, based on findings of abnormal myelin maintenance and repair in regions of deep white matter. The aim of this in vivo neuroimaging project is to assess the impact of early adolescent onset of regular cannabis use on brain white matter tissue integrity, and to differentiate this impact from the white matter abnormalities associated with schizophrenia. The ultimate goal is to determine the liability of early adolescent use of cannabis on brain white matter, in a vulnerable brain. METHODS/DESIGN Young adults with schizophrenia at the early stage of the illness (less than 5 years since diagnosis) will be the focus of this project. Four magnetic resonance imaging measurements will be used to assess different cellular aspects of white matter: a) diffusion tensor imaging, b) localized proton magnetic resonance spectroscopy with a focus on the neurochemical N-acetylaspartate, c) the transverse relaxation time constants of regional tissue water, d) and of N-acetylaspartate. These four neuroimaging indices will be assessed within the same brain region of interest, that is, a large white matter fibre bundle located in the frontal region, the left superior longitudinal fasciculus. DISCUSSION We will expand our knowledge regarding current theoretical models of schizophrenia with a more comprehensive multimodal neuroimaging approach to studying the underlying cellular abnormalities of white matter, while taking into consideration the important confounding variable of early adolescent onset of regular cannabis use.
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Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J, Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada.
| | - Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, 100 Perth Drive, London N6A 5K8, Ontario, Canada
| | - Christopher C Hanstock
- Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton T6G 2V2, Alberta, Canada
| | - Aaron J Newman
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
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Baker ST, Yücel M, Fornito A, Allen NB, Lubman DI. A systematic review of diffusion weighted MRI studies of white matter microstructure in adolescent substance users. Neurosci Biobehav Rev 2013; 37:1713-23. [DOI: 10.1016/j.neubiorev.2013.06.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/22/2013] [Accepted: 06/27/2013] [Indexed: 01/08/2023]
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Elofson J, Gongvatana W, Carey KB. Alcohol use and cerebral white matter compromise in adolescence. Addict Behav 2013; 38:2295-305. [PMID: 23583835 DOI: 10.1016/j.addbeh.2013.03.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/01/2013] [Accepted: 03/07/2013] [Indexed: 12/31/2022]
Abstract
Alcohol use is typically initiated during adolescence, a period known to be critical in neurodevelopment. The adolescent brain may be particularly susceptible to the harmful effects of alcohol. While the cognitive deficits associated with alcohol use during adolescence have been well-documented, the neural substrates underlying these effects remain inadequately understood. Cerebral white matter has been suggested as a primary site of alcohol-related damage and diffusion tensor imaging (DTI) allows for the quantification of white matter integrity in vivo. This review summarizes results from both cross-sectional and longitudinal studies employing DTI that indicate that white matter tracts, particularly those thought to be involved in executive functioning, continue to develop throughout adolescence and into adulthood. Numerous DTI studies reveal a positive correlation between white matter integrity and neurocognitive performance and, in adults, the detrimental effects of prolonged alcohol-dependence on white matter integrity. We provide a comprehensive review of the DTI studies exploring the relationship between alcohol use and white matter integrity in adolescents. Results from most of these studies suggest that alcohol use is associated with reduced white matter integrity, particularly in the superior longitudinal fasciculus (SLF), and some evidence suggests that this relationship may be influenced by sex. We conclude by highlighting confounds and limitations of the available research and suggesting directions for future research.
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Clark DB, Chung T, Pajtek S, Zhai Z, Long E, Hasler B. Neuroimaging methods for adolescent substance use disorder prevention science. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2013; 14:300-9. [PMID: 23417665 PMCID: PMC3640678 DOI: 10.1007/s11121-012-0323-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Magnetic resonance imaging (MRI) methods safely provide in vivo indicators of cerebral macrostructure, microstructure, and activation that can be examined in relation to substance use disorder (SUD) risks and effects. This article will provide an overview of MRI approaches, including volumetric measures, diffusion tensor imaging, and functional MRI, that have been applied to studies of adolescent neuromaturation in relationship to risk phenotypes and adolescent SUD. To illustrate these applications, examples of research findings will be presented. MRI indicators have demonstrated that neurobiological maturation continues throughout adolescence. MRI research has suggested that variations in neurobiological maturation may contribute to SUD risk, and that substance use adversely influences adolescent brain development. Directly measured neurobiological variables may be viable preventive intervention targets and outcome indicators. Further research is needed to provide definitive findings on neurodevelopmental immaturity as an SUD risk and to determine the directions such observations suggest for advancing prevention science.
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Affiliation(s)
- D B Clark
- School of Medicine and the School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
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Bates ME, Buckman JF, Nguyen TT. A role for cognitive rehabilitation in increasing the effectiveness of treatment for alcohol use disorders. Neuropsychol Rev 2013; 23:27-47. [PMID: 23412885 PMCID: PMC3610413 DOI: 10.1007/s11065-013-9228-3] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/31/2013] [Indexed: 12/14/2022]
Abstract
Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation.
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Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854-8001, USA.
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Batalla A, Bhattacharyya S, Yücel M, Fusar-Poli P, Crippa JA, Nogué S, Torrens M, Pujol J, Farré M, Martin-Santos R. Structural and functional imaging studies in chronic cannabis users: a systematic review of adolescent and adult findings. PLoS One 2013; 8:e55821. [PMID: 23390554 PMCID: PMC3563634 DOI: 10.1371/journal.pone.0055821] [Citation(s) in RCA: 267] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 01/02/2013] [Indexed: 12/18/2022] Open
Abstract
Background The growing concern about cannabis use, the most commonly used illicit drug worldwide, has led to a significant increase in the number of human studies using neuroimaging techniques to determine the effect of cannabis on brain structure and function. We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents. Methods Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered. Results One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks both in adolescents and adults, which may indicate compensatory effects in response to chronic cannabis exposure. Limitations However, the results pointed out methodological limitations of the work conducted to date and considerable heterogeneity in the findings. Conclusion Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives.
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Affiliation(s)
- Albert Batalla
- Psychiatry, Institute of Neurosciences, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, London, United Kingdom
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, London, United Kingdom
| | - Jose Alexandre Crippa
- Neuroscience and Cognitive Behavior Department, University of Sao Paulo, Ribeirao Preto, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM, CNPq), Ribeirao Preto, Brazil
| | - Santiago Nogué
- Clinical Toxicology Unit, Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Marta Torrens
- Neuroscience Program, Pharmacology Unit and Drug Addiction Unit, IMIM-INAD-Parc de Salut Mar, Autonomous University of Barcelona, Barcelona, Spain
- Red de Trastornos Adictivos (RETIC), IMIM-INAD-Parc de Salut Mar, Barcelona, Spain
| | - Jesús Pujol
- Institut d’Alta Tecnologia-PRBB, CRC Mar, Hospital del Mar, Barcelona, Spain
| | - Magí Farré
- Neuroscience Program, Pharmacology Unit and Drug Addiction Unit, IMIM-INAD-Parc de Salut Mar, Autonomous University of Barcelona, Barcelona, Spain
- Red de Trastornos Adictivos (RETIC), IMIM-INAD-Parc de Salut Mar, Barcelona, Spain
| | - Rocio Martin-Santos
- Psychiatry, Institute of Neurosciences, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- National Science and Technology Institute for Translational Medicine (INCT-TM, CNPq), Ribeirao Preto, Brazil
- * E-mail:
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Osorio MB, Kurowski BG, Beebe D, Taylor HG, Brown TM, Kirkwood MW, Wade SL. Association of daytime somnolence with executive functioning in the first 6 months after adolescent traumatic brain injury. PM R 2013; 5:554-62. [PMID: 23375631 DOI: 10.1016/j.pmrj.2012.11.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/06/2012] [Accepted: 11/12/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the relationship between severity of injury and self-reports and parent reports of daytime somnolence in adolescents after traumatic brain injury (TBI), and to determine the relationship between daytime somnolence and self-report and parent report of executive functioning in daily life. DESIGN Cross-sectional study conducted within the first 6 months (mean ± standard deviation 14.97 ± 7.51 weeks) after injury. Partial correlation controlling for injury severity was used to examine the associations of TBI severity with daytime somnolence and the association of daytime somnolence with executive functioning. SETTING Outpatient visits at 3 children's hospitals and 2 general hospitals with pediatric trauma commitment. PARTICIPANTS A total of 102 adolescents, 12-18 years old, who sustained moderate-to-severe TBI (n = 60) or complicated mild TBI (n = 42). MAIN OUTCOME MEASUREMENTS Parent-report Sleepiness Scale, Epworth Sleepiness Scale (youth report), Behavior Rating Inventory of Executive Function (BRIEF) (self-report and maternal report). RESULTS Adolescents who sustained moderate-to-severe TBI had increased daytime somnolence compared with those with complicated mild injuries in the parent report but not in the youth report. Based on the parent report, 51% of adolescents with moderate-to-severe TBI showed significant daytime somnolence compared with 22% of those with complicated mild TBI. The parent report of daytime somnolence was associated with executive dysfunction on both the BRIEF self-report and parent report; however, the youth report of daytime somnolence was associated only with the BRIEF self-report. CONCLUSIONS The parent report of daytime somnolence correlated with TBI severity and predicted executive functioning difficulties of the teens in everyday circumstances. Although a correlation between daytime somnolence and executive dysfunction were also apparent on self-report, this did not differ based on injury severity. Teens tended to report fewer difficulties with executive function, which suggests that the teens have decreased awareness of their impairments.
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Affiliation(s)
- Marisa B Osorio
- Division of Pediatric Rehabilitation Medicine, Department of Physical Medicine and Rehabilitation, University of Washington and Seattle Children's Hospital, Seattle, WA 98145-5005, USA.
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Dong G, DeVito E, Huang J, Du X. Diffusion tensor imaging reveals thalamus and posterior cingulate cortex abnormalities in internet gaming addicts. J Psychiatr Res 2012; 46:1212-6. [PMID: 22727905 PMCID: PMC3650484 DOI: 10.1016/j.jpsychires.2012.05.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 05/22/2012] [Accepted: 05/30/2012] [Indexed: 11/28/2022]
Abstract
Internet gaming addiction (IGA) is increasingly recognized as a widespread disorder with serious psychological and health consequences. Diminished white matter integrity has been demonstrated in a wide range of other addictive disorders which share clinical characteristics with IGA. Abnormal white matter integrity in addictive populations has been associated with addiction severity, treatment response and cognitive impairments. This study assessed white matter integrity in individuals with internet gaming addiction (IGA) using diffusion tensor imaging (DTI). IGA subjects (N = 16) showed higher fractional anisotropy (FA), indicating greater white matter integrity, in the thalamus and left posterior cingulate cortex (PCC) relative to healthy controls (N = 15). Higher FA in the thalamus was associated with greater severity of internet addiction. Increased regional FA in individuals with internet gaming addiction may be a pre-existing vulnerability factor for IGA, or may arise secondary to IGA, perhaps as a direct result of excessive internet game playing.
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Affiliation(s)
- Guangheng Dong
- Department of Psychology, Zhejiang Normal University, 688 of Yingbin Road, Jinhua, Zhejiang Province, PR China.
| | - Elise DeVito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jie Huang
- Department of Psychology, Zhejiang Normal University, Jinhua City, Zhejiang Province, P.R.China
| | - Xiaoxia Du
- Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai. P.R.China
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Chung T, Pajtek S, Clark DB. White matter integrity as a link in the association between motivation to abstain and treatment outcome in adolescent substance users. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 27:533-42. [PMID: 22369222 DOI: 10.1037/a0026716] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Readiness to change constitutes an important treatment target. This study examined white matter (WM) integrity as a possible link in the pathway between motivation to abstain and treatment outcome. Adolescents (age 14-18 years, n = 32) were recruited from intensive outpatient (IOP) substance use treatment and reported on motivation to abstain from alcohol and marijuana shortly after treatment admission (i.e., at baseline). Diffusion tensor imaging data were collected approximately 7 weeks after starting IOP and were used to quantify WM integrity (indexed by fractional anisotropy, FA) using a region of interest (ROI) approach. Treatment outcomes were assessed 6 months after baseline. Indirect effects analyses tested FA in prefrontal, orbitofrontal, and temporal ROIs as a linking variable in the pathway from motivation to abstain to alcohol and marijuana outcomes. Bivariate correlations indicated that greater motivation to abstain from alcohol was associated with lower FA in prefrontal, orbitofrontal, and temporal ROIs and that lower FA in these three ROIs was associated with greater 6-month alcohol problem severity. The indirect effect of FA was significant for the prefrontal ROI in the pathway from motivation to outcome for alcohol. FA values were not associated with motivation to abstain from marijuana or marijuana-related outcomes. Results suggest that lower WM integrity, particularly in the prefrontal brain region, may help to explain greater alcohol problem severity at 6 months despite higher motivation to abstain from alcohol. Interventions that aim to enhance WM integrity warrant attention to improve adolescent treatment outcomes.
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Affiliation(s)
- Tammy Chung
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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