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Fascher M, Nowaczynski S, Muehlhan M. Substance use disorders are characterised by increased voxel-wise intrinsic measures in sensorimotor cortices: An ALE meta-analysis. Neurosci Biobehav Rev 2024; 162:105712. [PMID: 38733896 DOI: 10.1016/j.neubiorev.2024.105712] [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] [Received: 02/14/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024]
Abstract
Substance use disorders (SUDs) are severe psychiatric illnesses. Seed region and independent component analyses are currently the dominant connectivity measures but carry the risk of false negatives due to selection. They can be complemented by a data-driven and whole-brain usage of voxel-wise intrinsic measures (VIMs). We meta-analytically integrated VIMs, namely regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), voxel-mirrored homotopy connectivity (VMHC) and degree centrality (DC) across different SUDs using the Activation Likelihood Estimation (ALE) algorithm, functionally decoded emerging clusters, and analysed their connectivity profiles. Our systematic search identified 51 studies including 1439 SUD participants. Although no overall convergent pattern of alterations across VIMs in SUDs was found, sensitivity analyses demonstrated two ALE-derived clusters of increased ReHo and ALFF in SUDs, which peaked in the left pre- and postcentral cortices. Subsequent analyses showed their involvement in action execution, somesthesis, finger tapping and vibrotactile monitoring/discrimination. Their numerous clinical correlates across included studies highlight the under-discussed role of sensorimotor cortices in SUD, urging a more attentive exploration of their clinical significance.
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Affiliation(s)
- Maximilian Fascher
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany.
| | - Sandra Nowaczynski
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; Department of Addiction Medicine, Carl-Friedrich-Flemming-Clinic, Helios Medical Center Schwerin, Wismarsche Str. 393, Schwerin 19055, Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany
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2
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Parmar A, Lal R, Sarkar S, Singh Balhara YP. Neurological Soft Signs in Cannabis Use Disorder with or without Psychosis: A Comparative Study from India. J Dual Diagn 2021; 17:267-276. [PMID: 34609263 DOI: 10.1080/15504263.2021.1979887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The purpose of this study was to assess and compare neurological soft signs in patients of cannabis use disorder (CUD) with and without co-occurring psychosis in a treatment-seeking sample. METHODS We included 30 right-handed male subjects aged 18-65 years diagnosed with CUD (as per DSM-5) without any co-occurring psychiatric disorder in group I and those with co-occurring non-affective psychosis in group II. Group III consisted of 30 age and sex-matched, right-handed, healthy subjects with no psychiatric or medical conditions. Neurological Evaluation Scale (NES) was applied to measure neurological soft signs across the groups. We also used the Severity of Dependence Scale (in CUD with or without co-occurring non-affective psychosis groups) and Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Barnes Akathisia Rating Scale, Abnormal Involuntary Movements Scale, and Simpson Angus Scale (in CUD with co-occurring non-affective psychosis group) . RESULTS Our data suggested higher total NES mean scores in CUD with (20.53 ± 13.77) or without co-occurring non-affective psychosis groups (15.93 ± 9.86) as compared to healthy controls (6.20 ± 5.40) (χ2 = 23.12; p < .001). However, there were no differences between cannabis use disorder with or without co-occurring non-affective psychosis groups. The mean of subdomain scores of motor incoordination, sequencing of complex motor tasks, sensory integration, and others was significantly higher in CUD with or without co-occurring non-affective psychosis groups compared to healthy controls. CONCLUSION Impairment in neurological soft signs is present in patients with CUD regardless of a co-occurring psychosis. Cannabinoids might be interacting with the brain circuits known to be involved in schizophrenia.
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Affiliation(s)
- Arpit Parmar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Rakesh Lal
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Yatan Pal Singh Balhara
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
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3
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Wolf RC, Werler F, Wittemann M, Schmitgen MM, Kubera KM, Wolf ND, Reith W, Hirjak D. Structural correlates of sensorimotor dysfunction in heavy cannabis users. Addict Biol 2021; 26:e13032. [PMID: 33951262 DOI: 10.1111/adb.13032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/21/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination and sensorimotor integration. Whether such abnormalities may also apply to non-dependent individuals with heavy cannabis use (HCU) is unknown, as much as the neural correlates underlying such deficits. In this study, we investigated associations between NSS and gray matter volume (GMV) in males with HCU and male controls. Twenty-four persons with HCU and 17 controls were examined using standardized assessment of NSS and structural magnetic resonance imaging (MRI) at 3 T. GMV was calculated using voxel-based morphometry algorithms provided by the Computational Anatomy Toolbox (CAT12). Individuals with HCU showed higher NSS total scores compared to controls. In particular, significant NSS-subdomain effects were found for "motor coordination" (MoCo), "complex motor tasks" (CoMT), and "hard signs" (HS) expression in HCU (p < 0.05, Bonferroni-corrected). Compared to controls, persons with HCU showed significant NSS/GMV interactions in putamen and inferior frontal cortex (MoCo), right cerebellum (CoMT) and middle and superior frontal cortices, and bilateral precentral cortex and thalamus (HS). In between-group analyses, individuals with HCU showed lower GMV in the right anterior orbital and precentral gyrus, as well as higher GMV in the right superior frontal gyrus and left supplementary motor cortex compared to controls. The data support the notion of abnormal sensorimotor performance associated with HCU. The data also provide a neuromechanistic understanding of such deficits, particularly with respect to aberrant cortical-thalamic-cerebellar-cortical circuit.
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Affiliation(s)
- Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Miriam Wittemann
- Department of Psychiatry and Psychotherapy Saarland University Saarbrücken Germany
| | - Mike M. Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Katharina M. Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Nadine D. Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Wolfgang Reith
- Department of Neuroradiology Saarland University Saarbrücken Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
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4
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Martin AMS, Kim DJ, Newman SD, Cheng H, Hetrick WP, Mackie K, O’Donnell BF. Altered cerebellar-cortical resting-state functional connectivity in cannabis users. J Psychopharmacol 2021; 35:823-832. [PMID: 34034553 PMCID: PMC8813046 DOI: 10.1177/02698811211019291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cannabis use has been associated with abnormalities in cerebellar mediated motor and non-motor (i.e. cognition and personality) phenomena. Since the cerebellum is a region with high cannabinoid type 1 receptor density, these impairments may reflect alterations of signaling between the cerebellum and other brain regions. AIMS We hypothesized that cerebellar-cortical resting-state functional connectivity (rsFC) would be altered in cannabis users, relative to their non-using peers. It was also hypothesized that differences in rsFC would be associated with cannabis use features, such as age of initiation and lifetime use. METHODS Cerebellar-cortical and subcortical rsFCs were computed between 28 cerebellar lobules, defined by a spatially unbiased atlas template of the cerebellum, and individual voxels in the cerebral regions, in 41 regular cannabis users (20 female) and healthy non-using peers (N = 31; 18 female). We also investigated associations between rsFC and cannabis use features (e.g. lifetime cannabis use and age of initiation). RESULTS Cannabis users demonstrated hyperconnectivity between the anterior cerebellar regions (i.e. lobule I-IV) with the posterior cingulate cortex, and hypoconnectivity between the rest of the cerebellum (i.e. Crus I and II, lobule VIIb, VIIIa, VIIIb, IX, and X) and the cortex. No associations were observed between features of cannabis use and rsFC. CONCLUSIONS Cannabis use was associated with altered patterns of rsFC from the cerebellum to the cerebral cortex which may have a downstream impact on behavior and cognition.
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Affiliation(s)
- Ashley M Schnakenberg Martin
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dae-Jin Kim
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Hu Cheng
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - William P Hetrick
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ken Mackie
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brian F O’Donnell
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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5
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Oral repeated-dose toxicity studies of BIA 10–2474 in cynomolgus monkeys. Regul Toxicol Pharmacol 2020; 111:104547. [DOI: 10.1016/j.yrtph.2019.104547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022]
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Bolbecker AR, Apthorp D, Martin AS, Tahayori B, Moravec L, Gomez KL, O’Donnell BF, Newman SD, Hetrick WP. Disturbances of postural sway components in cannabis users. Drug Alcohol Depend 2018; 190:54-61. [PMID: 29983392 PMCID: PMC7185833 DOI: 10.1016/j.drugalcdep.2018.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A prominent effect of acute cannabis use is impaired motor coordination and driving performance. However, few studies have evaluated balance in chronic cannabis users, even though density of the CB1 receptor, which mediates the psychoactive effects of cannabis, is extremely high in brain regions critically involved in this fundamental behavior. The present study measured postural sway in regular cannabis users and used rambling and trembling analysis to quantify the integrity of central and peripheral nervous system contributions to the sway signal. METHODS Postural sway was measured in 42 regular cannabis users (CB group) and 36 non-cannabis users (N-CB group) by asking participants to stand as still as possible on a force platform in the presence and absence of motor and sensory challenges. Center of pressure (COP) path length was measured, and the COP signal was decomposed into rambling and trembling components. Exploratory correlational analyses were conducted between sway variables, cannabis use history, and neurocognitive function. RESULTS The CB group had significantly increased path length and increased trembling in the anterior-posterior (AP) direction. Exploratory correlational analyses suggested that AP rambling was significantly inversely associated with visuo-motor processing speed. DISCUSSION Regular cannabis use is associated with increased postural sway, and this appears to be predominantly due to the trembling component, which is believed to reflect the peripheral nervous system's contribution to the sway signal.
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Affiliation(s)
- Amanda R. Bolbecker
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States,School of Psychology and Behavioural Science, University of New England, NSW, Australia,Corresponding author at: Dept. of Psychological and Brain Sciences, Indiana University, 1101 E. Tenth St., Bloomington, IN, 47405, United States. (A.R. Bolbecker)
| | - Deborah Apthorp
- School of Psychology and Behavioural Science, University of New England, NSW, Australia,Research School of Computer Science, Australian National University, ACT, Australia
| | | | - Behdad Tahayori
- Department of Biomedical Engineering, Florida International University, Miami, Florida, United States
| | - Leah Moravec
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Karen L. Gomez
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Brian F. O’Donnell
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States
| | - Sharlene D. Newman
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - William P. Hetrick
- Dept. of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States,Dept. of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Larue D. Carter Memorial Hospital, Indianapolis, IN, United States
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7
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Hirjak D, Thomann PA, Wolf RC, Kubera KM, Goch C, Hering J, Maier-Hein KH. White matter microstructure variations contribute to neurological soft signs in healthy adults. Hum Brain Mapp 2017; 38:3552-3565. [PMID: 28429448 DOI: 10.1002/hbm.23609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/26/2017] [Accepted: 03/29/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Neurological soft signs (NSS) are core features of psychiatric disorders with significant neurodevelopmental origin. However, it is unclear whether NSS correlates are associated with neuropathological processes underlying the disease or if they are confounded by medication. Given that NSS are also present in healthy persons (HP), investigating HP could reveal NSS correlates, which are not biased by disease-specific processes or drug treatment. Therefore, we used a combination of diffusion MRI analysis tools to provide a framework of specific white matter (WM) microstructure variations underlying NSS in HP. METHOD NSS of 59 HP were examined on the Heidelberg Scale and related to diffusion associated metrics. Using tract-based spatial statistics (TBSS), we studied WM variations in fractional anisotropy (FA) as well as radial (RD), axial (AD), and mean diffusivity (MD). Using graph analytics (clustering coefficient-CC, local betweenness centrality -BC), we then explored DTI-derived structural network variations in regions identified by previous MRI studies on NSS. RESULTS NSS scores were negatively associated with RD, AD and MD in corpus callosum, brainstem and cerebellum (P < 0.05, corr.). NSS scores were negatively associated with CC and BC of the pallidum, the superior parietal gyrus, the precentral sulcus, the insula, and the cingulate gyrus (P < 0.05, uncorr.). CONCLUSION The present study supports the notion that WM microstructure variations in subcortical and cortical sensorimotor regions contribute to NSS expression in young HP. Hum Brain Mapp 38:3552-3565, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.,Center for Mental Health, Odenwald District Healthcare Center, Albert-Schweitzer-Straße 10-20, 64711, Erbach, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Caspar Goch
- Medical Image Computing Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Hering
- Medical Image Computing Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Klaus H Maier-Hein
- Medical Image Computing Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Halayem S, Hammami M, Fakhfakh R, Gaddour N, Tabbane K, Amado I, Krebs MO, Bouden A. Adaptation et validation d’une échelle des signes neurologiques mineurs chez l’enfant. Encephale 2017; 43:128-134. [DOI: 10.1016/j.encep.2016.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/14/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
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9
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Rentzsch J, Kronenberg G, Stadtmann A, Neuhaus A, Montag C, Hellweg R, Jockers-Scherübl MC. Opposing Effects of Cannabis Use on Late Auditory Repetition Suppression in Schizophrenia Patients and Healthy Control Subjects. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [DOI: 10.1016/j.bpsc.2016.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Mhalla A, Ben Mohamed B, Correll CU, Amamou B, Mechri A, Gaha L. Neurological soft signs in Tunisian patients with first-episode psychosis and relation with cannabis use. Ann Gen Psychiatry 2017; 16:30. [PMID: 28717382 PMCID: PMC5508788 DOI: 10.1186/s12991-017-0153-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/01/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neurological soft signs (NSS) are minor non-localizing neurological abnormalities that are conceptualized as neurodevelopmental markers that mediate the biological risk for psychosis. We aimed to explore the relationship between NSS and cannabis use, an environmental risk factor of psychosis. METHODS This was a cross-sectional study in consecutively admitted patients hospitalized for first-episode psychosis. NSS were assessed by the NSS scale (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization). Presence of NSS was defined as a NSS scale total score ≥9.5. Cannabis use was ascertained with the cannabis subsection in the Composite International Diagnostic Interview. RESULTS Among 61 first-episode psychosis patients (mean age = 28.9 ± 9.4 years; male = 86.9%, antipsychotic-naïve = 75.4%), the prevalence of current cannabis use was 14.8% (heavy use = 8.2%, occasional use = 6.6%). NSS were present in 83.6% of the sample (cannabis users = 66.7% versus cannabis non-users = 85.5%, p = 0.16). The mean total NSS score was 15.3 ± 6.7, with a significant lower total NSS score in cannabis users (11.2 ± 5.6 versus 16.0 ± 6.7, p = 0.048). Differences were strongest for the "motor coordination" (p = 0.06) and "involuntary movements" (p = 0.07) sub-scores. CONCLUSIONS This study demonstrated a negative association between cannabis use and NSS, especially regarding motor discoordination. This finding supports the hypothesis that a strong environmental risk factor, such as cannabis, may contribute to the onset of psychosis even in the presence of lower biological and genetic vulnerability, as reflected indirectly by lower NSS scores. Nevertheless, additional studies are needed that explore this interaction further in larger samples and considering additional neurobiological and environmental risk factors.
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Affiliation(s)
- Ahmed Mhalla
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Bochra Ben Mohamed
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY USA.,Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY USA
| | - Badii Amamou
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Anouar Mechri
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Lotfi Gaha
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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Mild neurological impairment may indicate a psychomotor endophenotype in patients with borderline personality disorder. Psychiatry Res 2016; 245:22-26. [PMID: 27526313 DOI: 10.1016/j.psychres.2016.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 07/09/2016] [Accepted: 08/03/2016] [Indexed: 01/02/2023]
Abstract
The aim of the present study was to determine whether patients with borderline personality disorder (BPD) show any neurological soft signs compared to healthy controls. Furthermore we sought to examine the role of common symptoms related to BPD, such as depression, anxiety or impulsivity, in association with neurological soft signs. Thirty patients with borderline personality disorder and thirty hospital-based controls were examined for neurological soft signs. The total score of neurological soft signs in BPD was significantly higher than controls. In terms of subscales, patients had higher scores in Sensory Integration and Motor Coordination and other neurological soft signs compared to control group. Multiple regression analysis showed that the impulsivity score was the best significant predictor of neurological soft signs in BPD. The increase of neurological soft signs in patients with BPD may address a non-focal neurological dysfunction in borderline personality disorder.
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Walter C, Oertel BG, Felden L, Kell CA, Nöth U, Vermehren J, Kaiser J, Deichmann R, Lötsch J. Brain Mapping-Based Model of Δ(9)-Tetrahydrocannabinol Effects on Connectivity in the Pain Matrix. Neuropsychopharmacology 2016; 41:1659-69. [PMID: 26514581 PMCID: PMC4832029 DOI: 10.1038/npp.2015.336] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 10/09/2015] [Accepted: 10/10/2015] [Indexed: 01/08/2023]
Abstract
Cannabinoids receive increasing interest as analgesic treatments. However, the clinical use of Δ(9)-tetrahydrocannabinol (Δ(9)-THC) has progressed with justified caution, which also owes to the incomplete mechanistic understanding of its analgesic effects, in particular its interference with the processing of sensory or affective components of pain. The present placebo-controlled crossover study therefore focused on the effects of 20 mg oral THC on the connectivity between brain areas of the pain matrix following experimental stimulation of trigeminal nocisensors in 15 non-addicted healthy volunteers. A general linear model (GLM) analysis identified reduced activations in the hippocampus and the anterior insula following THC administration. However, assessment of psychophysiological interaction (PPI) revealed that the effects of THC first consisted in a weakening of the interaction between the thalamus and the secondary somatosensory cortex (S2). From there, dynamic causal modeling (DCM) was employed to infer that THC attenuated the connections to the hippocampus and to the anterior insula, suggesting that the reduced activations in these regions are secondary to a reduction of the connectivity from somatosensory regions by THC. These findings may have consequences for the way THC effects are currently interpreted: as cannabinoids are increasingly considered in pain treatment, present results provide relevant information about how THC interferes with the affective component of pain. Specifically, the present experiment suggests that THC does not selectively affect limbic regions, but rather interferes with sensory processing which in turn reduces sensory-limbic connectivity, leading to deactivation of affective regions.
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Affiliation(s)
- Carmen Walter
- Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Bruno G Oertel
- Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Lisa Felden
- Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Christian A Kell
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany,Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Johannes Vermehren
- Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Jochen Kaiser
- Institute of Medical Psychology, Goethe University, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Jörn Lötsch
- Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany,Institute of Clinical Pharmacology, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany, Tel: +49 69 6301 4589, Fax: +49 69 6301 4354, E-mail:
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13
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Benard V, Rolland B, Messaadi N, Petit A, Cottencin O, Karila L. [Cannabis use: what to do in general practice?]. Presse Med 2015; 44:707-15. [PMID: 26144274 DOI: 10.1016/j.lpm.2014.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 10/26/2014] [Accepted: 11/13/2014] [Indexed: 01/07/2023] Open
Abstract
Cannabis use is now more frequent than alcohol drinking or tobacco smoking among young people (15-34years), whereas it may induce numerous medical aftermaths. Identifying and assessing cannabis use in general practice have become a current public health issue. The two steps of screening consist in spotting risky use of cannabis, and then in checking criteria for cannabis use disorder (CUD). Risky use requires a "brief intervention" by the general practitioner (GP). In case of CUD, the new DSM-5 criteria allow measuring the severity of the subsequent disorder, and listing the medical and social consequences. Using these criteria can help the GP to decide when the patient should be referred to an addiction-specialized unit. The GP has also to spot the different physical and psychiatric complications of cannabis use, in order to coordinate care between the different specialists.
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Affiliation(s)
- Victoire Benard
- CHU de Lille, université Lille Nord de France, service d'addictologie, 59000 Lille, France
| | - Benjamin Rolland
- CHU de Lille, université Lille Nord de France, service d'addictologie, 59000 Lille, France
| | - Nassir Messaadi
- Université Lille Nord de France, département de médecine générale, 59000 Lille, France
| | - Aymeric Petit
- Hôpital universitaire Bichat-Claude Bernard, service d'addictologie, 75018 Paris, France
| | - Olivier Cottencin
- CHU de Lille, université Lille Nord de France, service d'addictologie, 59000 Lille, France
| | - Laurent Karila
- AP-HP, hôpital Paul-Brousse, université Paris Sud-11, centre d'enseignement, de recherche et de traitement des addictions, Inserm-CEA U1000, 94800 Villejuif, France.
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Le Seac'h A, Picard H, Gorsane MA, Vidal PP, Amado I, Krebs MO. A step toward an objective quantification of subtle neurological signs in schizophrenia. Psychiatry Res 2012; 198:230-4. [PMID: 22445071 DOI: 10.1016/j.psychres.2011.12.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 12/19/2011] [Accepted: 12/26/2011] [Indexed: 11/30/2022]
Abstract
Numerous reports have emphasized the value of neurological soft signs (NSS) as endophenotypic markers in schizophrenia. NSS also appear as useful prognostic predictors for functional outcome, response and tolerance to antipsychotics. Although several standardized scales have been proposed and offer fair inter-rater reliability, they still rely on the experience and accuracy of the investigators. This study was designed to assess NSS objectively. We evaluated 27 patients who met the Diagnostic and Statistical Manual, fourth edition (DSM-IV) criteria for schizophrenia and 15 healthy controls using a standardized examination encompassing a 23-item NSS scale as well as an assessment of parkinsonism and dyskinesia. Movements were then recorded using inertia sensors while the patients were performing a selection of motor items from the aforementioned scale (balance tasks, rapid alternative movements, rigidity). To our knowledge, this study is the first to provide an objective assessment of specific NSS in schizophrenia using inertial sensors. The results objectively demonstrate impairments in patients with schizophrenia when balance relies on proprioceptive information, with specific differences in groups of patients based on their NSS scores. Inertia sensors are promising, inexpensive and 'easy-to-use' tools that could improve the assessment of motor and sensory impairments in patients with schizophrenia in daily clinical practice, especially when the dysfunction is subtle.
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Affiliation(s)
- Anne Le Seac'h
- Laboratoire de Physiopathologie des Maladies Psychiatriques (INSERM U894), Centre de Psychiatrie et Neurosciences, Paris, France
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