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Kayir H, Ruffolo J, McCunn P, Khokhar JY. The Relationship Between Cannabis, Cognition, and Schizophrenia: It's Complicated. Curr Top Behav Neurosci 2023; 63:437-461. [PMID: 36318403 DOI: 10.1007/7854_2022_396] [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] [Indexed: 06/16/2023]
Abstract
The consequences of cannabis use, especially in the context of schizophrenia, have gained increased importance with the legalization of cannabis in North America and across the globe. Cannabis use has multifaceted impacts on cognition in schizophrenia patients and healthy subjects. Healthy subjects, particularly those who initiated cannabis use at earlier ages and used high-potency cannabis for longer durations, exhibited poorer cognition mainly in working memory and attention. Cannabis use in schizophrenia has been associated with symptom exacerbation, longer and more frequent psychotic episodes, and poorer treatment outcomes. However, cannabis-using patients have better overall cognitive performance compared to patients who were not cannabis users. Interestingly, these effects were only apparent in lifetime cannabis users, but not in current (or within last 6 months) users. Moreover, higher frequency and earlier age of cannabis use initiation (i.e., before 17 years of age) were associated with better cognitive performance, although they had an earlier illness onset. Three possible hypotheses seem to come forward to explain this paradox. First, some components of cannabis may have antipsychotic or cognitive-enhancing properties. Secondly, chronic cannabis use may alter endocannabinoid signaling in the brain which could be a protective factor for developing psychosis or cognitive impairments. A third explanation could be their representation of a phenotypically distinct patient group with more intact cognitive functioning and less neurodevelopmental pathology. Multiple factors need to be considered to understand the complex relationship between cannabis, cognitive function, and schizophrenia. In short, age at initiation, duration and rate of cannabis use, abstinence duration, co-use of substances and alcohol, prescribed medications, relative cannabinoid composition and potency of cannabis, presence of genetic and environmental vulnerability factors are prominent contributors to the variability in outcomes. Animal studies support the disruptive effects of Δ9-tetrahydrocannabinol (THC) administration during adolescence on attention and memory performance. They provide insights about interaction of cannabinoid receptors with other neurotransmitter systems, such as GABA and glutamate, and other regulatory molecules, such as PSD95 and synaptophysin. Cannabidiol (CBD), on the other hand, can improve cognitive deficits seen in neurodevelopmental and chemically-induced animal models of schizophrenia. Future studies focusing on bridging the translational gaps between human and animal studies, through the use of translationally relevant methods of exposure (e.g., vaping), consistent behavioral assessments, and congruent circuit interrogations (e.g., imaging) will help to further clarify this complex picture.
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Affiliation(s)
- Hakan Kayir
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jessica Ruffolo
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Patrick McCunn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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Levent A, Davelaar EJ. Recreational drug use and prospective memory. Psychopharmacology (Berl) 2022; 239:909-922. [PMID: 35129670 DOI: 10.1007/s00213-022-06081-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
Prospective memory (PM) impairment in recreational drug users has been documented in recent years. However, most studies on the effects of drugs on PM contain several methodological challenges, such as small sample size (< 100 participants), unrepresentative sample type (e.g., student or patient), short abstinence period (< 7 days), and lack of control of potential confounds (e.g., sleep and IQ). The present study investigated the possible consequences of recreational drug use on prospective memory, using self-report and lab-based prospective memory measures while overcoming the methodological challenges. The sample was composed of 47 non-users (27 females, age range from 18 to 50 +) and 53 drug users (21 females, age range from 18 to 50 +). Recreational drug users reported significantly more deficits in the long-term episodic, short-term habitual, and internally cued PM failures subscales of the Prospective Memory Questionnaire. However, these deficits were eliminated after controlling for covariates (e.g., age, sleep quality, general health, alcohol usage). Recreational drug users also performed worse than non-users in the short-term, long-term, event-based, and time-based PM subscales of the Royal Prince Alfred Prospective Memory Test. These results remained significant after controlling for the covariates. Drug users demonstrated greater impairments on time-based and long-term PM tasks thought to be linked with executive functioning. Taken together, the present study provides further support for recreational drug-related deficits in PM and highlights a dissociation between self-report and lab-based PM measures.
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Affiliation(s)
- Adnan Levent
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK.
| | - Eddy J Davelaar
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK
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Morie KP, Potenza MN. A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory. Front Psychiatry 2021; 12:657371. [PMID: 33967859 PMCID: PMC8100188 DOI: 10.3389/fpsyt.2021.657371] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 01/26/2023] Open
Abstract
Cannabis is commonly used, and use may be increasing in the setting of increasing legalization and social acceptance. The scope of the effects of cannabis products, including varieties with higher or lower levels of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD), on domains related to addictive behavior deserves attention, particularly as legalization continues. Cannabis use may impact neural underpinnings of cognitive functions linked to propensities to engage in addictive behaviors. Here we consider these neurocognitive processes within the framework of the dual-process model of addictions. In this mini-review, we describe data on the relationships between two main constituents of cannabis (THC and CBD) and neural correlates of reward processing, inhibitory control and working memory.
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Affiliation(s)
- Kristen P. Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
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Levent A, Davelaar EJ. Illegal drug use and prospective memory: A systematic review. Drug Alcohol Depend 2019; 204:107478. [PMID: 31715546 DOI: 10.1016/j.drugalcdep.2019.04.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/13/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Illegal drug use is proposed to interfere with neurobiological functioning by damaging the neurotransmitter communication systems that are believed to be responsible for cognitive abilities, including perception, attention, and memory. This review specifically examined effects of illegal drug use on prospective memory (PM) - memory for future actions. Twenty- seven studies spanning 14 years were included in this review which were divided into two broad categories based on testing methods used: self-report and lab-based testing methods. The quality of the included studies was assessed across five categories: sample type, sample size, abstinence period, testing methods and control for confounding factors. The overall quality of evidence was good for six studies and moderate for sixteen studies and low for five studies. The results from the studies employing self-report were inconsistent as illegal drug users exhibited PM deficits in some studies, but not in others. However, the studies with lab-based testing methods demonstrated more consistent findings with illegal drug users scoring worse than non-users on various PM tests. There were also consistent findings on the link between the dosage of drug taken and level of PM deficit. Based on the literature, there is moderate evidence that illegal drug use impairs PM ability. We recommend that further lab-based studies be conducted to assess dose-response effects on drug-specificity.
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Affiliation(s)
- Adnan Levent
- Department of Psychological Sciences, Birkbeck, University of London, UK.
| | - Eddy J Davelaar
- Department of Psychological Sciences, Birkbeck, University of London, UK
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Platt B, O'Driscoll C, Curran VH, Rendell PG, Kamboj SK. The effects of licit and illicit recreational drugs on prospective memory: a meta-analytic review. Psychopharmacology (Berl) 2019; 236:1131-1143. [PMID: 31093722 PMCID: PMC6591206 DOI: 10.1007/s00213-019-05245-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
Abstract
RATIONALE There are no recent reports summarising the magnitude of prospective memory (PM) impairments in recreational drug users. OBJECTIVE We performed a meta-analysis of studies (with a parallel group design) examining PM performance in users of common recreational drugs (including alcohol and tobacco) who were not intoxicated during testing. Studies were also evaluated for the presence of methodological bias. METHODS Twenty-seven studies were included in the meta-analysis following literature searches of MEDLINE, EMBASE and PsycINFO. Effect sizes (standardised mean difference; SMD) were calculated separately for the effects of alcohol, cannabis, ecstasy, methamphetamine and tobacco use. The influences of drug use and study characteristics on effect sizes were explored using meta-regressions. Sources of study bias were also assessed. RESULTS Heavy drinkers and regular drug users tended to perform worse than controls on event and time-based PM tasks. Effect sizes (standardised mean differences; SMDs) for event-based PM impairment across the different drug-using groups/heavy drinkers ranged between - 1.10 and - 0.49, with no 95% CI crossing 0.00. SMDs for time-based PM ranged between - 0.98 and - 0.70. Except for the CIs associated with the ES for smokers' time-based PM performance, no CIs crossed 0.00. CONCLUSIONS Although all drug-using groups showed moderate-large impairments in event and time-based PM, effect sizes had low precision and moderate-high levels of heterogeneity. In addition, several methodological and reporting issues were identified in the majority of studies. As such, considerable uncertainty remains regarding the role of confounds and the magnitude of PM impairments in non-intoxicated recreational drug users.
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Affiliation(s)
- Bradley Platt
- Clinical Psychopharmacology Unit, University College London, London, UK.
| | - Ciarán O'Driscoll
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Valerie H Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Peter G Rendell
- Cognition and Emotion Research Centre, Australian Catholic University, Melbourne, Australia
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, University College London, London, UK
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John WS, Martin TJ, Solingapuram Sai KK, Nader SH, Gage HD, Mintz A, Nader MA. Chronic Δ 9-THC in Rhesus Monkeys: Effects on Cognitive Performance and Dopamine D2/D3 Receptor Availability. J Pharmacol Exp Ther 2017; 364:300-310. [PMID: 29203575 DOI: 10.1124/jpet.117.244194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/30/2017] [Indexed: 01/24/2023] Open
Abstract
Cannabis-related impairments to cognitive function may represent novel therapeutic targets for cannabis-use disorder, although the nature, persistence, and reversibility of such deficits remain unclear. Adult male rhesus monkeys (N = 6) responded in the morning on tasks designed to assess different cognitive domains using the Cambridge Neuropsychological Test Automated Battery (CANTAB) touchscreens followed by responding maintained under a fixed-ratio (FR) 10 schedule of food presentation in different operant chambers. First, the acute effects of Δ9-tetrahydrocannabinol (THC; 0.01-0.56 mg/kg, i.v.) on cognitive performance, FR responding, and body temperature were determined. Next, THC (1.0-2.0 mg/kg, s.c.) was administered daily after FR 10 sessions for 12 weeks, during which the residual effects of THC (i.e., 22 hours after administration) on cognition were examined and the acute effects of THC were redetermined. In a subgroup of monkeys, dopamine D2/D3 receptor availability was assessed after 4 weeks of chronic THC exposure and compared with drug-naive controls using positron emission tomography and [11C]-raclopride (N = 4/group). Acute THC pretreatments dose-dependently decreased FR responding and body temperature, and impairment to cognitive performance was task specific. During chronic treatment, THC produced persistent residual impairment only to working memory; tolerance differentially developed to acute cognitive impairments. There was recovery from residual cognitive impairments to working memory within 2 weeks of abstinence. Compared with controls, D2/D3 receptor availability was not altered during chronic THC treatment. In conclusion, THC-induced disruptions in cognition were task-specific, as was tolerance development, and not related to changes in D2/D3 receptor availability. Intervention strategies for cannabis-use disorder that enhance working memory performance may facilitate positive treatment outcomes.
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Affiliation(s)
- William S John
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Thomas J Martin
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kiran Kumar Solingapuram Sai
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Susan H Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - H Donald Gage
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Akiva Mintz
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael A Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
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7
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Nusbaum AT, Whitney P, Cuttler C, Spradlin A, Hinson JM, McLaughlin RJ. Altered attentional control strategies but spared executive functioning in chronic cannabis users. Drug Alcohol Depend 2017; 181:116-123. [PMID: 29045919 DOI: 10.1016/j.drugalcdep.2017.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cannabis use has increased rapidly in recent decades. The increase in cannabis use makes it important to understand the potential influence of chronic use on attentional control and other executive functions (EFs). Because cannabis is often used to reduce stress, and because stress can constrain attentional control and EFs, the primary goal of this study was to determine the joint effect of acute stress and chronic cannabis use on specific EFs. METHODS Thirty-nine cannabis users and 40 non-users were assigned to either a stress or no stress version of the Maastricht Acute Stress Test. Participants then completed two cognitive tasks that involve EFs: (1) task switching, and (2) a novel Flexible Attentional Control Task. These two tasks provided assessments of vigilant attention, inhibitory control, top-down attentional control, and cognitive flexibility. Salivary cortisol was assessed throughout the study. RESULTS Reaction time indices showed an interaction between stress and cannabis use on top-down attentional control (p=0.036, np2=0.059). Follow-up tests showed that cannabis users relied less on top-down attentional control than did non-users in the no stress version. Despite not relying on top-down control, the cannabis users showed no overall performance deficits on the tasks. CONCLUSIONS Chronic cannabis users performed cognitive tasks involving EFs as well as non-users while not employing cognitive control processes that are typical for such tasks. These results indicate alterations in cognitive processing in cannabis users, but such alterations do not necessarily lead to global performance deficits.
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Affiliation(s)
- Amy T Nusbaum
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Paul Whitney
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Carrie Cuttler
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA; Translational Addiction Research Center, Washington State University, USA.
| | - Alexander Spradlin
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - John M Hinson
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA.
| | - Ryan J McLaughlin
- Washington State University, Department of Psychology, PO Box 644820, Pullman, WA, 99164-4820, USA; Translational Addiction Research Center, Washington State University, USA; Washington State University, Department of Integrative Physiology and Neuroscience, Pullman, WA, 99164-7620, USA.
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When increasing distraction helps learning: Distractor number and content interact in their effects on memory. Atten Percept Psychophys 2017; 79:2606-2619. [PMID: 28799028 PMCID: PMC5662706 DOI: 10.3758/s13414-017-1399-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Previous work has demonstrated that increasing the number of distractors in a search array can reduce interference from distractor content during target processing. However, it is unclear how this reduced interference influences learning of target information. Here, we investigated how varying the amount and content of distraction present in a learning environment affects visual search and subsequent memory for target items. In two experiments, we demonstrate that the number and content of competing distractors interact in their influence on target selection and memory. Specifically, while increasing the number of distractors present in a search array made target detection more effortful, it did not impair learning and memory for target content. Instead, when the distractors contained category information that conflicted with the target, increasing the number of distractors from one to three actually benefitted learning and memory. These data suggest that increasing numbers of distractors may reduce interference from conflicting conceptual information during encoding.
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Ratano P, Palmery M, Trezza V, Campolongo P. Cannabinoid Modulation of Memory Consolidation in Rats: Beyond the Role of Cannabinoid Receptor Subtype 1. Front Pharmacol 2017; 8:200. [PMID: 28446875 PMCID: PMC5388693 DOI: 10.3389/fphar.2017.00200] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/28/2017] [Indexed: 12/30/2022] Open
Abstract
The effects induced by exogenous manipulation of endocannabinoid neurotransmission on emotion and memory are often contradictory. Among the different factors involved, of particular interest is the binding affinity of endocannabinoids, and their analogs, for other receptor families beyond cannabinoid receptors, such as the peroxisome proliferator-activated receptors (PPARs), and the transient receptor potential cation channel subfamily V member 1 (TRPV1). The aim of this study was to investigate which receptor subtype mediates cannabinoid effects on memory consolidation for emotionally arousing experiences. We tested two cannabinoid compounds with different pharmacological properties in the inhibitory avoidance task, and evaluated whether the observed effects are mediated by cannabinoid, PPARα or TRPV1 receptor activation. We found that the synthetic cannabinoid agonist WIN55,212-2 and the FAAH inhibitor URB597 both enhanced memory consolidation for inhibitory avoidance training. WIN55,212-22 effects on memory consolidation were predominantly mediated by CB1 receptor activation but CB2 receptors were involved as well. The URB597-induced memory enhancement was dependent on the activation not only of CB1 and CB2 receptors but, notwithstanding, PPAR-α and TRPV1 receptors were involved as well. Our findings drive beyond the classical hypothesis centered on the unique role of CB1 receptor activation for cannabinoid effects on memory, and reveal new insights in the neural mechanisms of memory consolidation.
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Affiliation(s)
- Patrizia Ratano
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
| | - Maura Palmery
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
| | - Viviana Trezza
- Department of Science, Section of Biomedical Sciences and Technologies, Roma Tre UniversityRome, Italy
| | - Patrizia Campolongo
- Department of Physiology and Pharmacology, Sapienza University of RomeRome, Italy
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Carrigan N, Barkus E. A systematic review of the relationship between psychological disorders or substance use and self-reported cognitive failures. Cogn Neuropsychiatry 2016; 21:539-564. [PMID: 27809671 DOI: 10.1080/13546805.2016.1250620] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Cognitive failures are errors in normal everyday functioning. Individuals with psychological disorders may possess heightened vulnerability. We sought to review the literature on cognitive failures in psychological disorders to determine the nature of this association, and whether failures relate to neuropsychological performance. We also examine the relationship between cognitive failures and substance use since it is relevant to everyday cognition and co-occurs in many psychological disorders. METHODS We conducted a systematic review of self-reported cognitive failures in psychological disorders and substance use, identifying 21 papers in total. RESULTS Papers identified studied trauma, mood, and anxiety disorders, and schizophrenia. Substance use papers included nicotine, alcohol, cannabis, and ecstasy use. Cognitive failures were increased in some but not all papers; the most consistent findings were for depression, PTSD, and daily smokers of nicotine. Subjective failures did not correlate closely with neuropsychological outcomes in any disorders. We were unable to discern distinct profiles of failures for each disorder; rather they may reflect emotional dysregulation more broadly. CONCLUSIONS The real world cognitive experiences of people with psychological disorders may differ to their performance in the clinic or lab. It is important that self-reports of minor cognitive issues are considered as both a potential risk and a maintaining factor of illness. Substance use also needs to be considered in assessing cognitive failures.
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Affiliation(s)
- Nicole Carrigan
- a School of Psychology, Faculty of Social Sciences , University of Wollongong , Wollongong , NSW , Australia
| | - Emma Barkus
- a School of Psychology, Faculty of Social Sciences , University of Wollongong , Wollongong , NSW , Australia
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11
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Broyd SJ, van Hell HH, Beale C, Yücel M, Solowij N. Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic Review. Biol Psychiatry 2016; 79:557-67. [PMID: 26858214 DOI: 10.1016/j.biopsych.2015.12.002] [Citation(s) in RCA: 400] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 01/05/2023]
Abstract
Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistence or recovery across all cognitive domains remains underresearched. Associations between poorer performance and a range of cannabis use parameters, including a younger age of onset, are frequently reported. Little further evidence has emerged for the development of tolerance to the acutely impairing effects of cannabis. Evidence for potential protection from harmful effects by cannabidiol continues to increase but is not definitive. In light of increasing trends toward legalization of cannabis, the knowledge gained from this body of research needs to be incorporated into strategies to minimize harm.
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Affiliation(s)
- Samantha J Broyd
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Hendrika H van Hell
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Camilla Beale
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong.
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Problematic alcohol use among individuals with HIV: relations with everyday memory functioning and HIV symptom severity. AIDS Behav 2014; 18:1302-14. [PMID: 23979498 DOI: 10.1007/s10461-013-0602-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Problematic alcohol use has been shown to negatively impact cognitive functions germane to achieving optimal HIV health outcomes. The present study, a secondary data analysis, examined the impact of problematic alcohol use on aspects of everyday memory functioning in a sample of 172 HIV-infected individuals (22 % female; Mage = 48.37 years, SD = 8.64; 39 % Black/non-Hispanic). Additionally, we tested whether self-reported memory functioning explained the relation between problematic alcohol use and HIV symptom severity. Results indicated that problematic patterns of alcohol use were associated with lower total memory functioning, retrieval (e.g., recall-difficulty) and memory for activity (e.g., what you did yesterday) and greater HIV symptom severity. Memory functioning mediated the relation between problematic alcohol use and HIV symptom severity. However, the direction of this relation was unclear as HIV symptom severity also mediated the relation between problematic alcohol use and memory functioning. Findings highlight the importance of integrated care for HIV and alcohol use disorders and suggest that routine alcohol and cognitive screenings may bolster health outcomes among this vulnerable population.
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Task importance affects event-based prospective memory performance in adults with HIV-associated neurocognitive disorders and HIV-infected young adults with problematic substance use. J Int Neuropsychol Soc 2014; 20:652-62. [PMID: 24834469 PMCID: PMC4103958 DOI: 10.1017/s1355617714000435] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Two experiments were conducted to examine the effects of task importance on event-based prospective memory (PM) in separate samples of adults with HIV-associated neurocognitive disorders (HAND) and HIV-infected young adults with substance use disorders (SUD). All participants completed three conditions of an ongoing lexical decision task: (1) without PM task requirements; (2) with PM task requirements that emphasized the importance of the ongoing task; and (3) with PM task requirements that emphasized the importance of the PM task. In both experiments, all HIV+ groups showed the expected increase in response costs to the ongoing task when the PM task's importance was emphasized. In Experiment 1, individuals with HAND showed significantly lower PM accuracy as compared to HIV+ subjects without HAND when the importance of the ongoing task was emphasized, but improved significantly and no longer differed from HIV+ subjects without HAND when the PM task was emphasized. A similar pattern of findings emerged in Experiment 2, whereby HIV+ young adults with SUD (especially cannabis) showed significant improvements in PM accuracy when the PM task was emphasized. Findings suggest that both HAND and SUD may increase the amount of cognitive attentional resources that need to be allocated to support PM performance in persons living with HIV infection.
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The endocannabinoid system: an emotional buffer in the modulation of memory function. Neurobiol Learn Mem 2013; 112:30-43. [PMID: 24382324 DOI: 10.1016/j.nlm.2013.12.010] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/16/2013] [Accepted: 12/20/2013] [Indexed: 01/12/2023]
Abstract
Extensive evidence indicates that endocannabinoids modulate cognitive processes in animal models and human subjects. However, the results of endocannabinoid system manipulations on cognition have been contradictory. As for anxiety behavior, a duality has indeed emerged with regard to cannabinoid effects on memory for emotional experiences. Here we summarize findings describing cannabinoid effects on memory acquisition, consolidation, retrieval and extinction. Additionally, we review findings showing how the endocannabinoid system modulates memory function differentially, depending on the level of stress and arousal associated with the experimental context. Based on the evidence reviewed here, we propose that the endocannabinoid system is an emotional buffer that moderates the effects of environmental context and stress on cognitive processes.
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Crane NA, Schuster RM, Fusar-Poli P, Gonzalez R. Effects of cannabis on neurocognitive functioning: recent advances, neurodevelopmental influences, and sex differences. Neuropsychol Rev 2013; 23:117-37. [PMID: 23129391 PMCID: PMC3593817 DOI: 10.1007/s11065-012-9222-1] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/22/2012] [Indexed: 12/19/2022]
Abstract
Decades of research have examined the effects of cannabis on neurocognition. Recent advances in this field provide us with a better understanding of how cannabis use influences neurocognition both acutely (during intoxication) and non-acutely (after acute effects subside). Evidence of problems with episodic memory is one of the most consistent findings reported; however, several other neurocognitive domains appear to be adversely affected by cannabis use under various conditions. There is significant variability in findings across studies, thus a discussion of potential moderators is increasingly relevant. The purpose of this review was to 1) provide an update on research of cannabis' acute and non-acute effects on neurocognition, with a focus on findings since 2007 and 2) suggest and discuss how neurodevelopmental issues and sex differences may influence cannabis effects on neurocognition. Finally we discuss how future investigations may lead to better understanding of the complex interplay among cannabis, stages of neurodevelopment, and sex on neurocognitive functioning.
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Affiliation(s)
| | | | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London
| | - Raul Gonzalez
- Department of Psychology, Florida International University
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Cuttler C, McLaughlin RJ, Graf P. Mechanisms underlying the link between cannabis use and prospective memory. PLoS One 2012; 7:e36820. [PMID: 22606293 PMCID: PMC3350467 DOI: 10.1371/journal.pone.0036820] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 04/14/2012] [Indexed: 11/25/2022] Open
Abstract
While the effects of cannabis use on retrospective memory have been extensively examined, only a limited number of studies have focused on the links between cannabis use and prospective memory. We conducted two studies to examine the links between cannabis use and both time-based and event-based prospective memory as well as potential mechanisms underlying these links. For the first study, 805 students completed an online survey designed to assess cannabis consumption, problems with cannabis use indicative of a disorder, and frequency of experiencing prospective memory failures. The results showed small to moderate sized correlations between cannabis consumption, problems with cannabis use, and prospective memory. However, a series of mediation analyses revealed that correlations between problems with cannabis use and prospective memory were driven by self-reported problems with retrospective memory. For the second study, 48 non-users (who had never used cannabis), 48 experimenters (who had used cannabis five or fewer times in their lives), and 48 chronic users (who had used cannabis at least three times a week for one year) were administered three objective prospective memory tests and three self-report measures of prospective memory. The results revealed no objective deficits in prospective memory associated with chronic cannabis use. In contrast, chronic cannabis users reported experiencing more internally-cued prospective memory failures. Subsequent analyses revealed that this effect was driven by self-reported problems with retrospective memory as well as by use of alcohol and other drugs. Although our samples were not fully characterized with respect to variables such as neurological disorders and family history of substance use disorders, leaving open the possibility that these variables may play a role in the detected relationships, the present findings indicate that cannabis use has a modest effect on self-reported problems with prospective memory, with a primary problem with retrospective memory appearing to underlie this relationship.
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Affiliation(s)
- Carrie Cuttler
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
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Macher RB, Earleywine M. Enhancing neuropsychological performance in chronic cannabis users: The role of motivation. J Clin Exp Neuropsychol 2012; 34:405-15. [DOI: 10.1080/13803395.2011.646957] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Montgomery C, Seddon AL, Fisk JE, Murphy PN, Jansari A. Cannabis-related deficits in real-world memory. Hum Psychopharmacol 2012; 27:217-25. [PMID: 22389086 DOI: 10.1002/hup.1273] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Research shows that cannabis users exhibit deficits in prospective memory (PM) and executive function, which persist beyond acute intoxication. However, many studies rely on self-reports of memory failures or use laboratory-based measures that may not mimic functional deficits in the real world. The present study aimed to assess real-world memory functioning. METHOD Twenty cannabis-only users and 20 non-illicit drug users were recruited. Participants completed a substance use inventory and a mood scale, followed by a non-immersive virtual reality task assessing PM and executive functioning. The task involved the participant playing the role of an office worker for the day and performing routine office duties. A number of subscales were used to assess facets of executive function (planning, adaptive thinking, creative thinking, selection, prioritisation) and PM (time-based, event-based and action-based PM). RESULTS Multivariate analysis of variance revealed cannabis users performed worse overall on the task, with poor performance on the planning, time-based PM and event-based PM subscales. In addition, indices of cannabis (length, dose, frequency, total use) were correlated with performance on these three subscales. CONCLUSIONS The present study expands on previously established research, providing support for the cannabis-related deficits in PM and executive functioning, and the role of different aspects of cannabis use in these deficits.
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Palermo L, Bianchini F, Iaria G, Tanzilli A, Guariglia C. Assessing topographical orientation skills in cannabis users. ScientificWorldJournal 2012; 2012:137071. [PMID: 22272167 PMCID: PMC3259701 DOI: 10.1100/2012/137071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 11/17/2011] [Indexed: 11/26/2022] Open
Abstract
The long-term effects of cannabis on human cognition are still unclear, but, considering that cannabis is a widely used substance and, overall, its potential use in therapeutic interventions, it is important to evaluate them. We hypothesize that the discrepancies among studies could be attributed to the specific cognitive function investigated and that skills subserved by the hippocampus, such as the spatial orientation abilities and, specifically, the ability to form and use cognitive maps, should be more compromised than others. Indeed it has been showed that cannabis users have a reduced hippocampus and that the hippocampus is the brain region in which cannabis has the greatest effect since it contains the highest concentration of cannabinoid receptors. To test this hypothesis we asked 15 heavy cannabis users and 19 nonusers to perform a virtual navigational test, the CMT, that assesses the ability to form and use cognitive maps. We found that using cannabis has no effect on these hippocampus-dependent orientation skills. We discuss the implications of our findings and how they relate to evidence reported in the literature that the intervention of functional reorganization mechanisms in cannabis user allows them to cope with the cognitive demands of navigational tasks.
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Affiliation(s)
- Liana Palermo
- Dipartimento di Psicologia, "Sapienza" Università di Roma, 00185 Rome, Italy.
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Crean RD, Crane NA, Mason BJ. An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. J Addict Med 2011; 5:1-8. [PMID: 21321675 DOI: 10.1097/adm.0b013e31820c23fa] [Citation(s) in RCA: 406] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cannabis use has been shown to impair cognitive functions on a number of levels-from basic motor coordination to more complex executive function tasks, such as the ability to plan, organize, solve problems, make decisions, remember, and control emotions and behavior. These deficits differ in severity depending on the quantity, recency, age of onset and duration of marijuana use. Understanding how cannabis use impairs executive function is important. Individuals with cannabis-related impairment in executive functions have been found to have trouble learning and applying the skills required for successful recovery, putting them at increased risk for relapse to cannabis use. Here we review the research on the acute, residual, and long-term effects of cannabis use on executive functions, and discuss the implications for treatment.
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Affiliation(s)
- Rebecca D Crean
- Committee on the Neurobiology of Addictive Disorders; The Scripps Research Institute; La Jolla, CA 92037, USA
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Hadjiefthyvoulou F, Fisk JE, Montgomery C, Bridges N. Prospective memory functioning among ecstasy/polydrug users: evidence from the Cambridge Prospective Memory Test (CAMPROMPT). Psychopharmacology (Berl) 2011; 215:761-74. [PMID: 21301817 DOI: 10.1007/s00213-011-2174-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 01/10/2011] [Indexed: 11/26/2022]
Abstract
RATIONALE Prospective memory (PM) deficits in recreational drug users have been documented in recent years. However, the assessment of PM has largely been restricted to self-reported measures that fail to capture the distinction between event-based and time-based PM. The aim of the present study is to address this limitation. OBJECTIVES Extending our previous research, we augmented the range laboratory measures of PM by employing the CAMPROMPT test battery to investigate the impact of illicit drug use on prospective remembering in a sample of cannabis only, ecstasy/polydrug and non-users of illicit drugs, separating event and time-based PM performance. We also administered measures of executive function and retrospective memory in order to establish whether ecstasy/polydrug deficits in PM were mediated by group differences in these processes. RESULTS Ecstasy/polydrug users performed significantly worse on both event and time-based prospective memory tasks in comparison to both cannabis only and non-user groups. Furthermore, it was found that across the whole sample, better retrospective memory and executive functioning was associated with superior PM performance. Nevertheless, this association did not mediate the drug-related effects that were observed. Consistent with our previous study, recreational use of cocaine was linked to PM deficits. CONCLUSIONS PM deficits have again been found among ecstasy/polydrug users, which appear to be unrelated to group differences in executive function and retrospective memory. However, the possibility that these are attributable to cocaine use cannot be excluded.
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Hadjiefthyvoulou F, Fisk JE, Montgomery C, Bridges N. Everyday and prospective memory deficits in ecstasy/polydrug users. J Psychopharmacol 2011; 25:453-64. [PMID: 20123936 DOI: 10.1177/0269881109359101] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The impact of ecstasy/polydrug use on real-world memory (i.e. everyday memory, cognitive failures and prospective memory [PM]) was investigated in a sample of 42 ecstasy/polydrug users and 31 non-ecstasy users. Laboratory-based PM tasks were administered along with self-reported measures of PM to test whether any ecstasy/polydrug-related impairment on the different aspects of PM was present. Self-reported measures of everyday memory and cognitive failures were also administered. Ecstasy/polydrug associated deficits were observed on both laboratory and self-reported measures of PM and everyday memory. The present study extends previous research by demonstrating that deficits in PM are real and cannot be simply attributed to self-misperceptions. The deficits observed reflect some general capacity underpinning both time- and event-based PM contexts and are not task specific. Among this group of ecstasy/polydrug users recreational use of cocaine was also prominently associated with PM deficits. Further research might explore the differential effects of individual illicit drugs on real-world memory.
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Tait RJ, Anstey KJ, Butterworth P. Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey. BMC Public Health 2010; 10:171. [PMID: 20350327 PMCID: PMC2860359 DOI: 10.1186/1471-2458-10-171] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 03/29/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traumatic or serious brain injury (BI) has persistent and well documented adverse outcomes, yet 'mild' or 'moderate' BI, which often does not result in hospital treatment, accounts for half the total days of disability attributed to BI. There are currently few data available from community samples on the incidence and correlates of these injuries. Therefore, the study aimed to assess the 1) incidence of self-reported mild (not requiring hospital admission) and moderate (admitted to hospital)) brain injury (BI), 2) causes of injury 3) physical health scores and 4) relationship between BI and problematic alcohol or marijuana use. METHODS An Australian community sequential-cohort study (cohorts aged 20-24, 40-44 and 60-64 years at wave one) used a survey methodology to assess BI and substance use at baseline and four years later. RESULTS Of the 7485 wave one participants, 89.7% were re-interviewed at wave two. There were 56 mild (230.8/100000 person-years) and 44 moderate BI (180.5/100000 person-years) reported between waves one and two. Males and those in the 20-24 year cohort had increased risk of BI. Sports injury was the most frequent cause of BI (40/100) with traffic accidents being a greater proportion of moderate (27%) than mild (7%) BI. Neither alcohol nor marijuana problems at wave one were predictors of BI. BI was not a predictor of developing substance use problems by wave two. CONCLUSIONS BI were prevalent in this community sample, though the incidence declined with age. Factors associated with BI in community samples differ from those reported in clinical samples (e.g. typically traumatic brain injury with traffic accidents the predominate cause). Further, detailed evaluation of the health consequences of these injuries is warranted.
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Affiliation(s)
- Robert J Tait
- Centre for Mental Health Research, Australian National University, Canberra, ACT, 0200 Australia.
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