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Castelblanco CA, Springer SD, Schantell M, John JA, Coutant AT, Horne LK, Glesinger R, Eastman JA, Wilson TW. Chronic Cannabis users exhibit altered oscillatory dynamics and functional connectivity serving visuospatial processing. J Psychopharmacol 2024; 38:724-734. [PMID: 39087306 DOI: 10.1177/02698811241265764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
BACKGROUND Cannabis is the most widely used psychoactive drug in the United States. While multiple studies have associated acute cannabis consumption with alterations in cognitive function (e.g., visual and spatial attention), far less is known regarding the effects of chronic consumption on the neural dynamics supporting these cognitive functions. METHODS We used magnetoencephalography (MEG) and an established visuospatial processing task to elicit multi-spectral neuronal responses in 44 regular cannabis users and 53 demographically matched non-user controls. To examine the effects of chronic cannabis use on the oscillatory dynamics underlying visuospatial processing, neural responses were imaged using a time-frequency resolved beamformer and compared across groups. RESULTS Neuronal oscillations serving visuospatial processing were identified in the theta (4-8 Hz), alpha (8-14 Hz), and gamma range (56-76 Hz), and these were imaged and examined for group differences. Our key results indicated that users exhibited weaker theta oscillations in occipital and cerebellar regions and weaker gamma responses in the left temporal cortices compared to non-users. Lastly, alpha oscillations did not differ, but alpha connectivity among higher-order attention areas was weaker in cannabis users relative to non-users and correlated with performance. CONCLUSIONS Overall, these results suggest that chronic cannabis users have alterations in the oscillatory dynamics and neural connectivity serving visuospatial attention. Such alterations were observed across multiple cortical areas critical for higher-order processing and may reflect compensatory activity and/or the initial emergence of aberrant dynamics. Future work is needed to fully understand the implications of altered multispectral oscillations and neural connectivity in cannabis users.
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Affiliation(s)
- Camilo A Castelblanco
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Psychology and Brain Sciences, Dartmouth College, Hanover, NH, USA
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Seth D Springer
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jason A John
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Anna T Coutant
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Lucy K Horne
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Ryan Glesinger
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jacob A Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology and Neuroscience, Creighton University, Omaha, NE, USA
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al'Absi M, DeAngelis BN, Nakajima M, Hodges JS, Budney A, Hatsukami D, Allen S. Biobehavioral and affective stress responses during nicotine withdrawal: Influence of regular cannabis co-use. Psychopharmacology (Berl) 2024; 241:253-262. [PMID: 37897498 DOI: 10.1007/s00213-023-06481-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/09/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Co-use of cannabis is increasing in nicotine users and presents additional challenges in addressing nicotine dependence. This study examined the links between regular co-use of cannabis and nicotine with biobehavioral and affective changes in response to stress during nicotine withdrawal and ad libitum use. METHODS Participants (N = 79) who regularly used nicotine-only, cannabis-only, both substances, or neither substance were invited to attend two laboratory stress assessment sessions. For nicotine users, one session occurred during ad libitum nicotine use and one occurred after abstinence from nicotine. During the stress sessions, participants provided saliva samples for cortisol assay and completed measures of subjective states. Cardiovascular measures were collected during resting baseline, exposure to acute stressors, and a recovery rest period. RESULTS Nicotine-only users had higher average cortisol levels in the second lab session (nicotine withdrawal) relative to the first lab session (ad libitum nicotine use). Compared to nicotine non-users, nicotine users reported less positive affect and exhibited attenuated cortisol and systolic blood pressure (BP) stress responses. Cannabis users exhibited exaggerated diastolic BP responses to stress compared to cannabis non-users, and co-users of nicotine and cannabis had higher levels of cannabis craving than cannabis-only users (p < .01). CONCLUSIONS This study partially replicated earlier findings on the effects of chronic nicotine use and provided novel results regarding the influence of cannabis co-use on physiological and affective responses to stress in nicotine users during nicotine withdrawal.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN, 55812, USA.
| | - Briana N DeAngelis
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN, 55812, USA
| | - Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN, 55812, USA
- Eikei University of Hiroshima, Hiroshima, Japan
| | - James S Hodges
- School of Public Health, University of Minnesota, Twin Cities. Minneapolis, MN, USA
| | | | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Twin Cities. Minneapolis, MN, USA
| | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota, Twin Cities. Minneapolis, MN, USA
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3
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Johnson-Ferguson L, Shanahan L, Bechtiger L, Steinhoff A, Zimmermann J, Baumgartner MR, Binz TM, Eisner M, Ribeaud D, Quednow BB. Associations of psychoactive substances and steroid hormones in hair: Findings relevant to stress research from a large cohort of young adults. Psychoneuroendocrinology 2023; 157:106369. [PMID: 37639800 DOI: 10.1016/j.psyneuen.2023.106369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/03/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Epidemiological studies increasingly use hair samples to assess people's cumulative exposure to steroid hormones, but how the use of different psychoactive substances may affect steroid hormone levels in hair is, so far, largely unknown. The current study addresses this gap by establishing the substance exposure correlates of cortisol, cortisone, and testosterone in hair, while also accounting for a number of relevant covariates. METHOD Data came from a large urban community-sample of young adults with a high prevalence of substance use (N = 1002, mean age=20.6 years, 50.2% female), who provided 3 cm of hair samples. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) quantified cortisol, cortisone, and testosterone, as well as delta-9-tetrahydrocannabinol (THC), 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy"), cocaine, several opioids, and their respective metabolites. Multiple linear regression models with covariates were used to predict steroid hormone levels from substance exposure in a four-step approach: In the full sample, low and high substance hair concentrations (median split) were first tested against no use for each substance individually (step 1) and for all substances together (step 2). Then, within the participants with any substance in hair only, the continuous hair concentration of each substance in pg/mg (step 3) and finally of all substances together, were regressed (step 4). RESULTS Low, high, and continuous levels of THC in hair were robustly associated with higher levels of cortisol (sig. in step 1 low THC: β = 0.29, p = .021; high THC: β = 0.42, p = .001; step 2: low THC: β = 0.27, p = 0.036, and high THC: β = 0.40, p = .004, and step 4: β = 0.12, p = .041). Participants with high MDMA levels had higher levels of cortisone without adjusting for other substances (step 1: β = 0.34, p = .026), but this effect was not significant in the other models. While high THC levels were associated with lower levels of testosterone in step 2 (β = -0.35, p = .018), MDMA concentration was positively related to testosterone concentration with and without adjusting for other substances (step 3: β = 0.24, p = .041; step 4: β = 0.17, 95%, p = .015) in male participants. CONCLUSION The use of psychoactive substances, especially of cannabis and ecstasy, should be considered in studies investigating steroid hormones in hair.
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Affiliation(s)
- Lydia Johnson-Ferguson
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Annekatrin Steinhoff
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Zurich Institute of Legal Medicine, University of Zurich, Switzerland; Center for Forensic Hair Analytics, University of Zurich, Switzerland
| | - Tina M Binz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Institute of Criminology, University of Cambridge, United Kingdom
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Boris B Quednow
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
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4
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Larson ER, Moussa-Tooks AB, Tullar RL, Bolbecker AR, O'Donnell BF, Hetrick WP, Wisner KM. Sex differences in neuroendocrine, sympathetic nervous system, and affect responses to acute stress in cannabis users. Psychopharmacology (Berl) 2023; 240:1805-1821. [PMID: 37367968 DOI: 10.1007/s00213-023-06400-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/03/2023] [Indexed: 06/28/2023]
Abstract
RATIONALE Cannabis is the most widely used illicit substance in the USA and is often reportedly used for stress reduction. Indeed, cannabinoids modulate signaling of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. However, the role of biological sex in this interaction between cannabis use and stress is poorly understood, despite sex differences in neurobiological stress responsivity, endocannabinoid signaling, and clinical correlates of cannabis use. OBJECTIVE The study aims to examine the role of biological sex in multisystem stress responsivity in cannabis users. METHODS Frequent cannabis users (> 3 times/week, n = 48, 52% male) and non-users (n = 41, 49% male) participated in an acute psychosocial stress paradigm. Saliva was collected at eight timepoints and analyzed for hypothalamic-pituitary-adrenal (cortisol) and sympathetic (alpha-amylase) indices of stress responsivity, and basal estradiol. Subjective ratings of negative affect, including distress, were collected at three timepoints. RESULTS Cannabis users showed blunted pre-to-post-stress cortisol reactivity. Female cannabis users demonstrated greater blunted cortisol reactivity than their male counterparts. Sex moderated the effect of cannabis use on alpha-amylase responsivity over time, wherein female cannabis users showed flattened alpha-amylase responses across the stressor compared to male cannabis users and both non-user groups. Qualitatively, female cannabis users demonstrated the greatest pre-to-post-stress change in subjective distress. Differences in stress responding were not explained by estradiol or distress intolerance. CONCLUSIONS Biological sex impacts multisystem stress responding in cannabis users. Paradoxically, female cannabis users showed the least physiological, but greatest subjective, responses to the stressor. Further research into sex differences in the effects of cannabis use is warranted to better understand mechanisms and clinical implications.
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Affiliation(s)
- Eric R Larson
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA.
- Program in Neuroscience, Indiana University, Bloomington, IN, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel L Tullar
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amanda R Bolbecker
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
| | - Brian F O'Donnell
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Krista M Wisner
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
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5
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Gasparyan A, Maldonado Sanchez D, Navarrete F, Sion A, Navarro D, García-Gutiérrez MS, Rubio Valladolid G, Jurado Barba R, Manzanares J. Cognitive Alterations in Addictive Disorders: A Translational Approach. Biomedicines 2023; 11:1796. [PMID: 37509436 PMCID: PMC10376598 DOI: 10.3390/biomedicines11071796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 07/30/2023] Open
Abstract
The cognitive decline in people with substance use disorders is well known and can be found during both the dependence and drug abstinence phases. At the clinical level, cognitive decline impairs the response to addiction treatment and increases dropout rates. It can be irreversible, even after the end of drug abuse consumption. Improving our understanding of the molecular and cellular alterations associated with cognitive decline could be essential to developing specific therapeutic strategies for its treatment. Developing animal models to simulate drug abuse-induced learning and memory alterations is critical to continue exploring this clinical situation. The main aim of this review is to summarize the most recent evidence on cognitive impairment and the associated biological markers in patients addicted to some of the most consumed drugs of abuse and in animal models simulating this clinical situation. The available information suggests the need to develop more studies to further explore the molecular alterations associated with cognitive impairment, with the ultimate goal of developing new potential therapeutic strategies.
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Affiliation(s)
- Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | | | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Ana Sion
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Faculty of Psychology, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Gabriel Rubio Valladolid
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Department of Psychiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rosa Jurado Barba
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Faculty of Health, Universidad Camilo José Cela, 28001 Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, 03550 San Juan de Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
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6
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Gräfe EL, Reid HMO, Shkolnikov I, Conway K, Kit A, Acosta C, Christie BR. Women are Taking the Hit: Examining the Unique Consequences of Cannabis Use Across the Female Lifespan. Front Neuroendocrinol 2023; 70:101076. [PMID: 37217080 DOI: 10.1016/j.yfrne.2023.101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
Cannabis use has risen dramatically in recent years due to global decriminalization and a resurgence in the interest of potential therapeutic benefits. While emerging research is shaping our understanding of the benefits and harms of cannabis, there remains a paucity of data specifically focused on how cannabis affects the female population. The female experience of cannabis use is unique, both in the societal context and because of the biological ramifications. This is increasingly important given the rise in cannabis potency, as well as the implications this has for the prevalence of Cannabis Use Disorder (CUD). Therefore, this scoping review aims to discuss the prevalence of cannabis use and CUD in women throughout their lifespan and provide a balanced prospective on the positive and negative consequences of cannabis use. In doing so, this review will highlight the necessity for continued research that goes beyond sex differences.
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Affiliation(s)
- E L Gräfe
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - H M O Reid
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - I Shkolnikov
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - K Conway
- Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - A Kit
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - C Acosta
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - B R Christie
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada; Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada.
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7
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Lee S, Hong SB. Thalamocortical functional connectivity and cannabis use in men with childhood attention-deficit/hyperactivity disorder. PLoS One 2022; 17:e0278162. [PMID: 36441710 PMCID: PMC9704667 DOI: 10.1371/journal.pone.0278162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
Disruptions of the cortico-striato-thalamo-cortical circuit has been implicated in both attention-deficit/hyperactivity disorder and substance use disorder. Given the high prevalence of cannabis use among patients with attention-deficit/hyperactivity disorder, we set out to investigate the relationship between the two in the thalamus. We analyzed resting-state functional magnetic resonance imaging data obtained from the Addiction Connectome Preprocessed Initiative Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder database. Functional connectivity maps were extracted to compare thalamic connectivity among adults who had been diagnosed with attention-deficit/hyperactivity disorder during childhood according to whether or not they used cannabis. The study participants included 18 cannabis users and 15 cannabis non-users with childhood attention-deficit/hyperactivity disorder. Our results revealed that adults with attention-deficit/hyperactivity disorder who used cannabis (n = 18) had significantly decreased functional connectivity between the thalamus and parietal regions, which was particularly prominent in the inferior parietal areas, in comparison with those who did not use cannabis (n = 15). Left thalamic functional connectivity with the inferior parietal and middle frontal areas and right thalamic functional connectivity with the inferior parietal and superior frontal areas were increased in non-users of cannabis with attention-deficit/hyperactivity disorder compared with a local normative comparison group (n = 7). In conclusion, adults with a childhood history of attention-deficit/hyperactivity disorder who do not use cannabis often have relatively stronger thalamoparietal and thalamofrontal connectivity, which may help reduce the risk of cannabis use.
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Affiliation(s)
- Sanghyun Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon-Beom Hong
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- * E-mail:
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8
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Sorkhou M, Rabin RA, Rabin JS, Kloiber S, McIntyre RS, George TP. Effects of 28 days of cannabis abstinence on cognition in major depressive disorder: A pilot study. Am J Addict 2022; 31:454-462. [PMID: 35690891 DOI: 10.1111/ajad.13305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cannabis is a widely used substance that may impair select cognitive domains, including attention and memory. Problematic cannabis use is a common clinical problem among patients with major depressive disorder (MDD). Few studies have investigated the effects of cannabis abstinence on cognition in MDD. Thus, our study aimed to determine whether a 28-day period of cannabis abstinence is associated with improvements in cognition in patients with MDD and comorbid cannabis use disorder (CUD). METHODS We evaluated the effects of 28 days of cannabis abstinence on cognition in MDD patients with comorbid CUD facilitated by contingency management, motivational interviewing, psychoeducation, and coping-skills training (N = 11). Primary outcomes included Baseline to Day 28 changes in verbal memory and learning, while secondary outcomes included Baseline to Day 28 changes in working memory, visuospatial working memory (VSWM), visual search speed, mental flexibility, response inhibition, attention, manual dexterity, and fine motor movement. RESULTS Eight participants (72.7%) met the pre-specified criteria for cannabis abstinence and three participants significantly reduced their cannabis use (≥90%). Visual search speed, selective attention, and VSWM improved over the study period. These improvements were not associated with changes in cannabis metabolite levels from baseline to endpoint. DISCUSSION AND CONCLUSIONS Our findings suggest that 28 days of cannabis abstinence may improve select cognitive domains in patients with MDD and comorbid CUD. SCIENTIFIC SIGNIFICANCE This is the first study to longitudinally examine the effects of cannabis on cognition in MDD. CLINICAL TRIAL Effects of Cannabis Abstinence on Symptoms and Cognition in Depression (NCT03624933; https://www. CLINICALTRIALS gov).
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Affiliation(s)
- Maryam Sorkhou
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Rachel A Rabin
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Stefan Kloiber
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Adult Psychiatry and Health Systems Division, CAMH, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Mood Disorders Psychopharmacology Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Tony P George
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Addictions Divisions, Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
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9
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Gunasekera B, Davies C, Blest-Hopley G, Veronese M, Ramsey NF, Bossong MG, Radua J, Bhattacharyya S. Task-independent acute effects of delta-9-tetrahydrocannabinol on human brain function and its relationship with cannabinoid receptor gene expression: A neuroimaging meta-regression analysis. Neurosci Biobehav Rev 2022; 140:104801. [PMID: 35914625 DOI: 10.1016/j.neubiorev.2022.104801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/07/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
Abstract
The neurobiological mechanisms underlying the effects of delta-9-tetrahydrocannabinol (THC) remain unclear. Here, we examined the spatial acute effect of THC on human regional brain activation or blood flow (hereafter called 'activation signal') in a 'core' network of brain regions from 372 participants, tested using a within-subject repeated measures design under experimental conditions. We also investigated whether the neuromodulatory effects of THC are related to the local expression of the cannabinoid-type-1 (CB1R) and type-2 (CB2R) receptors. Finally, we investigated the dose-response relationship between THC and key brain substrates. These meta-analytic findings shed new light on the localisation of the effects of THC in the human brain, suggesting that THC has neuromodulatory effects in regions central to many cognitive tasks and processes, related to dose, with greater effects in regions with higher levels of CB1R expression.
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Affiliation(s)
- Brandon Gunasekera
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Centre for Neuroimaging Sciences, King's College London, UK; Department of Information Engineering, University of Padua, Italy
| | - Nick F Ramsey
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Joaquim Radua
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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10
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Meah F, Lundholm M, Emanuele N, Amjed H, Poku C, Agrawal L, Emanuele MA. The effects of cannabis and cannabinoids on the endocrine system. Rev Endocr Metab Disord 2022; 23:401-420. [PMID: 34460075 DOI: 10.1007/s11154-021-09682-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 01/24/2023]
Abstract
With the increase in cannabis use due to policy changes and areas of decriminalization, it is important to recognize the potential impact of these substances on endocrine processes. Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in the normal functioning of nearly every organ and consists of the body's natural endocannabinoids, the cannabinoid receptors, and the enzymes and processes that regulate endocannabinoids. Exogenous cannabinoids such as Δ9-tetrahydrocannabinol (THC) are known to act through cannabinoid type 1 and 2 receptors, and have been shown to mimic endocannabinoid signaling and affect receptor expression. This review summarizes the known impacts of cannabis on thyroid, adrenal, and gonadal function in addition to glucose control, lipids, and bone metabolism, including: reduced female fertility, increased risk of adverse pregnancy outcomes, reduced sperm counts and function, lower thyroid hormone levels with acute use, blunting of stress response with chronic use, increased risk of prediabetes but lower risk of diabetes, suggested improvement of high density lipoproteins and triglycerides, and modest increase in fracture risk. The known properties of endocannabinoids, animal data, population data, and the possible benefits and concerns of cannabinoid use on hormonal function are discussed. The interconnectivity of the endocrine and endocannabinoid systems suggests opportunities for future therapeutic modalities which are an area of active investigation.
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Affiliation(s)
- Farah Meah
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Michelle Lundholm
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Nicholas Emanuele
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Hafsa Amjed
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Caroline Poku
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Lily Agrawal
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Mary Ann Emanuele
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA.
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11
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Aloi J, McCusker MC, Lew BJ, Schantell M, Eastman JA, Frenzel MR, Wilson TW. Altered amygdala-cortical connectivity in individuals with Cannabis use disorder. J Psychopharmacol 2021; 35:1365-1374. [PMID: 34730052 PMCID: PMC9659472 DOI: 10.1177/02698811211054163] [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: 11/16/2022]
Abstract
BACKGROUND Cannabis is one of the most commonly used substances in the United States. Prior literature using task-based functional magnetic resonance imaging (fMRI) has identified that individuals with Cannabis use disorder (CUD) show impairments in emotion processing circuitry. However, whether the functional networks involving these regions are also altered in CUD remains poorly understood. AIMS Investigate changes in resting-state functional connectivity (rsFC) in regions related to emotional processing in CUD. METHODS Sixty-two participants completed resting-state fMRI, including 21 with CUD, 20 with histories of illicit substance use but no current CUD diagnosis, and 21 with no history of illicit substance use. Whole-brain seed-based connectivity analyses were performed and one-way analyses of covariance (ANCOVAs) were conducted to detect group differences in the bilateral amygdalae, hippocampi, and the anterior and posterior cingulate cortices. RESULTS The CUD group exhibited significant reductions in rsFC between the amygdala and the cuneus, paracentral lobule, and supplementary motor area, and between the cingulate cortices and the occipital and temporal lobes. There were no significant group differences in hippocampal functional connectivity. In addition, CUD symptom counts based on the Structured Clinical Interview for DSM-5 (SCID) and the Cannabis Use Disorders Identification Test (CUDIT) significantly correlated with multiple connectivity metrics. CONCLUSION These data expand on emerging literature indicating that CUD is associated with dysfunction in the neural circuits underlying emotion processing. Dysfunction in emotion processing circuits may play a role in the behavioral impairments seen in emotion processing tasks in individuals with CUD, and the severity of CUD symptoms appears to be directly related to the degree of dysfunction in these circuits.
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Affiliation(s)
- Joseph Aloi
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Marie C. McCusker
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Brandon J. Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Jacob A. Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Michaela R. Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
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12
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Glodosky NC, Cuttler C, McLaughlin RJ. A review of the effects of acute and chronic cannabinoid exposure on the stress response. Front Neuroendocrinol 2021; 63:100945. [PMID: 34461155 PMCID: PMC8605997 DOI: 10.1016/j.yfrne.2021.100945] [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: 06/01/2021] [Revised: 07/28/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
While cannabis has been used for centuries for its stress-alleviating properties, the effects of acute and chronic cannabinoid exposure on responses to stress remain poorly understood. This review provides an overview of studies that measured stress-related endpoints following acute or chronic cannabinoid exposure in humans and animals. Acute cannabinoid exposure increases basal concentrations of stress hormones in rodents and humans and has dose-dependent effects on stress reactivity in humans and anxiety-like behavior in rodents. Chronic cannabis exposure is associated with dampened stress reactivity, a blunted cortisol awakening response (CAR), and flattened diurnal cortisol slope in humans. Sex differences in these effects remain underexamined, with limited evidence for sex differences in effects of cannabinoids on stress reactivity in rodents. Future research is needed to better understand sex differences in the effects of cannabis on the stress response, as well as downstream impacts on mental health and stress-related disorders.
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Affiliation(s)
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, WA, USA.
| | - Ryan J McLaughlin
- Department of Psychology, Washington State University, Pullman, WA, USA; Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
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13
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Cajachagua-Torres KN, Jaddoe VWV, de Rijke YB, van den Akker ELT, Reiss IKM, van Rossum EFC, El Marroun H. Parental cannabis and tobacco use during pregnancy and childhood hair cortisol concentrations. Drug Alcohol Depend 2021; 225:108751. [PMID: 34051550 DOI: 10.1016/j.drugalcdep.2021.108751] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/19/2021] [Accepted: 04/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Fetal exposure to cannabis and tobacco during pregnancy leads to adverse fetal and childhood outcomes. We hypothesized that fetal exposure to cannabis and tobacco have persistent programming effects on hypothalamic pituitary adrenal (HPA) axis functioning in childhood. Therefore, we examined the associations of parental cannabis and tobacco use during pregnancy with childhood hair cortisol and cortisone concentrations at 6 years, as biomarkers of long-term HPA-axis functioning. METHOD In a population-based prospective birth cohort among 2577 mothers and their children, information of parental cannabis and tobacco use was collected by questionnaires, and maternal urine samples were additionally analyzed to detect cannabis metabolite concentrations. Cortisol and cortisone were measured in hair samples at 6 years. Linear regression analysis with adjustment for several confounders was used to test our hypothesis. RESULTS As compared to non-exposed children, offspring exposed to cannabis during pregnancy (in combination with tobacco) had higher childhood cortisol concentrations (log-10 transformed difference 0.16, 95 % Confidence Interval 0.04 to 0.28). This association was not mediated by birth weight. No differences in cortisone concentrations among cannabis-exposed children were observed. Maternal tobacco use during pregnancy was not associated with childhood cortisol or cortisone concentrations. Further, paternal cannabis or tobacco use was not associated with childhood cortisol or cortisone concentrations. CONCLUSIONS Our findings suggest that maternal cannabis use, combined with tobacco, during pregnancy is associated with alterations in offspring HPA-axis functioning. Further studies need to replicate these findings, and assess the causality and long-term consequences of these associations.
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Affiliation(s)
- Kim N Cajachagua-Torres
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, 3015GD, Rotterdam, the Netherlands; Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Erica L T van den Akker
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands; Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Irwin K M Reiss
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, 3000CB, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, 3062PA, Rotterdam, the Netherlands
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14
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Kuzma-Hunt AG, Truong VB, Favetta LA. Glucocorticoids, Stress and Delta-9 Tetrahydrocannabinol (THC) during Early Embryonic Development. Int J Mol Sci 2021; 22:7289. [PMID: 34298908 PMCID: PMC8307766 DOI: 10.3390/ijms22147289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022] Open
Abstract
Elevated molecular stress in women is known to have negative impacts on the reproductive development of oocytes and the embryos prior to implantation. In recent years, the prevalence of cannabis use among women of reproductive age has risen due to its ability to relieve psychological stress and nausea, which are mediated by its psychoactive component, ∆-9-tetrahydrocannabinol (THC). Although cannabis is the most popular recreational drug of the 21st century, much is unknown about its influence on molecular stress in reproductive tissues. The current literature has demonstrated that THC causes dose- and time-dependent alterations in glucocorticoid signaling, which have the potential to compromise morphology, development, and quality of oocytes and embryos. However, there are inconsistencies across studies regarding the mechanisms for THC-dependent changes in stress hormones and how either compounds may drive or arrest development. Factors such as variability between animal models, physiologically relevant doses, and undiscovered downstream gene targets of both glucocorticoids and THC could account for such inconsistencies. This review evaluates the results of studies which have investigated the effects of glucocorticoids on reproductive development and how THC may alter stress signaling in relevant tissues.
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Affiliation(s)
| | | | - Laura A. Favetta
- Reproductive Health and Biotechnology Laboratory, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada; (A.G.K.-H.); (V.B.T.)
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15
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al'Absi M, Allen AM. Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping. Front Psychol 2021; 12:687106. [PMID: 34276511 PMCID: PMC8283823 DOI: 10.3389/fpsyg.2021.687106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Although research has only recently started to examine the impact of cannabis use on stress response, there is some evidence that indicates acute and chronic impacts of cannabis on these processes. In this paper, we review processes involved in regulating the stress response and we review the influence of acute and chronic exposure to cannabis on patterns and regulation of the stress response. We also highlight the role of stress as a risk factor for initiation and maintenance of cannabis use. In this context, we examine moderating variables, including sex and life adversity. In light of recent observations indicating increasing prevalence of cannabis use during pregnancy, we provide additional focus on cannabis use in this vulnerable population, including how acute and chronic stress may predispose some individuals to use cannabis during pregnancy. While this line of research is in its infancy, we review available articles that focus on the perinatal period and that examined the association between cannabis use and various life stressors, including partner violence, job loss, and lack of housing. We also review psychiatric co-morbidities (e.g., post-traumatic stress disorder, anxiety). A better understanding of the way stress and cannabis use relate within the general population, as well as within certain subgroups that may be at a greater risk of using and/or at greater risk for adverse outcomes of use, may lead to the development of novel prevention and intervention approaches.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, United States
| | - Alicia M Allen
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
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16
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Sex Differences in Neuropsychological Functioning are Domain-Specific in Adolescent and Young Adult Regular Cannabis Users. J Int Neuropsychol Soc 2021; 27:592-606. [PMID: 34261559 DOI: 10.1017/s1355617720001435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Adolescence into young adulthood represents a sensitive period in which brain development significantly diverges by sex. Regular cannabis use by young people is associated with neuropsychological vulnerabilities, but the potential impact of sex on these relationships is unclear. METHOD In a cross-sectional study, we examined sex differences in multi-domain neuropsychological functioning using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and tested whether sex moderated the relationship between cognitive performance and age of initiation, frequency of cannabis use, amount of cannabis use, and withdrawal symptoms in at least weekly adolescent and young adult cannabis users (n = 171; aged 13-25 years; 46.2% female). RESULTS Male cannabis users had poorer visual recognition memory and female cannabis users showed worse attention and executive functions, with medium to large effect sizes. These sex effects persisted, when controlling for age, IQ, amount of alcohol and nicotine use, mood and anxiety symptoms, emotional stability and impulsive behavior. Earlier age of initiated use and more use were associated with worse attentional functions in females, but not males. More use was more strongly associated with worse episodic memory in males than in females. More use was associated with poorer learning in males only. CONCLUSIONS Domain-specific patterns of neuropsychological performance were found by sex, such that males showed poorer visual memory and females showed worse performance on measures of attention (sustained visual, multitasking) and executive functioning (spatial planning/working memory subdomains). Larger studies including healthy controls are needed to determine if the observed sex differences are more exaggerated relative to non-users.
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17
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Glodosky NC, Cuttler C, Freels TG, Wright HR, Rojas MJ, Baglot SL, Hill MN, McLaughlin RJ. Cannabis vapor self-administration elicits sex- and dose-specific alterations in stress reactivity in rats. Neurobiol Stress 2020; 13:100260. [PMID: 33344714 PMCID: PMC7739171 DOI: 10.1016/j.ynstr.2020.100260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 01/15/2023] Open
Abstract
Rationale Cannabis users frequently report stress relief as their primary reason for use. Recent studies indicate that human cannabis users exhibit blunted stress reactivity; however, it is unknown whether this is a cause or a consequence of chronic cannabis use. Objectives To determine whether chronic cannabis vapor self-administration elicits sex- and/or dose-dependent alterations in stress reactivity and basal corticosterone (CORT) concentrations, or whether pre-vapor exposure stress reactivity predicts rates of cannabis vapor self-administration. Methods Male and female rats were subjected to 30 min acute restraint stress to assess stress reactivity prior to vapor self-administration. Rats were then trained to self-administer cannabis extract vapor containing 69.9% Δ9-tetrahydrocannabinol (THC) at one of four extract concentrations (0, 75, 150, or 300 mg/ml) daily for 30 days. Half of the rats were then subjected to a second restraint stress challenge 24 h after the final self-administration session, while the other half served as no-stress controls. Plasma CORT concentrations were measured prior to stress and immediately post-stress offset. Results Female rats earned significantly more vapor deliveries than male rats. Pre-vapor stress reactivity was not a predictor of self-administration rates in either sex. Basal CORT concentrations were increased following vapor self-administration relative to pre-vapor assessment, irrespective of treatment condition. Importantly, cannabis self-administration dose-dependently reduced stress reactivity in female, but not male, rats. Conclusions These data indicate that chronic cannabis use can significantly dampen stress reactivity in female rats and further support the use of the cannabis vapor self-administration model in rats of both sexes.
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Affiliation(s)
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Timothy G. Freels
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Hayden R. Wright
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Manuel J. Rojas
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
- Animal Health Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Samantha L. Baglot
- Departments of Cell Biology and Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Matthew N. Hill
- Departments of Cell Biology and Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Ryan J. McLaughlin
- Department of Psychology, Washington State University, Pullman, WA, USA
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
- Corresponding author. Washington State University, College of Veterinary Medicine, Department of Integrative Physiology and Neuroscience, P.O. Box 647620, Pullman, WA, 99164, USA.
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18
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DeVuono MV, La Caprara O, Sullivan MT, Bath A, Petrie GN, Limebeer CL, Rock EM, Hill MN, Parker LA. Role of the stress response and the endocannabinoid system in Δ 9-tetrahydrocannabinol (THC)-induced nausea. Psychopharmacology (Berl) 2020; 237:2187-2199. [PMID: 32399633 DOI: 10.1007/s00213-020-05529-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE Dysregulation of the endocannabinoid (eCB) system by high doses of Δ9-tetrahydrocannabinol (THC) is hypothesized to generate a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis contributing to cannabinoid hyperemesis syndrome (CHS). OBJECTIVES AND METHODS Using the conditioned gaping model of nausea, we aimed to determine if pre-treatments that interfere with stress, or an anti-emetic drug, interfere with THC-induced nausea in male rats. The corticotropin-releasing hormone (CRH) antagonist, antalarmin, was given to inhibit the HPA axis during conditioning. Since eCBs inhibit stress, MJN110 (which elevates 2-arachidonylglycerol (2-AG)) and URB597 (which elevates anandamide (AEA)) were also tested. Propranolol (β-adrenergic antagonist) and WAY-100635 (5-HT1A antagonist) attenuate HPA activation by cannabinoids and, therefore, were assessed. In humans, CHS symptoms are not alleviated by anti-emetic drugs, such as ondansetron (5-HT3 antagonist); however, benzodiazepines are effective. Therefore, ondansetron and chlordiazepoxide were tested. To determine if HPA activation by THC is dose-dependent, corticosterone (CORT) was analyzed from serum of rats treated with 0.0, 0.5, or 10 mg/kg THC. RESULTS Antalarmin (10 and 20 mg/kg), MJN110 (10 mg/kg), URB597 (0.3 mg/kg), propranolol (2.5 and 5 mg/kg), WAY-100635 (0.5 mg/kg), and chlordiazepoxide (5 mg/kg) interfered with THC-induced conditioned gaping, but the anti-emetic ondansetron (0.1 and 0.01 mg/kg) did not. THC produced significantly higher CORT levels at 10 mg/kg than at 0.0 and 0.5 mg/kg THC. CONCLUSIONS Treatments that interfere with the stress response also inhibit THC-induced conditioned gaping, but a typical anti-emetic drug does not, supporting the hypothesis that THC-induced nausea, and CHS, is a result of a dysregulated stress response.
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Affiliation(s)
- Marieka V DeVuono
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Olivia La Caprara
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Megan T Sullivan
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Alexandra Bath
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Gavin N Petrie
- Departments of Cell Biology and, Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Cheryl L Limebeer
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Erin M Rock
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Matthew N Hill
- Departments of Cell Biology and, Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Linda A Parker
- Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Guelph, ON, N1G 2W1, Canada.
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DeVuono MV, Parker LA. Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms. Cannabis Cannabinoid Res 2020; 5:132-144. [PMID: 32656345 PMCID: PMC7347072 DOI: 10.1089/can.2019.0059] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction: Cannabinoids have long been known for their ability to treat nausea and vomiting. Recent reports, however, have highlighted the paradoxical proemetic effects of cannabinoids. Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclical episodes of nausea and vomiting, accompanied by abdominal pain following prolonged, high-dose cannabis use, which is alleviated by hot baths and showers. Little is known about the cause of this syndrome. Discussion: Cannabinoids produce a biphasic effect on nausea and vomiting, with low doses having an antiemetic effect and high doses producing emesis. Presentation and treatment of CHS are similar to cyclical vomiting syndrome as well as chemotherapy-related anticipatory nausea and vomiting, suggesting that these phenomena may share mechanisms. The prevalence of CHS is not known because of the symptomatic overlap with other disorders and the lack of knowledge of the syndrome by the public and physicians. Treatment with typical antiemetic drugs is ineffective for CHS, but anxiolytic and sedative drugs, along with hot showers, seem to be consistently effective at reducing symptoms. The only known way to permanently end CHS, however, is abstinence from cannabinoids. Case studies and limited pre-clinical data on CHS indicate that prolonged high doses of the main psychotropic compound in cannabis, Δ9-tetrahydrocannabinol (THC), result in changes to the endocannabinoid system by acting on the cannabinoid 1 (CB1) receptor. These endocannabinoid system changes can dysregulate stress and anxiety responses, thermoregulation, the transient receptor potential vanilloid system, and several neurotransmitters systems, and are thus potential candidates for mediating the pathophysiology of CHS. Conclusions: Excessive cannabinoid administration disrupts the normal functioning of the endocannabinoid system, which may cause CHS. More clinical and pre-clinical research is needed to fully understand the underlying pathophysiology of this disorder and the negative consequences of prolonged high-dose cannabis use.
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Affiliation(s)
- Marieka V. DeVuono
- Department of Psychology and Collabortive Neuroscience Program, University of Guelph, Guelph, Canada
| | - Linda A. Parker
- Department of Psychology and Collabortive Neuroscience Program, University of Guelph, Guelph, Canada
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20
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Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta. Sci Rep 2020; 10:544. [PMID: 31953475 PMCID: PMC6969028 DOI: 10.1038/s41598-019-57318-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/20/2019] [Indexed: 02/08/2023] Open
Abstract
1 in 5 women report cannabis use during pregnancy, with nausea cited as their primary motivation. Studies show that (-)-△9-tetrahydrocannabinol (Δ9-THC), the major psychoactive ingredient in cannabis, causes fetal growth restriction, though the mechanisms are not well understood. Given the critical role of the placenta to transfer oxygen and nutrients from mother, to the fetus, any compromise in the development of fetal-placental circulation significantly affects maternal-fetal exchange and thereby, fetal growth. The goal of this study was to examine, in rats, the impact of maternal Δ9-THC exposure on fetal development, neonatal outcomes, and placental development. Dams received a daily intraperitoneal injection (i.p.) of vehicle control or Δ9-THC (3 mg/kg) from embryonic (E)6.5 through 22. Dams were allowed to deliver normally to measure pregnancy and neonatal outcomes, with a subset sacrificed at E19.5 for placenta assessment via immunohistochemistry and qPCR. Gestational Δ9-THC exposure resulted in pups born with symmetrical fetal growth restriction, with catch up growth by post-natal day (PND)21. During pregnancy there were no changes to maternal food intake, maternal weight gain, litter size, or gestational length. E19.5 placentas from Δ9-THC-exposed pregnancies exhibited a phenotype characterized by increased labyrinth area, reduced Epcam expression (marker of labyrinth trophoblast progenitors), altered maternal blood space, decreased fetal capillary area and an increased recruitment of pericytes with greater collagen deposition, when compared to vehicle controls. Further, at E19.5 labyrinth trophoblast had reduced glucose transporter 1 (GLUT1) and glucocorticoid receptor (GR) expression in response to Δ9-THC exposure. In conclusion, maternal exposure to Δ9-THC effectively compromised fetal growth, which may be a result of the adversely affected labyrinth zone development. These findings implicate GLUT1 as a Δ9-THC target and provide a potential mechanism for the fetal growth restriction observed in women who use cannabis during pregnancy.
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Abstract
Given the aging Baby Boomer generation, changes in cannabis legislation, and the growing acknowledgment of cannabis for its therapeutic potential, it is predicted that cannabis use in the older population will escalate. It is, therefore, important to determine the interaction between the effects of cannabis and aging. The aim of this report is to describe the link between cannabis use and the aging brain. Our review of the literature found few and inconsistent empirical studies that directly address the impact of cannabis use on the aging brain. However, research focused on long-term cannabis use points toward cumulative effects on multimodal systems in the brain that are similarly affected during aging. Specifically, the effects of cannabis and aging converge on overlapping networks in the endocannabinoid, opioid, and dopamine systems that may affect functional decline particularly in the hippocampus and prefrontal cortex, which are critical areas for memory and executive functioning. To conclude, despite the limited current knowledge on the potential interactive effects between cannabis and aging, evidence from the literature suggests that cannabis and aging effects are concurrently present across several neurotransmitter systems. There is a great need for future research to directly test the interactions between cannabis and aging.
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Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Jennifer DiMuzio
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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Blithikioti C, Miquel L, Batalla A, Rubio B, Maffei G, Herreros I, Gual A, Verschure P, Balcells‐Oliveró M. Cerebellar alterations in cannabis users: A systematic review. Addict Biol 2019; 24:1121-1137. [PMID: 30811097 DOI: 10.1111/adb.12714] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 01/18/2023]
Abstract
Cannabis is the most used illicit substance in the world. As many countries are moving towards decriminalization, it is crucial to determine whether and how cannabis use affects human brain and behavior. The role of the cerebellum in cognition, emotion, learning, and addiction is increasingly recognized. Because of its high density in CB1 receptors, it is expected to be highly affected by cannabis use. The aim of this systematic review is to investigate how cannabis use affects cerebellar structure and function, as well as cerebellar-dependent behavioral tasks. Three databases were searched for peer-reviewed literature published until March 2018. We included studies that focused on cannabis effects on cerebellar structure, function, or cerebellar-dependent behavioral tasks. A total of 348 unique records were screened, and 40 studies were included in the qualitative synthesis. The most consistent findings include (1) increases in cerebellar gray matter volume after chronic cannabis use, (2) alteration of cerebellar resting state activity after acute or chronic use, and (3) deficits in memory, decision making, and associative learning. Age of onset and higher exposure to cannabis use were frequently associated with increased cannabis-induced alterations. Chronic cannabis use is associated with alterations in cerebellar structure and function, as well as with deficits in behavioral paradigms that involve the cerebellum (eg, eyeblink conditioning, memory, and decision making). Future studies should consider tobacco as confounding factor and use standardized methods for assessing cannabis use. Paradigms exploring the functional activity of the cerebellum may prove useful as monitoring tools of cannabis-induced impairment.
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Affiliation(s)
- Chrysanthi Blithikioti
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Laia Miquel
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Albert Batalla
- Department of Psychiatry, Brain Center Rudolf MagnusUniversity Medical Center Utrecht Utrecht the Netherlands
- Nijmegen Institute for Scientist‐Practitioners in Addiction (NISPA)Radboud University Nijmegen The Netherlands
| | - Belen Rubio
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Giovanni Maffei
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Ivan Herreros
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Antoni Gual
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Paul Verschure
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
- ICREAInstitucio Catalana de Recerca I Estudis Avançats, Passeig Lluis Companys Barcelona Spain
| | - Mercedes Balcells‐Oliveró
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
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23
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Burggren AC, Shirazi A, Ginder N, London ED. Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:563-579. [PMID: 31365275 PMCID: PMC7027431 DOI: 10.1080/00952990.2019.1634086] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Background: Cannabis is the most widely used illicit substance worldwide, and legalization for recreational and medical purposes has substantially increased its availability and use in the United States.Objectives: Decades of research have suggested that recreational cannabis use confers risk for cognitive impairment across various domains, and structural and functional differences in the brain have been linked to early and heavy cannabis use.Methods: With substantial evidence for the role of the endocannabinoid system in neural development and understanding that brain development continues into early adulthood, the rising use of cannabis in adolescents and young adults raises major concerns. Yet some formulations of cannabinoid compounds are FDA-approved for medical uses, including applications in children.Results: Potential effects on the trajectory of brain morphology and cognition, therefore, should be considered. The goal of this review is to update and consolidate relevant findings in order to inform attitudes and public policy regarding the recreational and medical use of cannabis and cannabinoid compounds.Conclusions: The findings point to considerations for age limits and guidelines for use.
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Affiliation(s)
- Alison C Burggren
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Anaheed Shirazi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
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24
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Wemm SE, Sinha R. Drug-induced stress responses and addiction risk and relapse. Neurobiol Stress 2019; 10:100148. [PMID: 30937354 PMCID: PMC6430516 DOI: 10.1016/j.ynstr.2019.100148] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/07/2018] [Accepted: 01/30/2019] [Indexed: 12/21/2022] Open
Abstract
A number of studies have assessed the effects of psychoactive drugs on stress biology, the neuroadaptations resulting from chronic drug use on stress biology, and their effects on addiction risk and relapse. This review mainly covers human research on the acute effects of different drugs of abuse (i.e., nicotine, cannabis, psychostimulants, alcohol, and opioids) on the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) responses. We review the literature on acute peripheral stress responses in naïve or light recreational users and binge/heavy or chronic drug users. We also discuss evidence of alterations in tonic levels, or tolerance, in the latter relative to the former and associated changes in the phasic stress responses. We discuss the impact of the stress system tolerance in heavy users on their response to drug- and stress-related cue responses and craving as compared to control subjects. A summary is provided of the effects of glucocorticoid responses and their adaptations on brain striatal and prefrontal cortices involved in the regulation of drug seeking and relapse risk. Finally, we summarize important considerations, including individual difference factors such as gender, co-occurring drug use, early trauma and adversity and drug use history and variation in methodologies, that may further influence the effects of these drugs on stress biology.
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Affiliation(s)
- Stephanie E. Wemm
- Yale Stress Center, Yale School of Medicine, 2 Church St South Suite 209, New Haven, CT, 06519, USA
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25
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Petrowski K, Conrad R. Comparison of Cortisol Stress Response in Patients with Panic Disorder, Cannabis-Induced Panic Disorder, and Healthy Controls. Psychopathology 2019; 52:26-32. [PMID: 30879013 DOI: 10.1159/000496559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/24/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Little research effort has so far been dedicated to the analysis of the hypothalamic-pituitary-adrenal axis of aetiologically differing subgroups of patients with panic disorder (PD). The current study aimed at a deeper understanding of the cortisol stress response in cannabis-induced PD (CIPD) patients. METHODS Matched groups of 7 PD patients (mean age ± SD: 32.95 ± 9.04 years), 7 CIPD patients (31.94 ± 8.40 years), and 7 healthy controls (HC) (31.13 ± 8.57 years) were included in the study. The Trier Social Stress Test (TSST) was used for stress induction. Salivary cortisol samples were collected and panic- and depression-related questionnaires were applied. RESULTS A stress response to the TSST was found in 28.6% of PD patients, in 51.1% of CIPD patients, and in 100% of HC subjects. Statistical analyses revealed a cortisol hyporesponsiveness in PD and CIPD patients. While cortisol values of PD patients and HC participants differed significantly, CIPD patients' cortisol courses balanced between those of PD patients and HC subjects. CONCLUSIONS Current findings show a distinctive pattern of the stress-induced cortisol reaction in CIPD patients, which is markedly different from the hormonal response in PD patients as well as HC subjects. Previous findings of cortisol hyporesponsiveness in PD patients compared to HC subjects were confirmed.
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Affiliation(s)
- Katja Petrowski
- Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany, .,Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany,
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
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26
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Sagar KA, Gruber SA. Interactions between recreational cannabis use and cognitive function: lessons from functional magnetic resonance imaging. Ann N Y Acad Sci 2018; 1451:42-70. [PMID: 30426517 DOI: 10.1111/nyas.13990] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 10/13/2018] [Accepted: 10/19/2018] [Indexed: 12/28/2022]
Abstract
Cannabis use is becoming increasingly popular as a growing number of states pass legislation to legalize cannabis and cannabis-derived products for recreational and/or medical purposes. Given the widespread use of cannabis, it is critical to understand the neural consequences related to cannabis use. In this review, we focus on evidence from functional magnetic resonance imaging studies that document acute and residual alterations in brain function during tasks spanning a variety of cognitive domains: executive function, attention and working memory, memory, motor skills, error monitoring, and reward and affective processing. Although it is clear that cannabis affects brain function, the findings are somewhat inconsistent; variables that potentially affect study outcomes are outlined, including a discussion of the impact of chronological age and age of cannabis onset as well as length of abstinence at the time of assessment, which are important considerations when measuring cannabis use patterns. Inherent differences between recreational/adult cannabis use versus use for medical purposes are also discussed, given their importance to public policy decisions.
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Affiliation(s)
- Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Boston University School of Medicine, Boston, Massachusetts
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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27
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Arranz S, Monferrer N, Jose Algora M, Cabezas A, Sole M, Vilella E, Labad J, Sanchez-Gistau V. The relationship between the level of exposure to stress factors and cannabis in recent onset psychosis. Schizophr Res 2018; 201:352-359. [PMID: 29743139 DOI: 10.1016/j.schres.2018.04.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is a lack of studies investigating the dose-response effect of childhood trauma, recent events and cannabis use on recent psychosis. This study aims to determine the relationship between the level of exposure to stress factors and cannabis use with psychosis and to determine the combination effect among these factors in predicting a psychotic disorder. METHODS 146 recent onset psychotic (ROP) patients and 61 healthy controls were included. Childhood trauma was evaluated using the childhood trauma questionnaire (CTQ) and recent events using the Holmes-Rahe social readjustment scale. The pattern of cannabis use was assessed by a detailed interview. A hierarchical multiple regression was run in order to determine both the cumulative and independent contribution of each factor in predicting a psychotic disorder. RESULTS The highest levels of exposure to childhood trauma and cannabis were associated with psychosis while neither low nor high recent event exposure was associated. The combined effect of risk factors yielded a significant association with psychosis (×2 = 86.76, p < .001) explaining the 49% of its variation. ROP were more likely to be exposed to one, two or three environmental factors than HC. Exposed to two or all factors were 7.5-fold and 26.7-fold more likely to have a diagnosis of psychosis, respectively. CONCLUSIONS Our study provides evidence for a cumulative and a dose-response effect of environmental factors on recent psychosis. Considering that cannabis use and stress are highly prevalent in the population with psychosis, investigations of their relationships are needed to implement targeted prevention and treatment strategies.
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Affiliation(s)
- Sara Arranz
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
| | - Nuria Monferrer
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
| | - M Jose Algora
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
| | - Angel Cabezas
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
| | - Montse Sole
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
| | - E Vilella
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain
| | - J Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Vanessa Sanchez-Gistau
- Hospital Universitari Institut Pere Mata of Reus, IISPV, Universitat Rovira Virgili and CIBERSAM, Spain.
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28
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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Mood Fluctuation and Psychobiological Instability: The Same Core Functions Are Disrupted by Novel Psychoactive Substances and Established Recreational Drugs. Brain Sci 2018. [PMID: 29533974 PMCID: PMC5870361 DOI: 10.3390/brainsci8030043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Many novel psychoactive substances (NPS) have entered the recreational drug scene in recent years, yet the problems they cause are similar to those found with established drugs. This article will debate the psychobiological effects of these newer and more traditional substances. It will show how they disrupt the same core psychobiological functions, so damaging well-being in similar ways. Every psychoactive drug causes mood states to fluctuate. Users feel better on-drug, then feel worse off-drug. The strength of these mood fluctuations is closely related to their addiction potential. Cyclical changes can occur with many other core psychobiological functions, such as information processing and psychomotor speed. Hence the list of drug-related impairments can include: homeostatic imbalance, HPA axis disruption, increased stress, altered sleep patterns, neurohormonal changes, modified brain rhythms, neurocognitive impairments, and greater psychiatric vulnerability. Similar patterns of deficit are found with older drugs such as cocaine, nicotine and cannabis, and newer substances such as 3,4-methylenedioxymethamphetamine (MDMA), mephedrone and spice. All psychoactive drugs damage human well-being through similar basic neuropsychobiological mechanisms.
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30
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Blest-Hopley G, Giampietro V, Bhattacharyya S. Residual effects of cannabis use in adolescent and adult brains - A meta-analysis of fMRI studies. Neurosci Biobehav Rev 2018. [PMID: 29535069 DOI: 10.1016/j.neubiorev.2018.03.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While numerous studies have investigated the residual effects of cannabis use on human brain function, results of these studies have been inconsistent. Using meta-analytic approaches we summarize the effects of prolonged cannabis exposure on human brain function as measured using task-based functional MRI (fMRI) across studies employing a range of cognitive activation tasks comparing regular cannabis users with non-users. Separate meta-analyses were carried out for studies investigating adult and adolescent cannabis users. Systematic literature search identified 20 manuscripts (13 adult and 7 adolescent studies) meeting study inclusion criteria. Adult analyses compared 530 cannabis users to 580 healthy controls while adolescent analyses compared 219 cannabis users to 224 healthy controls. In adult cannabis users brain activation was increased in the superior and posterior transverse temporal and inferior frontal gyri and decreased in the striate area, insula and middle temporal gyrus. In adolescent cannabis users, activation was increased in the inferior parietal gyrus and putamen compared to healthy controls. Functional alteration in these areas may reflect compensatory neuroadaptive changes in cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, PO Box 089, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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31
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The effect of interactions between genetics and cannabis use on neurocognition. A review. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:95-106. [PMID: 29191570 DOI: 10.1016/j.pnpbp.2017.11.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cannabis is one of the most widely-used drugs in industrialized countries. It is now well established that cannabis use impacts neurocognition. In the intoxication period time episodic memory, working memory and attention are impacted and impulsivity is increased. The long-term effects of cannabis use tend to be similar. Various internal factors, such as sex differences, modulate this impact. It is unclear whether genetic variations can also influence the impact of cannabis on neurocognition. We set out to examine the impact of genetic variations on neurocognition in cannabis users. METHOD We conducted a search via the PubMed, Web of Science, and ScienceDirect databases to identify studies measuring neurocognition and assessing genotypes in the context of cannabis use. RESULTS We included 13 articles. We found that working memory, verbal and visual memory and sustained attention are more impacted during intoxication in subjects with the Val COMT allele. COMT gene could also modulate sustained attention in regular use. The CNR1, AKT1, DBH and 5-HTT/SLC6A4 genes may also modulate effects. CONCLUSION Most of these genes are linked to schizophrenia. A fuller understanding of their impact on the effects of cannabis on neurocognition would thus help elucidate the mechanisms linking cannabis and psychosis. However, evidence is still scant, and more research is needed.
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32
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Yanes JA, Riedel MC, Ray KL, Kirkland AE, Bird RT, Boeving ER, Reid MA, Gonzalez R, Robinson JL, Laird AR, Sutherland MT. Neuroimaging meta-analysis of cannabis use studies reveals convergent functional alterations in brain regions supporting cognitive control and reward processing. J Psychopharmacol 2018; 32:283-295. [PMID: 29338547 PMCID: PMC5858977 DOI: 10.1177/0269881117744995] [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: 11/17/2022]
Abstract
Lagging behind rapid changes to state laws, societal views, and medical practice is the scientific investigation of cannabis's impact on the human brain. While several brain imaging studies have contributed important insight into neurobiological alterations linked with cannabis use, our understanding remains limited. Here, we sought to delineate those brain regions that consistently demonstrate functional alterations among cannabis users versus non-users across neuroimaging studies using the activation likelihood estimation meta-analysis framework. In ancillary analyses, we characterized task-related brain networks that co-activate with cannabis-affected regions using data archived in a large neuroimaging repository, and then determined which psychological processes may be disrupted via functional decoding techniques. When considering convergent alterations among users, decreased activation was observed in the anterior cingulate cortex, which co-activated with frontal, parietal, and limbic areas and was linked with cognitive control processes. Similarly, decreased activation was observed in the dorsolateral prefrontal cortex, which co-activated with frontal and occipital areas and linked with attention-related processes. Conversely, increased activation among users was observed in the striatum, which co-activated with frontal, parietal, and other limbic areas and linked with reward processing. These meta-analytic outcomes indicate that cannabis use is linked with differential, region-specific effects across the brain.
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Affiliation(s)
- Julio A Yanes
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Michael C Riedel
- Center for Imaging Science, Florida International University, Miami, FL, USA
| | - Kimberly L Ray
- Imaging Research Center, University of California Davis, Sacramento, CA, USA
| | - Anna E Kirkland
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Ryan T Bird
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Emily R Boeving
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
| | - Meredith A Reid
- Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Raul Gonzalez
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Jennifer L Robinson
- Department of Psychology, Auburn University, Auburn, AL, USA,Auburn University Magnetic Resonance Imaging Research Center, Auburn University, Auburn, AL, USA,Advanced Alabama Imaging Consortium, Alabama, USA
| | - Angela R Laird
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Physics, Florida International University, Miami, FL, USA
| | - Matthew T Sutherland
- Center for Imaging Science, Florida International University, Miami, FL, USA,Department of Psychology, Florida International University, Miami, FL, USA
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Cservenka A, Lahanas S, Dotson-Bossert J. Marijuana Use and Hypothalamic-Pituitary-Adrenal Axis Functioning in Humans. Front Psychiatry 2018; 9:472. [PMID: 30327619 PMCID: PMC6174415 DOI: 10.3389/fpsyt.2018.00472] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/10/2018] [Indexed: 01/30/2023] Open
Abstract
Preclinical studies suggest cannabinoids affect functioning of the hypothalamic-pituitary-adrenal (HPA) axis, but little is known about the effects of marijuana (MJ) use on HPA axis functioning in humans. Since previous work indicates substances of abuse may dysregulate the HPA axis, it is critical to understand how MJ use affects HPA axis activity. Here, we review studies that (a) examined the effects of acute MJ administration on HPA axis functioning, (b) investigated the impact of stress on HPA axis functioning in MJ users, (c) examined the effect of chronic MJ use on basal cortisol levels, and (d) studied the relationship between MJ use and the cortisol awakening response (CAR). Findings indicate acute MJ administration typically raises cortisol levels, but this increase is blunted in MJ-dependent users relative to controls. Frequent MJ users have blunted adrenocorticotropic hormone and cortisol reactivity in response to acute stress. These findings suggest HPA axis activity may be dysregulated by heavy MJ use. Alternatively, dysregulation of the HPA axis may be a risk marker for heavy MJ use. There is mixed evidence for how MJ use affects basal cortisol levels and the CAR. Future studies should consider MJ use characteristics, method of hormone collection, time when samples are collected, and environmental factors that may influence HPA axis activity in MJ users. By examining existing studies we provide one of the first reviews aimed at synthesizing the literature on HPA axis functioning in MJ users.
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Affiliation(s)
- Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| | - Sarah Lahanas
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
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The relationship between cannabis use and cortisol levels in youth at ultra high-risk for psychosis. Psychoneuroendocrinology 2017; 83:58-64. [PMID: 28595088 PMCID: PMC5531192 DOI: 10.1016/j.psyneuen.2017.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/28/2017] [Accepted: 04/30/2017] [Indexed: 02/01/2023]
Abstract
Recent studies have posited a relationship between cannabis use and the biological stress system, but this critical relationship has not been evaluated during the ultra high-risk (UHR) period immediately preceding the onset of psychotic disorders. Salivary cortisol samples were collected on 46 UHR and 29 control adolescents; these individuals were assessed for current cannabis use with a urine panel and self-report. UHR participants where separated into two groups: Current Cannabis Use (UHR-CU) and No Current Cannabis Use (UHR-NC). Healthy Control participants (HC) were free of cannabis use. Consistent with the literature, results indicate UHR individuals showed elevated cortisol levels when compared to HC participants. Further, we also observed that UHR-CU participants exhibited elevated levels when compared to both the non-using UHR and HC groups. Findings suggest that cannabis use may interact with underlying biological vulnerability associated with the hypothalamic-pituitary-adrenal (HPA) axis system.
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Cuttler C, Spradlin A, Nusbaum AT, Whitney P, Hinson JM, McLaughlin RJ. Blunted stress reactivity in chronic cannabis users. Psychopharmacology (Berl) 2017; 234:2299-2309. [PMID: 28567696 DOI: 10.1007/s00213-017-4648-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/07/2017] [Indexed: 01/01/2023]
Abstract
RATIONALE One of the most commonly cited reasons for chronic cannabis use is to cope with stress. Consistent with this, cannabis users have shown reduced emotional arousal and dampened stress reactivity in response to negative imagery. OBJECTIVES To our knowledge, the present study represents the first to examine the effects of an acute stress manipulation on subjective stress and salivary cortisol in chronic cannabis users compared to non-users. METHODS Forty cannabis users and 42 non-users were randomly assigned to complete either the stress or no stress conditions of the Maastricht Acute Stress Test (MAST). The stress condition of the MAST manipulates both physiological (placing hand in ice bath) and psychosocial stress (performing math under conditions of social evaluation). Participants gave baseline subjective stress ratings before, during, and after the stress manipulation. Cortisol was measured from saliva samples obtained before and after the stress manipulation. Further, cannabis cravings and symptoms of withdrawal were measured. RESULTS Subjective stress ratings and cortisol levels were significantly higher in non-users in the stress condition relative to non-users in the no stress condition. In contrast, cannabis users demonstrated blunted stress reactivity; specifically, they showed no increase in cortisol and a significantly smaller increase in subjective stress ratings. The stress manipulation had no impact on cannabis users' self-reported cravings or withdrawal symptoms. CONCLUSION Chronic cannabis use is associated with blunted stress reactivity. Future research is needed to determine whether this helps to confer resiliency or vulnerability to stress-related psychopathology as well as the mechanisms underlying this effect.
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Affiliation(s)
- Carrie Cuttler
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA.
- Translational Addiction Research Center, Washington State University, Pullman, WA, USA.
| | - Alexander Spradlin
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA
| | - Amy T Nusbaum
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA
| | - Paul Whitney
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA
| | - John M Hinson
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA
| | - Ryan J McLaughlin
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA, 99164-4820, USA
- Translational Addiction Research Center, Washington State University, Pullman, WA, USA
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, 99164-7620, USA
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Blanco-Hinojo L, Pujol J, Harrison BJ, Macià D, Batalla A, Nogué S, Torrens M, Farré M, Deus J, Martín-Santos R. Attenuated frontal and sensory inputs to the basal ganglia in cannabis users. Addict Biol 2017; 22:1036-1047. [PMID: 26934839 DOI: 10.1111/adb.12370] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/30/2015] [Accepted: 01/07/2016] [Indexed: 12/18/2022]
Abstract
Heavy cannabis use is associated with reduced motivation. The basal ganglia, central in the motivation system, have the brain's highest cannabinoid receptor density. The frontal lobe is functionally coupled to the basal ganglia via segregated frontal-subcortical circuits conveying information from internal, self-generated activity. The basal ganglia, however, receive additional influence from the sensory system to further modulate purposeful behaviors according to the context. We postulated that cannabis use would impact functional connectivity between the basal ganglia and both internal (frontal cortex) and external (sensory cortices) sources of influence. Resting-state functional connectivity was measured in 28 chronic cannabis users and 29 controls. Selected behavioral tests included reaction time, verbal fluency and exposition to affective pictures. Assessments were repeated after one month of abstinence. Cannabis exposure was associated with (1) attenuation of the positive correlation between the striatum and areas pertaining to the 'limbic' frontal-basal ganglia circuit, and (2) attenuation of the negative correlation between the striatum and the fusiform gyrus, which is critical in recognizing significant visual features. Connectivity alterations were associated with lower arousal in response to affective pictures. Functional connectivity changes had a tendency to normalize after abstinence. The results overall indicate that frontal and sensory inputs to the basal ganglia are attenuated after chronic exposure to cannabis. This effect is consistent with the common behavioral consequences of chronic cannabis use concerning diminished responsiveness to both internal and external motivation signals. Such an impairment of the fine-tuning in the motivation system notably reverts after abstinence.
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Affiliation(s)
| | - Jesus Pujol
- MRI Research Unit; Hospital del Mar; Barcelona Spain
- Centro Investigación Biomédica en Red de Salud Mental; CIBERSAM G21; Barcelona Spain
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry; The University of Melbourne; Melbourne Australia
| | - Dídac Macià
- MRI Research Unit; Hospital del Mar; Barcelona Spain
| | - Albert Batalla
- Department of Psychiatry and Psychology; Hospital Clínic, Institut d'Investigació Biomédica August Pi I Sunyer (IDIBAPS), CIBERSAM G25; Barcelona Spain
- Nijmegen Institute for Scientist-Practitioners in Addiction; Nijmegen Netherlands
| | - Santiago Nogué
- Section of Clinical Toxicology, Emergency Service, Hospital Clínic, IDIBAPS; University of Barcelona; Barcelona Spain
| | - Marta Torrens
- Human Pharmacology and Clinical Neurosciences; Institute of Neuropsychiatry and Addiction, Hospital del Mar Medical Research Institute; Barcelona Spain
- School of Medicine, Autonomous University of Barcelona; Red de Trastornos Adictivos (RETIC); Barcelona Spain
| | - Magí Farré
- Human Pharmacology and Clinical Neurosciences; Institute of Neuropsychiatry and Addiction, Hospital del Mar Medical Research Institute; Barcelona Spain
- School of Medicine, Autonomous University of Barcelona; Red de Trastornos Adictivos (RETIC); Barcelona Spain
| | - Joan Deus
- MRI Research Unit; Hospital del Mar; Barcelona Spain
- Department of Clinical and Health Psychology; Autonomous University of Barcelona; Barcelona Spain
| | - Rocío Martín-Santos
- Department of Psychiatry and Psychology; Hospital Clínic, Institut d'Investigació Biomédica August Pi I Sunyer (IDIBAPS), CIBERSAM G25; Barcelona Spain
- Department of Psychiatry and Clinical Psychobiology; University of Barcelona; Barcelona Spain
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Parrott AC, Hayley AC, Downey LA. Recreational stimulants, herbal, and spice cannabis: The core psychobiological processes that underlie their damaging effects. Hum Psychopharmacol 2017; 32. [PMID: 28557129 DOI: 10.1002/hup.2594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/13/2017] [Accepted: 03/18/2017] [Indexed: 12/19/2022]
Abstract
AIMS Recreational drugs are taken for their positive mood effects, yet their regular usage damages well-being. The psychobiological mechanisms underlying these damaging effects will be debated. METHODS The empirical literature on recreational cannabinoids and stimulant drugs is reviewed. A theoretical explanation for how they cause similar types of damage is outlined. RESULTS All psychoactive drugs cause moods and psychological states to fluctuate. The acute mood gains underlie their recreational usage, while the mood deficits on withdrawal explain their addictiveness. Cyclical mood changes are found with every central nervous system stimulant and also occur with cannabis. These mood state changes provide a surface index for more profound psychobiological fluctuations. Homeostatic balance is altered, with repetitive disturbances of the hypothalamic-pituitary-adrenal axis, and disrupted cortisol-neurohormonal secretions. Hence, these drugs cause increased stress, disturbed sleep, neurocognitive impairments, altered brain activity, and psychiatric vulnerability. Equivalent deficits occur with novel psychoactive stimulants such as mephedrone and artificial "spice" cannabinoids. These psychobiological fluctuations underlie drug dependency and make cessation difficult. Psychobiological stability and homeostatic balance are optimally restored by quitting psychoactive drugs. CONCLUSIONS Recreational stimulants such as cocaine or MDMA (3.4-methylenedioxymethamphetamine) and sedative drugs such as cannabis damage human homeostasis and well-being through similar core psychobiological mechanisms.
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Affiliation(s)
- Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, UK.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - Amie C Hayley
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - Luke A Downey
- Department of Psychology, Swansea University, Swansea, UK.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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Abstract
Cannabis use affects cortico-striatal networks that are essential for producing movement. In this review, we summarize the literature on motor system dysfunction in cannabis users and provide a rationale for why motor learning should be considered an important area in cannabis research. A majority of studies have addressed cognitive impairments in cannabis users and some have focused on driving performance, motor impulsivity, and motor inhibition. Our review of the literature has found that cannabis use is associated with motor performance impairments; however, there is a gap in the literature regarding impairments in motor learning. The involvement of the cortico-striatal network in both cannabis addiction and movement also suggests potential avenues for treatment and rehabilitation via the motor system.
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Affiliation(s)
- Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA
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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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Hillard CJ, Beatka M, Sarvaideo J. Endocannabinoid Signaling and the Hypothalamic-Pituitary-Adrenal Axis. Compr Physiol 2016; 7:1-15. [PMID: 28134998 DOI: 10.1002/cphy.c160005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The elucidation of Δ9-tetrahydrocannabinol as the active principal of Cannabis sativa in 1963 initiated a fruitful half-century of scientific discovery, culminating in the identification of the endocannabinoid signaling system, a previously unknown neuromodulatory system. A primary function of the endocannabinoid signaling system is to maintain or recover homeostasis following psychological and physiological threats. We provide a brief introduction to the endocannabinoid signaling system and its role in synaptic plasticity. The majority of the article is devoted to a summary of current knowledge regarding the role of endocannabinoid signaling as both a regulator of endocrine responses to stress and as an effector of glucocorticoid and corticotrophin-releasing hormone signaling in the brain. We summarize data demonstrating that cannabinoid receptor 1 (CB1R) signaling can both inhibit and potentiate the activation of the hypothalamic-pituitary-adrenal axis by stress. We present a hypothesis that the inhibitory arm has high endocannabinoid tone and also serves to enhance recovery to baseline following stress, while the potentiating arm is not tonically active but can be activated by exogenous agonists. We discuss recent findings that corticotropin-releasing hormone in the amygdala enables hypothalamic-pituitary-adrenal axis activation via an increase in the catabolism of the endocannabinoid N-arachidonylethanolamine. We review data supporting the hypotheses that CB1R activation is required for many glucocorticoid effects, particularly feedback inhibition of hypothalamic-pituitary-adrenal axis activation, and that glucocorticoids mobilize the endocannabinoid 2-arachidonoylglycerol. These features of endocannabinoid signaling make it a tantalizing therapeutic target for treatment of stress-related disorders but to date, this promise is largely unrealized. © 2017 American Physiological Society. Compr Physiol 7:1-15, 2017.
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Affiliation(s)
- Cecilia J Hillard
- Department of Pharmacology and Toxicology, and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Margaret Beatka
- Department of Pharmacology and Toxicology, and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jenna Sarvaideo
- Department of Medicine, and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Barkus E, Morrison P, Di Forti M, Murray RM. Are deficits in cognition associated with psychotic-like experiences after cannabis? Hum Psychopharmacol 2016; 31:402-411. [PMID: 27859664 DOI: 10.1002/hup.2556] [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: 11/26/2015] [Revised: 07/07/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022]
Abstract
UNLABELLED Not all individuals who smoke cannabis report psychotic-like experiences. Given that risk factors for psychotic disorders are multifaceted, precipitating factors to psychotic-like experiences after cannabis are likely to be equally complex. Reduced neurocognitive performance is associated with both psychosis risk and cannabis use. Therefore, it is possible cognitive performance may differentiate those who report psychotic-like experiences after cannabis from those who do not. We determined whether those reporting psychotic/dysphoric experiences after cannabis had reduced neurocognitive performance compared to those reporting primarily euphoric experiences. METHODS Participants were recruited on the basis of responses to the cannabis high captured by the Psychosis-Dysphoric and Euphoric experiences subscales from the Cannabis Experiences Questionnaire (CEQ). RESULTS Compared to participants reporting primarily euphoric cannabis experiences (n = 36; 44% male; mean age (SD) = 28 (9) years), those who reported psychotic/dysphoric experiences (n = 40; 45% male; mean age (SD) = 26 (5) years) demonstrated significantly faster responses to a trial and error learning task. In the presence of distracters, those with psychotic/dysphoric experiences after cannabis made more errors on a Continuous Performance Task. CONCLUSIONS Those who report psychotic/dysphoric experiences after cannabis have subtle inefficiencies in their cognitive processes. The multiple factors which predict vulnerability to psychotic-like experiences after cannabis require further investigation.
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Affiliation(s)
- Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Paul Morrison
- Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Marta Di Forti
- Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Osuch EA, Manning K, Hegele RA, Théberge J, Neufeld R, Mitchell D, Williamson P, Gardner RC. Depression, marijuana use and early-onset marijuana use conferred unique effects on neural connectivity and cognition. Acta Psychiatr Scand 2016; 134:399-409. [PMID: 27565994 DOI: 10.1111/acps.12629] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Marijuana (MJ) use is common. Research shows risks for psychiatric illnesses, including major depressive disorder (MDD) and cognitive deficits with MJ use, particularly early-onset use. We investigated cognitive function, functional connectivity, and genetic risk with MDD alone and combined with MJ use, and differences between early-vs. late-onset/non-MJ use in youth. METHOD A total of 74 youth in four groups were studied: healthy control, MDD, frequent MJ use and current/past MDD plus frequent MJ use. Psychiatric symptoms, cognitive performance and demographics were measured. Default mode network (DMN) brain connectivity was determined. Risk alleles in six genes of interest were evaluated. RESULTS DMN differences among groups in reward-processing and motor control regions were found; the effects of MJ use and MDD were distinct. Early-onset MJ use was associated with lower IQ and hyperconnectivity within areas of the DMN. Early-onset MJ use was associated with the BDNF risk allele. CONCLUSIONS Cognitive deficits linked with early-onset MJ use were present within several years after MJ use began and may result from, predispose to, or share a common cause with early-onset MJ use. The DMN was affected by MDD, MJ and their combination, as well as by early-onset MJ use. BDNF carrier state may predispose to early-onset MJ use.
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Affiliation(s)
- E A Osuch
- Department of Psychiatry, University of Western Ontario, London, ON, Canada. .,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada. .,Program in Neuroscience, University of Western Ontario, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada.
| | - K Manning
- Robarts Research Institute, London, ON, Canada
| | - R A Hegele
- Robarts Research Institute, London, ON, Canada
| | - J Théberge
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Department of Medical Imaging, University of Western Ontario, London, ON, Canada.,Department of Diagnostic Imaging, St. Joseph's Hospital, London, ON, Canada
| | - R Neufeld
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Program in Neuroscience, University of Western Ontario, London, ON, Canada.,Department of Psychology, University of Western Ontario, London, ON, Canada
| | - D Mitchell
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Psychology, University of Western Ontario, London, ON, Canada.,Brain and Mind Institute, London, ON, Canada
| | - P Williamson
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada.,Program in Neuroscience, University of Western Ontario, London, ON, Canada
| | - R C Gardner
- Department of Psychology, University of Western Ontario, London, ON, Canada
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Sharkey KA, Wiley JW. The Role of the Endocannabinoid System in the Brain-Gut Axis. Gastroenterology 2016; 151:252-66. [PMID: 27133395 PMCID: PMC4961581 DOI: 10.1053/j.gastro.2016.04.015] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/21/2016] [Accepted: 04/11/2016] [Indexed: 12/17/2022]
Abstract
The actions of cannabis are mediated by receptors that are part of an endogenous cannabinoid system. The endocannabinoid system (ECS) consists of the naturally occurring ligands N-arachidonoylethanolamine (anandamide) and 2-arachidonoylglycerol (2-AG), their biosynthetic and degradative enzymes, and the cannabinoid (CB) receptors CB1 and CB2. The ECS is a widely distributed transmitter system that controls gut functions peripherally and centrally. It is an important physiologic regulator of gastrointestinal motility. Polymorphisms in the gene encoding CB1 (CNR1) have been associated with some forms of irritable bowel syndrome. The ECS is involved in the control of nausea and vomiting and visceral sensation. The homeostatic role of the ECS also extends to the control of intestinal inflammation. We review the mechanisms by which the ECS links stress and visceral pain. CB1 in sensory ganglia controls visceral sensation, and transcription of CNR1 is modified through epigenetic processes under conditions of chronic stress. These processes might link stress with abdominal pain. The ECS is also involved centrally in the manifestation of stress, and endocannabinoid signaling reduces the activity of hypothalamic-pituitary-adrenal pathways via actions in specific brain regions, notably the prefrontal cortex, amygdala, and hypothalamus. Agents that modulate the ECS are in early stages of development for treatment of gastrointestinal diseases. Increasing our understanding of the ECS will greatly advance our knowledge of interactions between the brain and gut and could lead to new treatments for gastrointestinal disorders.
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Affiliation(s)
- Keith A. Sharkey
- Hotchkiss Brain Institute and Snyder Institute of Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N 4N1, Canada,Corresponding author: Dr. Keith Sharkey, Department of Physiology and Pharmacology, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada, , Tel: 403-220-4601
| | - John W. Wiley
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
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Cuttler C, Mischley LK, Sexton M. Sex Differences in Cannabis Use and Effects: A Cross-Sectional Survey of Cannabis Users. Cannabis Cannabinoid Res 2016; 1:166-175. [PMID: 28861492 PMCID: PMC5576608 DOI: 10.1089/can.2016.0010] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction: Despite known sex differences in the endocannabinoid system of animals, little attention has been paid to sex differences in human's cannabis use patterns and effects. The purpose of the present study was to examine sex differences in cannabis use patterns and effects in a large sample of recreational and medical cannabis users. Methods: A large sample (n=2374) of cannabis users completed an anonymous, online survey that assessed their cannabis use practices and experiences, including the short-term acute effects of cannabis and withdrawal effects. A subsample of 1418 medical cannabis users further indicated the medical conditions for which they use cannabis and its perceived efficacy. Results: The results indicated that men reported using cannabis more frequently and in higher quantities than did women. Men were more likely to report using joints/blunts, vaporizers, and concentrates, while women were more likely to report using pipes and oral administration. Men were more likely than women to report increased appetite, improved memory, enthusiasm, altered time perception, and increased musicality when high, while women were more likely than men to report loss of appetite and desire to clean when high. Men were more likely than women to report insomnia and vivid dreams during periods of withdrawal, while women were more likely than men to report nausea and anxiety as withdrawal symptoms. Sex differences in the conditions for which medical cannabis is used, and its efficacy, were trivial. Conclusions: These results may be used to focus research on biological and psychosocial mechanisms underlying cannabis-related sex differences, to inform clinicians treating individuals with cannabis use disorders, and to inform cannabis consumers, clinicians, and policymakers about the risks and benefits of cannabis for both sexes.
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Affiliation(s)
- Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, Washington
| | | | - Michelle Sexton
- Center for the Study of Cannabis and Social Policy, Seattle, Washington
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Cortical thinness and volume differences associated with marijuana abuse in emerging adults. Drug Alcohol Depend 2015; 155:275-83. [PMID: 26249265 PMCID: PMC4581973 DOI: 10.1016/j.drugalcdep.2015.06.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/14/2015] [Accepted: 06/09/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. METHODS Fifteen MJ users (age 21.8±3.6, 2 females) and 15 non-user (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. RESULTS Whole brain CT analysis did not result in significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group differences. CONCLUSIONS RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing.
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Power BD, Dragovic M, Badcock JC, Morgan VA, Castle D, Jablensky A, Stefanis NC. No additive effect of cannabis on cognition in schizophrenia. Schizophr Res 2015; 168:245-51. [PMID: 26235754 DOI: 10.1016/j.schres.2015.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/18/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to examine the association between lifetime cannabis use and estimates of both premorbid and current cognitive function in psychotic disorders in an Australian cohort. METHODS In an Australian multicenter cohort, 1237 participants with an established ICD-10 diagnosis of psychotic disorder were categorised according to history of lifetime cannabis use (non-users, n=354; cannabis users, n=221; cannabis dependency, n=662). Groups were analyzed according to available indices of cognitive ability: the National Adult Reading Test - Revised (NART-R) for ability prior to illness onset; and the Digit Symbol Coding Test (DSCT) for current ability. Two-way analysis of variance was conducted without any covariate, followed by a two-way analysis of covariance (using age, age at onset of psychiatric illness, premorbid IQ and the Socio-Economic Index for Areas (SEIFA) rankings). RESULTS Whilst there appeared to be a significant association between cannabis use and mean DSCT (higher DSCT scores in cannabis using groups) F(2,1080)=9.478, p<0.001, η2=0.017), once covariates were used in the analysis there were no significant differences between groups in mean DSCT scores (F(2,1011)=0.929, p=0.395, η2=0.002). Similarly there were no differences between groups in mean NART scores once, age, age at illness onset and SEIFA rankings were used as covariates (F(2,1032)=1.617, p=0.199, η2=0.003). CONCLUSIONS Confounding variables underpin the association between cannabis use and cognitive function in psychotic disorders. Taken together, it would appear that cannabis use or dependence has no additive effect on cognitive dysfunction in these disorders.
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Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, Australia; South Metropolitan Area Health Service, Perth, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia.
| | - Milan Dragovic
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Johanna C Badcock
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Vera A Morgan
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - David Castle
- St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Assen Jablensky
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Nikos C Stefanis
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
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Tomasi D, Wang GJ, Volkow ND. Balanced modulation of striatal activation from D2 /D3 receptors in caudate and ventral striatum: Disruption in cannabis abusers. Hum Brain Mapp 2015; 36:3154-66. [PMID: 26058801 DOI: 10.1002/hbm.22834] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 02/05/2023] Open
Abstract
Proper communication between dorsal caudate (CD) and ventral striatum (VS) is likely to be crucial for on-time responses and its disruption might result in impulsivity. Here, we used functional magnetic resonance imaging (fMRI) with a sensorimotor reaction time task and positron emission tomography (PET) with [(11)C]raclopride in 14 healthy controls and 18 cannabis abusers to contrast the modulation of striatal fMRI responses by dopamine receptors (D2 /D3 R) in CD and VS. In controls, we show that the fMRI signals in VS that occurs concomitantly with on-time responses showed opposite modulation from D2 /D3 R in CD (inhibitory) and D2 /D3 R in VS (stimulatory). In contrast, this modulation was not significant in cannabis abusers. Findings suggest that action speed requires balanced VS-inhibition from D2 /D3 R in CD and VS-facilitation from D2 /D3 R in VS.
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Affiliation(s)
- Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, 20892.,National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, 20892
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Wetherill RR, Jagannathan K, Hager N, Childress AR, Rao H, Franklin TR. Cannabis, Cigarettes, and Their Co-Occurring Use: Disentangling Differences in Gray Matter Volume. Int J Neuropsychopharmacol 2015; 18:pyv061. [PMID: 26045474 PMCID: PMC4648161 DOI: 10.1093/ijnp/pyv061] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 05/25/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Structural magnetic resonance imaging techniques are powerful tools for examining the effects of drug use on the brain. The nicotine and cannabis literature has demonstrated differences between nicotine cigarette smokers and cannabis users compared to controls in brain structure; however, less is known about the effects of co-occurring cannabis and tobacco use. METHODS We used voxel-based morphometry to examine gray matter volume differences between four groups: (1) cannabis-dependent individuals who do not smoke tobacco (Cs); (2) cannabis-dependent individuals who smoke tobacco (CTs); (3) cannabis-naïve, nicotine-dependent individuals who smoke tobacco (Ts); and (4) healthy controls (HCs). We also explored associations between gray matter volume and measures of cannabis and tobacco use. RESULTS A significant group effect was observed in the left putamen, thalamus, right precentral gyrus, and left cerebellum. Compared to HCs, the Cs, CTs, and Ts exhibited larger gray matter volumes in the left putamen. Cs also had larger gray matter volume than HCs in the right precentral gyrus. Cs and CTs exhibited smaller gray matter volume than HCs in the thalamus, and CTs and Ts had smaller left cerebellar gray matter volume than HCs. CONCLUSIONS This study extends previous research that independently examined the effects of cannabis or tobacco use on brain structure by including an examination of co-occurring cannabis and tobacco use, and provides evidence that cannabis and tobacco exposure are associated with alterations in brain regions associated with addiction.
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Affiliation(s)
- Reagan R Wetherill
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager).
| | - Kanchana Jagannathan
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager)
| | - Nathan Hager
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager)
| | - Anna Rose Childress
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager)
| | - Hengyi Rao
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager)
| | - Teresa R Franklin
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA (Drs Wetherill, Jagannathan, Childress, Rao, and Franklin, and Mr Hager)
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Cloak CC, Alicata D, Ernst TM, Chang L. Psychiatric Symptoms, Salivary Cortisol and Cytokine Levels in Young Marijuana Users. J Neuroimmune Pharmacol 2015; 10:380-90. [PMID: 25875137 PMCID: PMC4470746 DOI: 10.1007/s11481-015-9606-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/17/2015] [Indexed: 02/07/2023]
Abstract
Psychological maturation continues into young adulthood when substance abuse and several psychiatric disorders often emerge. Marijuana is the most common illicit drug abused by youths, typically preceding other illicit substances. We aimed to evaluate the complex and poorly studied relationships between marijuana use, psychiatric symptoms, and cortisol levels in young marijuana users. Psychiatric symptoms and salivary cortisol were measured in 122 youths (13-23 years old) with and without marijuana use. Psychiatric symptoms were evaluated using the Symptom-Checklist-90-R and Brief Psychiatric Rating Scale. Mid-day salivary cortisol levels were measured. Additionally, salivary cytokine levels were measured in a subset of participants. Although the cortisol levels and salivary cytokine levels were similar, the young marijuana users had more self-reported and clinician rated psychiatric symptoms than controls, especially anxiety-associated symptoms. Moreover, marijuana users with earlier age of first use had more symptoms, while those with longer abstinence had fewer symptoms. Greater cumulative lifetime marijuana use was also associated with greater psychiatric symptoms. The discordant anxiety (feeling stressed or anxious despite normal cortisol) in the marijuana users, as well as symptom exacerbations with early and continued marijuana use in young marijuana users suggest that marijuana use may contribute to an aberrant relationship between stress response and psychiatric symptoms. The greater symptomatology, especially in those with earlier initiation and greater marijuana usage, emphasize the need to intervene for substance use and perceived anxiety in this population.
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Affiliation(s)
- Christine C Cloak
- John A. Burns School of Medicine, Department of Medicine, University of Hawaii, Manoa, 1356 Lusitana St 7th Floor, Honolulu, HI, 96813, USA,
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Downey LA, Sands H, Jones L, Clow A, Evans P, Stalder T, Parrott AC. Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits. Hum Psychopharmacol 2015; 30:199-207. [PMID: 25900184 DOI: 10.1002/hup.2474] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. METHODS The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. RESULTS Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. CONCLUSIONS Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users.
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Affiliation(s)
- Luke A Downey
- Department of Psychology, Swansea University, Swansea, UK; Centre for Human Psychopharmacology (CHP), Swinburne University, Melbourne, Australia
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