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Brown T, Ackerman RA, Kroon E, Kuhns L, Cousijn J, Filbey FM. The role of sleep in the link between cannabis use and memory function: evidence from a cross-sectional study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-10. [PMID: 38917114 DOI: 10.1080/00952990.2024.2362832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/29/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024]
Abstract
Background: It is known that cannabis use affects memory and sleep problems independently. However, to date, how memory and sleep problems may interact as a result of cannabis use remains unknown.Objectives: We performed a secondary analysis of existing data to determine whether sleep quality mediates the association between cannabis use and memory and whether sex moderated these effects.Methods: A total of 141 adults with cannabis use disorder (CUD) (83 men) and 87 without CUD (39 men) participated in this study. Outcome measures included self-reported sleep problems from the past 7 days (Marijuana Withdrawal Checklist), learning and memory performance via the short visual object learning task (sVOLT), short visual object learning task delayed (sVOLTd), and verbal memory via the N-back. Bootstrapped mediation and moderated mediation analyses were run to test if sleep quality mediated the association between cannabis use and memory outcomes and whether sex moderated these effects, respectively.Results: Sleep quality mediated the effect of group (i.e. adults with and without CUD) on sVOLT efficiency scores (indirect effect ß = -.08, 95% CI [-0.14, -0.04]) and sVOLTd efficiency scores (indirect effect ß = -.09, 95% CI [-0.14, -0.04]), where greater sleep difficulties was associated with poorer memory performance (decreased efficiency scores). Sex did not moderate these relationships.Conclusion: These initial findings of a mediating role of sleep in the association between CUD and visual learning memory highlight potential critical downstream effects of disrupted sleep in those with CUD and suggest the importance of investigating sleep in CUD.
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Affiliation(s)
- T Brown
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - R A Ackerman
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - E Kroon
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - L Kuhns
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - J Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - F M Filbey
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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Anderson NE, Maurer JM, Stephenson D, Harenski K, Caldwell M, Van Rybroek G, Kiehl KA. Striatal brain volume linked to severity of substance use in high-risk incarcerated youth. Dev Psychopathol 2024:1-10. [PMID: 38738358 DOI: 10.1017/s0954579424000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Substance use disorders among juveniles are a major public health concern and are often intertwined with other psychosocial risk factors including antisocial behavior. Identifying etiological risks and mechanisms promoting substance use disorders remains a high priority for informing more focused interventions in high-risk populations. The present study examined brain gray matter structure in relation to substance use severity among n = 152 high-risk, incarcerated boys (aged 14-20). Substance use severity was positively associated with gray matter volume across several frontal/striatal brain regions including amygdala, pallidum, putamen, insula, and orbitofrontal cortex. Effects were apparent when using voxel-based-morphometric analysis, as well as in whole-brain, data-driven, network-based approaches (source-based morphometry). These findings support the hypothesis that elevated gray matter volume in striatal reward circuits may be an endogenous marker for vulnerability to severe substance use behaviors among youth.
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Affiliation(s)
| | | | | | | | - Michael Caldwell
- Mendota Mental Health Institute, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Greg Van Rybroek
- Mendota Mental Health Institute, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Kent A Kiehl
- The Mind Research Network, Albuquerque, NM, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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3
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McKowen JW, Lowman KL, Watt L, Yule AM, Burke C, Kaminiski T, Wilens T, Kelly J. The Relationship Between Cannabis Use and Self-Reported Trait Anger in Treatment-Seeking Young People. Cannabis Cannabinoid Res 2024; 9:223-229. [PMID: 35833834 DOI: 10.1089/can.2021.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Trait anger has been shown to be predictive of emotion-focused coping and alcohol use. Yet, the connection between cannabis use and trait anger remains poorly characterized. The present study sought to investigate the relationship between cannabis use and self-reported trait anger in youth seeking substance use treatment. Methods: A retrospective chart review was conducted on youth (n=168) aged 14-26 presenting for an initial evaluation at an outpatient substance use treatment program. Patients self-reported trait anger score (TAS) and lifetime, recent, and Diagnostic and Statistics Manual-5th Edition diagnostic status of cannabis use were assessed. Clinician-coded psychiatric and substance use patterns were collected, along with urine carboxy delta-9-tetrahydrocannabinol (THC) concentration levels. Additional measures of anxiety, depression, and demographic variables were assessed. Results: Higher self-reported TAS were associated with cannabis use, cannabis use disorder (CUD), and more recent and frequent cannabis use. The presence of a CUD was independently associated with TAS after controlling for the presence of other substance use disorders and co-occurring depression and anxiety disorders. Higher urine THC concentration levels were associated with higher TAS. Conclusions: Findings support an association between heavy, chronic cannabis use and elevated self-reported trait anger at intake. There may be important neurological consequences of heavy, chronic cannabis use that impact anger regulation. It is also plausible that trait anger maybe a predisposing factor for elevated cannabis use. Better controlled prospective research is needed to help determine directionality. Treatment programs should target both cannabis use and anger regulation in youth.
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Affiliation(s)
- James W McKowen
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelsey L Lowman
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa Watt
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy M Yule
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Colin Burke
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Tamar Kaminiski
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy Wilens
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - John Kelly
- Department of Psychiatry, Addiction Recovery Management Service and West End Clinic, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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4
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Zoghbi AW, Lieberman JA, Girgis RR. The neurobiology of duration of untreated psychosis: a comprehensive review. Mol Psychiatry 2023; 28:168-190. [PMID: 35931757 PMCID: PMC10979514 DOI: 10.1038/s41380-022-01718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 01/11/2023]
Abstract
Duration of untreated psychosis (DUP) is defined as the time from the onset of psychotic symptoms until the first treatment. Studies have shown that longer DUP is associated with poorer response rates to antipsychotic medications and impaired cognition, yet the neurobiologic correlates of DUP are poorly understood. Moreover, it has been hypothesized that untreated psychosis may be neurotoxic. Here, we conducted a comprehensive review of studies that have examined the neurobiology of DUP. Specifically, we included studies that evaluated DUP using a range of neurobiologic and imaging techniques and identified 83 articles that met inclusion and exclusion criteria. Overall, 27 out of the total 83 studies (32.5%) reported a significant neurobiological correlate with DUP. These results provide evidence against the notion of psychosis as structurally or functionally neurotoxic on a global scale and suggest that specific regions of the brain, such as temporal regions, may be more vulnerable to the effects of DUP. It is also possible that current methodologies lack the resolution needed to more accurately examine the effects of DUP on the brain, such as effects on synaptic density. Newer methodologies, such as MR scanners with stronger magnets, PET imaging with newer ligands capable of measuring subcellular structures (e.g., the PET ligand [11C]UCB-J) may be better able to capture these limited neuropathologic processes. Lastly, to ensure robust and replicable results, future studies of DUP should be adequately powered and specifically designed to test for the effects of DUP on localized brain structure and function with careful attention paid to potential confounds and methodological issues.
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Affiliation(s)
- Anthony W Zoghbi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA.
- Institute of Genomic Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA.
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA.
- Office of Mental Health, New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Jeffrey A Lieberman
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Ragy R Girgis
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA.
- Office of Mental Health, New York State Psychiatric Institute, New York, NY, 10032, USA.
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5
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Cong Z, Fu Y, Chen N, Zhang L, Yao C, Wang Y, Yao Z, Hu B. Individuals with cannabis use are associated with widespread morphological alterations in the subregions of the amygdala, hippocampus, and pallidum. Drug Alcohol Depend 2022; 239:109595. [PMID: 35961268 DOI: 10.1016/j.drugalcdep.2022.109595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/02/2022] [Accepted: 07/30/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cannabis is the most frequently used illicit drug worldwide. Although multiple structural MRI studies of individuals with cannabis use (CB) have been undertaken, the reports of the volume alterations in the amygdala, hippocampus, and pallidum are not consistent. This study aims to detect subregion-level morphological alterations, analyze the correlation areas with cannabis usage characteristics, and gain new insights into the neuro mechanisms of CB. METHODS By leveraging the novel surface-based subcortical morphometry method, 20 CB and 22 age- and sex-matched healthy controls (HC) were included to explore their volumetric and morphological differences in the three subcortical structures. Afterward, the correlation analysis between surface morphological eigenvalues and cannabis usage characteristics was performed. RESULTS Compared with volumetric measures, the surface-based subcortical morphometry method detected more significant global morphological deformations in the left amygdala, right hippocampus, and right pallidum (overall-p < 0.05, corrected). More obvious morphological alterations (atrophy or expansion) were observed in specific subregions (vertex-based p-value<0.05, uncorrected) of the three subcortical structures. Both positive and negative subregional correlation areas were reported by the correlation analysis. CONCLUSIONS The current study illuminated new pathophysiologic mechanisms in the amygdala, hippocampus, and pallidum at the subregion level, which may inform the subsequent smaller-scale CB research.
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Affiliation(s)
- Zhaoyang Cong
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China
| | - Yu Fu
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, Zhejiang Province 310027, China
| | - Nan Chen
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China
| | - Lingyu Zhang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China
| | - Chaofan Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ 85281, USA
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China.
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province 730000, China; Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Chinese Academy of Sciences, Lanzhou, Gansu Province 730000, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200233, China; Engineering Research Center of Open Source Software and Real-Time System (Lanzhou University), Ministry of Education, Lanzhou, Gansu Province 730000, China.
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6
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Xu H, Li D, Yin B. Aberrant hippocampal shape development in young adults with heavy cannabis use: Evidence from a longitudinal study. J Psychiatr Res 2022; 152:343-351. [PMID: 35785577 DOI: 10.1016/j.jpsychires.2022.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
Abstract
Cannabis is one of the most commonly used illicit drugs globally. Mounting evidence indicates that cannabis use, particularly consumption during young adulthood, is related to adverse mental and behavioral outcomes and an increased risk of the onset and relapse of psychosis. However, the neuromechanism underpinnings of heavy cannabis use (HCU) in young adults remain largely unknown, and no study has yet investigated the development of hippocampal shape in young adults with HCU. Twenty young adults with HCU and 22 matched non-cannabis-use healthy controls (HCs) were enrolled. Neuroimaging scanning and clinical assessments for all participants were performed at baseline (BL) and 3-year follow-up (FU). The vertex-wise shape analysis was conducted to investigate aberrant hippocampal shape development in young adults with HCU. Aberrant shape development pattern of the hippocampus was observed in young adults with HCU. There was no significant difference in hippocampal shape between the groups at BL, but young adults with HCU at FU exhibited significant shape atrophy of the right dorsal anterior hippocampus related to HCs. In addition, there was a significantly lower growth rate of the right hippocampal shape. Furthermore, there were significant associations of heavy cannabis use, as indicated by the age at onset first and frequent cannabis use, with the growth rate of hippocampal shape in young adults with HCU. The aberrant hippocampal shape development may reflect the effect of heavy cannabis use on young adults and it may be a potential target for heavy cannabis use treatment for young adults.
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Affiliation(s)
- Hui Xu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada.
| | - Dandong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.
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7
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Sonti S, Tyagi K, Pande A, Daniel R, Sharma AL, Tyagi M. Crossroads of Drug Abuse and HIV Infection: Neurotoxicity and CNS Reservoir. Vaccines (Basel) 2022; 10:vaccines10020202. [PMID: 35214661 PMCID: PMC8875185 DOI: 10.3390/vaccines10020202] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 01/27/2023] Open
Abstract
Drug abuse is a common comorbidity in people infected with HIV. HIV-infected individuals who abuse drugs are a key population who frequently experience suboptimal outcomes along the HIV continuum of care. A modest proportion of HIV-infected individuals develop HIV-associated neurocognitive issues, the severity of which further increases with drug abuse. Moreover, the tendency of the virus to go into latency in certain cellular reservoirs again complicates the elimination of HIV and HIV-associated illnesses. Antiretroviral therapy (ART) successfully decreased the overall viral load in infected people, yet it does not effectively eliminate the virus from all latent reservoirs. Although ART increased the life expectancy of infected individuals, it showed inconsistent improvement in CNS functioning, thus decreasing the quality of life. Research efforts have been dedicated to identifying common mechanisms through which HIV and drug abuse lead to neurotoxicity and CNS dysfunction. Therefore, in order to develop an effective treatment regimen to treat neurocognitive and related symptoms in HIV-infected patients, it is crucial to understand the involved mechanisms of neurotoxicity. Eventually, those mechanisms could lead the way to design and develop novel therapeutic strategies addressing both CNS HIV reservoir and illicit drug use by HIV patients.
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Affiliation(s)
- Shilpa Sonti
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA; (S.S.); (A.L.S.)
| | - Kratika Tyagi
- Department of Biotechnology, Banasthali Vidyapith, Vanasthali, Jaipur 304022, Rajasthan, India;
| | - Amit Pande
- Cell Culture Laboratory, ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, Nainital 263136, Uttarakhand, India;
| | - Rene Daniel
- Farber Hospitalist Service, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Adhikarimayum Lakhikumar Sharma
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA; (S.S.); (A.L.S.)
| | - Mudit Tyagi
- Center for Translational Medicine, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA 19107, USA; (S.S.); (A.L.S.)
- Correspondence: ; Tel.: +1-215-503-5157 or +1-703-909-9420
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8
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Association between age of cannabis initiation and gray matter covariance networks in recent onset psychosis. Neuropsychopharmacology 2021; 46:1484-1493. [PMID: 33658653 PMCID: PMC8209059 DOI: 10.1038/s41386-021-00977-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/04/2022]
Abstract
Cannabis use during adolescence is associated with an increased risk of developing psychosis. According to a current hypothesis, this results from detrimental effects of early cannabis use on brain maturation during this vulnerable period. However, studies investigating the interaction between early cannabis use and brain structural alterations hitherto reported inconclusive findings. We investigated effects of age of cannabis initiation on psychosis using data from the multicentric Personalized Prognostic Tools for Early Psychosis Management (PRONIA) and the Cannabis Induced Psychosis (CIP) studies, yielding a total sample of 102 clinically-relevant cannabis users with recent onset psychosis. GM covariance underlies shared maturational processes. Therefore, we performed source-based morphometry analysis with spatial constraints on structural brain networks showing significant alterations in schizophrenia in a previous multisite study, thus testing associations of these networks with the age of cannabis initiation and with confounding factors. Earlier cannabis initiation was associated with more severe positive symptoms in our cohort. Greater gray matter volume (GMV) in the previously identified cerebellar schizophrenia-related network had a significant association with early cannabis use, independent of several possibly confounding factors. Moreover, GMV in the cerebellar network was associated with lower volume in another network previously associated with schizophrenia, comprising the insula, superior temporal, and inferior frontal gyrus. These findings are in line with previous investigations in healthy cannabis users, and suggest that early initiation of cannabis perturbs the developmental trajectory of certain structural brain networks in a manner imparting risk for psychosis later in life.
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9
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Rangel-Pacheco A, Lew BJ, Schantell MD, Frenzel MR, Eastman JA, Wiesman AI, Wilson TW. Altered fronto-occipital connectivity during visual selective attention in regular cannabis users. Psychopharmacology (Berl) 2021; 238:1351-1361. [PMID: 33241479 PMCID: PMC8068572 DOI: 10.1007/s00213-020-05717-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/10/2020] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVES Cognitive processing impairments have been associated with acute cannabis use, but there is mixed evidence regarding the cognitive effects of chronic cannabis use. Several neuroimaging studies have noted selective-attention processing differences in those who chronically use cannabis, but the neural dynamics governing the altered processing is unclear. METHODS Twenty-four adults reporting at least weekly cannabis use in the past 6 months on the Cannabis Use Disorder Identification Test - Revised were compared to 24 demographically matched controls who reported no prior cannabis use. All participants completed a visual selective attention processing task while undergoing magnetoencephalography. Time-frequency windows of interest were identified using a data-driven method, and spectrally specific neural activity was imaged using a beamforming approach. RESULTS All participants performed within normal range on the cognitive task. Regular cannabis users displayed an aberrant cognitive interference effect in the theta (4-8 Hz) frequency range shortly after stimulus onset (i.e., 0-250 ms) in the right occipital cortex. Cannabis users also exhibited altered functional connectivity between the right prefrontal cortex and right occipital cortices in comparison to controls. CONCLUSIONS Individuals with a history of regular cannabis use exhibited abnormal theta interference activity in the occipital cortices, as well as altered prefrontal-occipital functional connectivity in the theta range during a visual selective attention task. Such differences may reflect compensatory processing, as these participants performed within normal range on the task. Understanding the neural dynamics in chronic, regular cannabis users may provide insight on how long-term and/or frequent use may affect neural networks underlying cognitive processes.
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Affiliation(s)
- Abril Rangel-Pacheco
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA,College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Brandon J. Lew
- 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 D. 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
| | - Michaela R. Frenzel
- 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
| | - Alex I. Wiesman
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA,Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA,College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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10
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Wittemann M, Brielmaier J, Rubly M, Kennel J, Werler F, Schmitgen MM, Kubera KM, Hirjak D, Wolf ND, Reith W, Wolf RC. Cognition and Cortical Thickness in Heavy Cannabis Users. Eur Addict Res 2021; 27:115-122. [PMID: 33080597 DOI: 10.1159/000509987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acute and long-term adverse effects of heavy cannabis use (HCU) on neurocognitive function have been suggested, as much as regional changes of brain volume. However, little is known about the relationship between impaired cognition and brain structure in individuals with HCU. OBJECTIVE Here, we investigated associations between cognition and cortical thickness (CT) in males with HCU and male controls. METHODS Twenty-six individuals with HCU and 20 controls were examined using a comprehensive neuropsychological test battery and high-resolution structural MRI at 3T. CT was calculated using the Computational Anatomy Toolbox (CAT12). RESULTS Individuals with HCU differed from controls with respect to verbal learning performance and verbal working memory only. Individuals with HCU showed reduced CT in medial temporal, orbitofrontal, and cingulate regions, as well as in areas of the middle temporal and fusiform cortex (peak voxel family-wise error-corrected p < 0.001, followed by empirically determined correction for spatial extent) compared to HC. Verbal learning performance was associated with right entorhinal and left orbitofrontal CT reductions. Entorhinal CT was also significantly associated with amount and frequency of current weekly cannabis use. CONCLUSIONS The data support the notion of domain-specific cognitive impairment in individuals with HCU and provide a neuromechanistic understanding of such deficits, particularly with respect to abnormal CT in brain areas associated with long-term memory processing.
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Affiliation(s)
- Miriam Wittemann
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jule Brielmaier
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany.,Department of Obstetrics and Gynecology, RKH Clinic Ludwigsburg, Ludwigsburg, Germany
| | - Mathias Rubly
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jennifer Kennel
- Department of Psychiatry and Psychotherapy, SHG-Kliniken Saarbrücken, Saarbrücken, Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadine D Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University, Saarbrücken, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,
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11
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Gray matter changes in chronic heavy cannabis users: a voxel-level study using multivariate pattern analysis approach. Neuroreport 2020; 31:1236-1241. [PMID: 33044327 DOI: 10.1097/wnr.0000000000001532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent structural MRI studies on gray matter (GM) volumes using group-level mass-univariate statistical analysis suggest that chronic and heavy cannabis exposure may affect brain region-based morphology. In this prospective study, we use a multivariate pattern analysis approach to investigate the voxel-level change of GM densities in chronic heavy cannabis users. Principal component analysis and linear support vector machine are used in this study, resulting in an 88.1% separation between chronic heavy cannabis users (N = 20) and non-cannabis healthy controls (HCs, N = 22) through leave-one-out cross-validation. The model's discriminative pattern showed that GM density decreases in the part of middle frontal gyrus, inferior frontal gyrus, middle temporal gyrus, inferior temporal gyrus and left occipital lobe in heavy cannabis users with respect to HCs and increases in the part of lentiform nucleus, left cerebellum and right parietal lobe. These results suggest that GM densities alteration has taken place on chronic heavy cannabis users compared with HCs at voxel level.
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12
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Yeh CL, Levar N, Broos HC, Dechert A, Potter K, Evins AE, Gilman JM. White matter integrity differences associated with post-traumatic stress disorder are not normalized by concurrent marijuana use. Psychiatry Res Neuroimaging 2020; 295:111017. [PMID: 31760337 PMCID: PMC7730843 DOI: 10.1016/j.pscychresns.2019.111017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/22/2022]
Abstract
Marijuana (MJ) use and post-traumatic stress disorder (PTSD) have both been associated with abnormalities in brain white matter tracts, including the cingulum and the anterior thalamic radiations (ATR), which project from subcortical regions to frontal cortex. Studies have not assessed the integrity of these tracts in patients with comorbid PTSD and MJ use. To examine effects of PTSD and MJ use on brain structure, we performed diffusion tensor imaging scans on seventy-two trauma-exposed participants, categorized into four groups: those with PTSD who used MJ at least weekly (PTSD+MJ; n = 20), those with PTSD with no regular MJ use (PTSD; n = 19), trauma-exposed controls without PTSD who used MJ (TEC+MJ; n = 14) and trauma-exposed controls with no PTSD or MJ use (TEC; n = 19). White matter integrity was evaluated by calculating fractional anisotropy (FA). Results showed that while FA values in the right ATR and the cingulum differed across groups, there were no significant interactions between PTSD and MJ in any white matter tracts, indicating that MJ exposure neither normalizes nor worsens white matter abnormalities in those with PTSD. Further study is needed to evaluate the impact of MJ use on other neurobiological markers of PTSD.
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Affiliation(s)
- Chien-Lin Yeh
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Nina Levar
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Hannah C Broos
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Alyson Dechert
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin Potter
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - A Eden Evins
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jodi M Gilman
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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13
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Fatima H, Howlett AC, Whitlow CT. Reward, Control & Decision-Making in Cannabis Use Disorder: Insights from Functional MRI. Br J Radiol 2019; 92:20190165. [PMID: 31364398 PMCID: PMC6732906 DOI: 10.1259/bjr.20190165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 01/22/2023] Open
Abstract
The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States, 4.1 million are currently diagnosed with cannabis use disorder. Cannabis dependence and abuse was combined into a single entity as a behavioral disorder with a problematic pattern of cannabis use and termed cannabis use disorder by the Diagnostic and Statistical Manual of Mental Disorders. Chronic use of cannabis has been linked with region-specific effects across the brain mediating reward processing, cognitive control and decision-making that are central to understanding addictive behaviors. This review presents a snapshot of the current literature assessing the effects of chronic cannabis use on human brain function via functional MRI. Studies employing various paradigms and contrasting cognitive activation amongst cannabis users and non-users were incorporated. The effects of trans-del-ta-9-tetrahydrocannabinol (Δ9-THC) in marijuana and other preparations of cannabis are mediated by the endocannabinoid system, which is also briefly introduced.Much variation exists in the current literature regarding the functional changes associated with chronic cannabis use. One possible explanation for this variation is the heterogeneity in study designs, with little implementation of standardized diagnostic criteria when selecting chronic users, distinct time points of participant assessment, differing cognitive paradigms and imaging protocols. As such, there is an urgent requirement for future investigations that further characterize functional changes associated with chronic cannabis use.
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Affiliation(s)
- Hudaisa Fatima
- Department of Radiology, Wake Forest School of Medicine, Section of Neuroradiology, Winston-Salem, North Carolina, United States
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14
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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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15
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Zeiger JS, Silvers WS, Fleegler EM, Zeiger RS. Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes. J Cannabis Res 2019; 1:7. [PMID: 33526101 PMCID: PMC7819305 DOI: 10.1186/s42238-019-0006-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/20/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is a paucity of information regarding cannabis use behaviors in adult community-based athletes as most research in athletes has focused on misuse of cannabis in elite, adolescent, university-based athletes. We aimed to determine whether age related differences exist in patterns of cannabis use and subjective effects to cannabis in adult athletes. METHODS The Athlete PEACE Survey used mainly social media and email blasts to recruit and SurveyGizmo to collect data. Cannabis patterns of use (duration of use, frequency of use, routes of administration, cannabinoid used, concurrent use with exercise), benefits, and adverse effects were reported. Age was reported by decade from 21 to ≥60. Age trends in cannabis use patterns and subjective effects were assessed using linear trend analysis. RESULTS Of the 1161 participants, 301 (26%) athletes currently used cannabis. Younger athletes compared to older athletes reported significantly more positive and adverse subjective effects to cannabis, used cannabis longer, and used both tetrahydrocannabinol and cannabidiol for medical and recreational purposes. Younger athletes used cannabis concurrently with exercise more often than older athletes and consumed edibles, vaporized, and smoked more than older athletes. CONCLUSIONS We found age-related cannabis patterns of use and subjective effects to cannabis. Concerns about cannabis mis-use and abuse in athletes maybe overstated with the potential benefits (improved sleep, decreased anxiety, less pain) outweighing the adverse effects (increased anxiety, increased appetite, difficulty concentrating).
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Affiliation(s)
- Joanna S Zeiger
- Canna Research Group, 3996 Savannah Ct., Boulder, CO, 80301, USA.
| | - William S Silvers
- Canna Research Group, 3996 Savannah Ct., Boulder, CO, 80301, USA
- Division of Allergy and Clinical Immunology, University of Colorado Denver School of Medicine, 12700 E. 19th Ave., Room 10C03, Aurora, CO, 80045, USA
| | - Edward M Fleegler
- Canna Research Group, 3996 Savannah Ct., Boulder, CO, 80301, USA
- To-Life in Peace, LLC, 3812 Taft Court, Wheat Ridge, Colorado, 80033, USA
| | - Robert S Zeiger
- Canna Research Group, 3996 Savannah Ct., Boulder, CO, 80301, USA
- Kaiser Permanente Southern California, 7060 Clairemont Mesa Blvd, San Diego, CA, 92111, USA
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16
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Roberts BA. Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects. West J Emerg Med 2019; 20:557-572. [PMID: 31316694 PMCID: PMC6625695 DOI: 10.5811/westjem.2019.4.39935] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 11/11/2022] Open
Abstract
Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers (“budtenders”) without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.
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Affiliation(s)
- Brad A Roberts
- University of New Mexico, Department of Emergency Medicine, Albuquerque, New Mexico Partner, Southern Colorado Emergency Medicine Associates, Pueblo, Colorado
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17
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Korponay C, Kosson DS, Decety J, Kiehl KA, Koenigs M. Brain Volume Correlates with Duration of Abstinence from Substance Abuse in a Region-Specific and Substance-Specific Manner. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 2:626-635. [PMID: 29308437 DOI: 10.1016/j.bpsc.2017.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Human neuroimaging studies indicate that the loss of brain volume associated with substance abuse may be recovered during abstinence. Subcortical and prefrontal cortical regions involved in reward and decision-making are among the regions most consistently implicated in damage and recovery from substance abuse, but the relative capacities of these different brain regions to recover volume during abstinence remains unclear, and it is unknown whether recovery capacities depend on the substance that was abused. Methods Voxel-based morphometry in a prison inmate sample (n=107) of long-term abstinent former regular users (FRUs) and former light users (FLUs) of alcohol, cocaine, and/or cannabis. Cross-sectional indicators of volume recovery were operationalized as 1) positive correlation between abstinence duration and volume in FRUs and 2) absence of lower volume in FRUs compared to FLUs. Results In FRUs of alcohol, abstinence duration positively correlated with volume in subcortical regions (particularly the putamen and amygdala) but not prefrontal regions; lower prefrontal but not subcortical volume was observed in FRUs compared to FLUs. In FRUs of cocaine, abstinence duration positively correlated with volume in both subcortical regions (particularly the nucleus accumbens) and prefrontal regions; lower volume was not observed in either subcortical or prefrontal regions in FRUs. In FRUs of cannabis, abstinence duration positively correlated with subcortical but not prefrontal volume; lower prefrontal but not subcortical volume was observed in FRUs. Conclusions Subcortical structures displayed indicators of volume recovery across FRUs of all three substances, whereas prefrontal regions displayed indicators of volume recovery only in FRUs of cocaine.
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Affiliation(s)
- Cole Korponay
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park, Boulevard, Madison, Wisconsin, 53719, USA.,Neuroscience Training Program, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA
| | - David S Kosson
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, Illinois, 60064, USA
| | - Jean Decety
- Department of Psychology, University of Chicago, 5848 South University Avenue, Chicago, Illinois, 60637, USA
| | - Kent A Kiehl
- The non-profit MIND Research Network, an affiliate of Lovelace Biomedical and Environmental Research Institute, 1101 Yale C NE, Albuquerque, New Mexico, 87131, USA.,Departments of Psychology, Neuroscience, and Law, University of New Mexico, 1 University of New Mexico MSC03 2220, Albuquerque, New Mexico, 87131, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park, Boulevard, Madison, Wisconsin, 53719, USA
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18
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Orr C, Spechler P, Cao Z, Albaugh M, Chaarani B, Mackey S, D'Souza D, Allgaier N, Banaschewski T, Bokde ALW, Bromberg U, Büchel C, Burke Quinlan E, Conrod P, Desrivières S, Flor H, Frouin V, Gowland P, Heinz A, Ittermann B, Martinot JL, Martinot MLP, Nees F, Papadopoulos Orfanos D, Paus T, Poustka L, Millenet S, Fröhner JH, Radhakrishnan R, Smolka MN, Walter H, Whelan R, Schumann G, Potter A, Garavan H. Grey Matter Volume Differences Associated with Extremely Low Levels of Cannabis Use in Adolescence. J Neurosci 2019; 39:1817-1827. [PMID: 30643026 PMCID: PMC6407302 DOI: 10.1523/jneurosci.3375-17.2018] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 01/27/2023] Open
Abstract
Rates of cannabis use among adolescents are high, and are increasing concurrent with changes in the legal status of marijuana and societal attitudes regarding its use. Recreational cannabis use is understudied, especially in the adolescent period when neural maturation may make users particularly vulnerable to the effects of Δ-9-tetrahydrocannabinol (THC) on brain structure. In the current study, we used voxel-based morphometry to compare gray matter volume (GMV) in forty-six 14-year-old human adolescents (males and females) with just one or two instances of cannabis use and carefully matched THC-naive controls. We identified extensive regions in the bilateral medial temporal lobes as well as the bilateral posterior cingulate, lingual gyri, and cerebellum that showed greater GMV in the cannabis users. Analysis of longitudinal data confirmed that GMV differences were unlikely to precede cannabis use. GMV in the temporal regions was associated with contemporaneous performance on the Perceptual Reasoning Index and with future generalized anxiety symptoms in the cannabis users. The distribution of GMV effects mapped onto biomarkers of the endogenous cannabinoid system providing insight into possible mechanisms for these effects.SIGNIFICANCE STATEMENT Almost 35% of American 10th graders have reported using cannabis and existing research suggests that initiation of cannabis use in adolescence is associated with long-term neurocognitive effects. We understand very little about the earliest effects of cannabis use, however, because most research is conducted in adults with a heavy pattern of lifetime use. This study presents evidence suggesting structural brain and cognitive effects of just one or two instances of cannabis use in adolescence. Converging evidence suggests a role for the endocannabinoid system in these effects. This research is particularly timely as the legal status of cannabis is changing in many jurisdictions and the perceived risk by youth associated with smoking cannabis has declined in recent years.
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Affiliation(s)
- Catherine Orr
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405,
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
| | - Philip Spechler
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Zhipeng Cao
- Department of Psychology, University College Dublin, Dublin 4, Ireland
- Department of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Matthew Albaugh
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Bader Chaarani
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Scott Mackey
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Deepak D'Souza
- Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut 06516
| | - Nicholas Allgaier
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Christian Büchel
- University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Erin Burke Quinlan
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, WC2R 2LS United Kingdom
| | - Patricia Conrod
- Centre de recherche du CHU Ste-Justine and
- Department of Psychiatry, Université de Montréal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, Québec H3T 1C5, Canada
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addiction Sciences Building, London SE5 8BB, United Kingdom
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, WC2R 2LS United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, 68131 Mannheim, Germany
| | - Vincent Frouin
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany, Berlin, 10587 Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging and Psychiatry", University Paris Sud-University Paris Saclay, DIGITEO Labs, 91190 Gif sur Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging and Psychiatry", and AP-HP, Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, 75014 Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | | | - Tomáš Paus
- Rotman Research Institute, Baycrest, and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario M6A 2E1, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, 37075, Göttingen, Germany
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, 1090, Vienna, Austria, and
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, 01069 Germany
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut 06516
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, 01069 Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Robert Whelan
- Department of Psychology, University College Dublin, Dublin 4, Ireland
- Department of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, WC2R 2LS United Kingdom
| | - Alexandra Potter
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont 05405
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19
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Burggren AC, Siddarth P, Mahmood Z, London ED, Harrison TM, Merrill DA, Small GW, Bookheimer SY. Subregional Hippocampal Thickness Abnormalities in Older Adults with a History of Heavy Cannabis Use. Cannabis Cannabinoid Res 2018; 3:242-251. [PMID: 30547094 PMCID: PMC6290479 DOI: 10.1089/can.2018.0035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and Aims: Legalization of cannabis (CB) for both medicinal and, in some states, recreational use, has given rise to increasing usage rates across the country. Of particular concern are indications that frequent CB use may be selectively harmful to the developing adolescent brain compared with adult-onset usage. However, the long-term effects of heavy, adolescent CB use on brain structure and cognitive performance in late-life remain unknown. A critical brain region is the hippocampus (HC), where there is a striking intersection between high concentrations of cannabinoid 1 (CB1) receptors and age-related pathology. Design: We investigated whether older adults (average age=66.6+7.2 years old) with a history of early life CB use show morphological differences in hippocampal subregions compared with older, nonusers. Methods: We performed high-resolution magnetic resonance imaging combined with computational techniques to assess cortical thickness of the medial temporal lobe, neuropsychological testing, and extensive drug use histories on 50 subjects (24 formerly heavy cannabis users [CB+ group] abstinent for an average of 28.7 years, 26 nonusers [CB− group]). We investigated group differences in hippocampal subregions, controlling for age, sex, and intelligence (as measured by the Wechsler Test of Adult Reading), years of education, and cigarette use. Results: The CB+ subjects exhibited thinner cortices in subfields cornu ammonis 1 [CA1; F(1,42)=9.96, p=0.0003], and CA2, 3, and the dentate gyrus [CA23DG; F(1,42)=23.17, p<0.0001], and in the entire HC averaged over all subregions [F(1,42)=8.49, p=0.006]. Conclusions: Negative effects of chronic adolescent CB use on hippocampal structure are maintained well into late life. Because hippocampal cortical loss underlies and exacerbates age-related cognitive decline, these findings have profound implications for aging adults with a history of early life usage. Clinical Trial Registration: ClinicalTrials.gov # NCT01874886.
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Affiliation(s)
- Alison C Burggren
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Zanjbeel Mahmood
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California, Berkeley, California
| | - David A Merrill
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Gary W Small
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Susan Y Bookheimer
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
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20
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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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21
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Memedovich KA, Dowsett LE, Spackman E, Noseworthy T, Clement F. The adverse health effects and harms related to marijuana use: an overview review. CMAJ Open 2018; 6:E339-E346. [PMID: 30115639 PMCID: PMC6182105 DOI: 10.9778/cmajo.20180023] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND With impending marijuana legislation in Canada, a broad understanding of the harms associated with marijuana use is needed to inform the clinical community and public, and to support evidence-informed public policy development. The purpose of the review was to synthesize the evidence on adverse health effects and harms of marijuana use. METHODS We searched MEDLINE, The Cochrane Database of Systematic Reviews, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Health Technology Assessment Database from the inception of each database to May 2018. Given that systematic reviews evaluating one or other specific harm have been published, this is an overview review with the primary objective of assessing a health effect or harm. Data on author, country and year of publication, search strategy and results, and outcomes were extracted. Quality was assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist. RESULTS The final analysis included 68 reviews. Evidence of harm was reported in 62 reviews for several mental health disorders, brain changes, cognitive outcomes, pregnancy outcomes and testicular cancer. Inconclusive evidence was found for 20 outcomes (some mental health outcomes, other types of cancers and all-cause mortality). No evidence of harm was reported for 6 outcomes. INTERPRETATION Harm was associated with most outcomes assessed. These results should be viewed with concern by physicians and policy-makers given the prevalence of use, the persistent reporting of a lack of recognition of marijuana as a possibly harmful substance and the emerging context of legalization for recreational use.
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Affiliation(s)
- K Ally Memedovich
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Laura E Dowsett
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Eldon Spackman
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Tom Noseworthy
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Fiona Clement
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta.
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22
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Agrawal A, Chou YL, Carey CE, Baranger DAA, Zhang B, Sherva R, Wetherill L, Kapoor M, Wang JC, Bertelsen S, Anokhin AP, Hesselbrock V, Kramer J, Lynskey MT, Meyers JL, Nurnberger JI, Rice JP, Tischfield J, Bierut LJ, Degenhardt L, Farrer LA, Gelernter J, Hariri AR, Heath AC, Kranzler HR, Madden PAF, Martin NG, Montgomery GW, Porjesz B, Wang T, Whitfield JB, Edenberg HJ, Foroud T, Goate AM, Bogdan R, Nelson EC. Genome-wide association study identifies a novel locus for cannabis dependence. Mol Psychiatry 2018; 23:1293-1302. [PMID: 29112194 PMCID: PMC5938138 DOI: 10.1038/mp.2017.200] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 06/26/2017] [Accepted: 07/13/2017] [Indexed: 01/01/2023]
Abstract
Despite moderate heritability, only one study has identified genome-wide significant loci for cannabis-related phenotypes. We conducted meta-analyses of genome-wide association study data on 2080 cannabis-dependent cases and 6435 cannabis-exposed controls of European descent. A cluster of correlated single-nucleotide polymorphisms (SNPs) in a novel region on chromosome 10 was genome-wide significant (lowest P=1.3E-8). Among the SNPs, rs1409568 showed enrichment for H3K4me1 and H3K427ac marks, suggesting its role as an enhancer in addiction-relevant brain regions, such as the dorsolateral prefrontal cortex and the angular and cingulate gyri. This SNP is also predicted to modify binding scores for several transcription factors. We found modest evidence for replication for rs1409568 in an independent cohort of African American (896 cases and 1591 controls; P=0.03) but not European American (EA; 781 cases and 1905 controls) participants. The combined meta-analysis (3757 cases and 9931 controls) indicated trend-level significance for rs1409568 (P=2.85E-7). No genome-wide significant loci emerged for cannabis dependence criterion count (n=8050). There was also evidence that the minor allele of rs1409568 was associated with a 2.1% increase in right hippocampal volume in an independent sample of 430 EA college students (fwe-P=0.008). The identification and characterization of genome-wide significant loci for cannabis dependence is among the first steps toward understanding the biological contributions to the etiology of this psychiatric disorder, which appears to be rising in some developed nations.
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Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Yi-Ling Chou
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Caitlin E. Carey
- Washington University in St. Louis, Dept. of Psychological and Brain Sciences, St. Louis, MO, USA
| | - David A. A. Baranger
- Washington University in St. Louis, Dept. of Psychological and Brain Sciences, St. Louis, MO, USA
| | - Bo Zhang
- Washington University School of Medicine, Dept. of Developmental Biology, St. Louis, MO, USA
| | - Richard Sherva
- Boston University School of Medicine, Dept. of Medicine (Biomedical Genetics), Boston, MA, USA
| | - Leah Wetherill
- Indiana University School of Medicine, Dept. of Medical and Molecular Genetics, Indianapolis, IN, USA
| | - Manav Kapoor
- Icahn School of Medicine at Mount Sinai, Dept. of Neuroscience, New York, NY USA
| | - Jen-Chyong Wang
- Icahn School of Medicine at Mount Sinai, Dept. of Neuroscience, New York, NY USA
| | - Sarah Bertelsen
- Icahn School of Medicine at Mount Sinai, Dept. of Neuroscience, New York, NY USA
| | - Andrey P Anokhin
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Victor Hesselbrock
- University of Connecticut Health, Dept. of Psychiatry, Farmington, CT, USA
| | - John Kramer
- University of Iowa Carver College of Medicine, Dept. of Psychiatry, Iowa City, IA USA
| | - Michael T. Lynskey
- King’s College, Institute of Psychiatry, Psychology and Neuroscience, Addictions Department, London, UK
| | - Jacquelyn L. Meyers
- State University of New York, Downstate Medical Center, Dept. of Psychiatry, Brooklyn, NY USA
| | - John I Nurnberger
- Indiana University School of Medicine, Depts. of Psychiatry and Medical and Molecular Genetics, and Stark Neuroscience Center, Indianapolis, IN, USA
| | - John P. Rice
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Jay Tischfield
- Rutgers, The State University of New Jersey: New Brunswick, NJ, United States
| | - Laura J. Bierut
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lindsay A Farrer
- Boston University School of Medicine, Dept. of Medicine (Biomedical Genetics), Boston, MA, USA
| | - Joel Gelernter
- Yale University School of Medicine: New Haven, CT, USA
- US Department of Veterans Affairs: West Haven, CT, USA
| | - Ahmad R. Hariri
- Duke University, Department of Psychology and Neuroscience, Durham, NC, USA
| | - Andrew C. Heath
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | - Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA, USA
| | - Pamela A. F. Madden
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
| | | | - Grant W Montgomery
- University of Queensland, Institute for Molecular Bioscience, Queensland, Australia
| | - Bernice Porjesz
- State University of New York, Downstate Medical Center, Dept. of Psychiatry, Brooklyn, NY USA
| | - Ting Wang
- Washington University School of Medicine, Department of Genetics, St. Louis, MO, USA
| | | | - Howard J. Edenberg
- Indiana University School of Medicine, Dept. of Medical and Molecular Genetics, Indianapolis, IN, USA
- Indiana University, Dept. of Biochemistry and Molecular Biology, Indianapolis, IN, USA
| | - Tatiana Foroud
- Indiana University School of Medicine, Dept. of Medical and Molecular Genetics, Indianapolis, IN, USA
| | - Alison M. Goate
- Icahn School of Medicine at Mount Sinai, Dept. of Neuroscience, New York, NY USA
| | - Ryan Bogdan
- Washington University in St. Louis, Dept. of Psychological and Brain Sciences, St. Louis, MO, USA
| | - Elliot C. Nelson
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110, USA
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23
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Cilia R. Molecular Imaging of the Cannabinoid System in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:305-345. [DOI: 10.1016/bs.irn.2018.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
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24
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Social Factors and Animal Models of Cannabis Use. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 140:171-200. [DOI: 10.1016/bs.irn.2018.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Cortical thickness, cortical surface area and subcortical volumes in schizophrenia and bipolar disorder patients with cannabis use. Eur Neuropsychopharmacol 2018; 28:37-47. [PMID: 29254657 DOI: 10.1016/j.euroneuro.2017.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/03/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022]
Abstract
Cannabis is associated with increased risk for severe mental illness and is commonly used among individuals with schizophrenia or bipolar disorder. In this study we investigated associations between cannabis use and brain structures among patients with schizophrenia or bipolar disorders. Magnetic resonance imaging scans were obtained for 77 schizophrenia and 55 bipolar patients with a history of cannabis use (defined as lifetime use >10 times during one month or abuse/dependence), and 97 schizophrenia, 85 bipolar disorder patients and 277 healthy controls without any previous cannabis use. Cortical thickness, cortical surface area and subcortical volumes were compared between groups. Both hypothesis-driven region-of-interest analyses from 11 preselected brain regions in each hemisphere and exploratory point-by-point analyses were performed. We tested for diagnostic interactions and controlled for potential confounders. After controlling for confounders such as tobacco use and alcohol use disorders we found reduced cortical thickness in the caudal middle frontal gyrus compared to non-user patients and healthy controls. The findings were not significant when patients with co-morbid alcohol and illicit drug use were excluded from the analyses, but onset of cannabis use before illness onset was associated with cortical thinning in the caudal middle frontal gyrus. To conclude, we found no structural brain changes associated with cannabis use among patients with severe mental illness, but the findings indicate excess cortical thinning among those who use cannabis before illness onset. The present findings support the understanding that cannabis use is associated with limited brain effects in schizophrenia as well as bipolar disorder.
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Moreno-Alcázar A, Gonzalvo B, Canales-Rodríguez EJ, Blanco L, Bachiller D, Romaguera A, Monté-Rubio GC, Roncero C, McKenna PJ, Pomarol-Clotet E. Larger Gray Matter Volume in the Basal Ganglia of Heavy Cannabis Users Detected by Voxel-Based Morphometry and Subcortical Volumetric Analysis. Front Psychiatry 2018; 9:175. [PMID: 29773998 PMCID: PMC5943550 DOI: 10.3389/fpsyt.2018.00175] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Structural imaging studies of cannabis users have found evidence of both cortical and subcortical volume reductions, especially in cannabinoid receptor-rich regions such as the hippocampus and amygdala. However, the findings have not been consistent. In the present study, we examined a sample of adult heavy cannabis users without other substance abuse to determine whether long-term use is associated with brain structural changes, especially in the subcortical regions. Method: We compared the gray matter volume of 14 long-term, heavy cannabis users with non-using controls. To provide robust findings, we conducted two separate studies using two different MRI techniques. Each study used the same sample of cannabis users and a different control group, respectively. Both control groups were independent of each other. First, whole-brain voxel-based morphometry (VBM) was used to compare the cannabis users against 28 matched controls (HC1 group). Second, a volumetric analysis of subcortical regions was performed to assess differences between the cannabis users and a sample of 100 matched controls (HC2 group) obtained from a local database of healthy volunteers. Results: The VBM study revealed that, compared to the control group HC1, the cannabis users did not show cortical differences nor smaller volume in any subcortical structure but showed a cluster (p < 0.001) of larger GM volume in the basal ganglia, involving the caudate, putamen, pallidum, and nucleus accumbens, bilaterally. The subcortical volumetric analysis revealed that, compared to the control group HC2, the cannabis users showed significantly larger volumes in the putamen (p = 0.001) and pallidum (p = 0.0015). Subtle trends, only significant at the uncorrected level, were also found in the caudate (p = 0.05) and nucleus accumbens (p = 0.047). Conclusions: This study does not support previous findings of hippocampal and/or amygdala structural changes in long-term, heavy cannabis users. It does, however, provide evidence of basal ganglia volume increases.
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Affiliation(s)
- Ana Moreno-Alcázar
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Begoña Gonzalvo
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Erick J Canales-Rodríguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Signal Processing Lab (LTS5), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Laura Blanco
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Diana Bachiller
- Addictions and Dual Diagnosis Unit, Vall d'Hebron University Hospital-Public Health Agency of Barcelona (ASPB), Barcelona, Spain
| | - Anna Romaguera
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Gemma C Monté-Rubio
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Carlos Roncero
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Addictions and Dual Diagnosis Unit, Vall d'Hebron University Hospital-Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain.,Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, Rehm J, Room R. Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations. Am J Public Health 2017. [PMID: 28644037 DOI: 10.2105/ajph.2017.303818] [Citation(s) in RCA: 253] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cannabis use is common in North America, especially among young people, and is associated with a risk of various acute and chronic adverse health outcomes. Cannabis control regimes are evolving, for example toward a national legalization policy in Canada, with the aim to improve public health, and thus require evidence-based interventions. As cannabis-related health outcomes may be influenced by behaviors that are modifiable by the user, evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG)-akin to similar guidelines in other health fields-offer a valuable, targeted prevention tool to improve public health outcomes. OBJECTIVES To systematically review, update, and quality-grade evidence on behavioral factors determining adverse health outcomes from cannabis that may be modifiable by the user, and translate this evidence into revised LRCUG as a public health intervention tool based on an expert consensus process. SEARCH METHODS We used pertinent medical search terms and structured search strategies, to search MEDLINE, EMBASE, PsycINFO, Cochrane Library databases, and reference lists primarily for systematic reviews and meta-analyses, and additional evidence on modifiable risk factors for adverse health outcomes from cannabis use. SELECTION CRITERIA We included studies if they focused on potentially modifiable behavior-based factors for risks or harms for health from cannabis use, and excluded studies if cannabis use was assessed for therapeutic purposes. DATA COLLECTION AND ANALYSIS We screened the titles and abstracts of all studies identified by the search strategy and assessed the full texts of all potentially eligible studies for inclusion; 2 of the authors independently extracted the data of all studies included in this review. We created Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow-charts for each of the topical searches. Subsequently, we summarized the evidence by behavioral factor topic, quality-graded it by following standard (Grading of Recommendations Assessment, Development, and Evaluation; GRADE) criteria, and translated it into the LRCUG recommendations by the author expert collective on the basis of an iterative consensus process. MAIN RESULTS For most recommendations, there was at least "substantial" (i.e., good-quality) evidence. We developed 10 major recommendations for lower-risk use: (1) the most effective way to avoid cannabis use-related health risks is abstinence, (2) avoid early age initiation of cannabis use (i.e., definitively before the age of 16 years), (3) choose low-potency tetrahydrocannabinol (THC) or balanced THC-to-cannabidiol (CBD)-ratio cannabis products, (4) abstain from using synthetic cannabinoids, (5) avoid combusted cannabis inhalation and give preference to nonsmoking use methods, (6) avoid deep or other risky inhalation practices, (7) avoid high-frequency (e.g., daily or near-daily) cannabis use, (8) abstain from cannabis-impaired driving, (9) populations at higher risk for cannabis use-related health problems should avoid use altogether, and (10) avoid combining previously mentioned risk behaviors (e.g., early initiation and high-frequency use). AUTHORS' CONCLUSIONS Evidence indicates that a substantial extent of the risk of adverse health outcomes from cannabis use may be reduced by informed behavioral choices among users. The evidence-based LRCUG serve as a population-level education and intervention tool to inform such user choices toward improved public health outcomes. However, the LRCUG ought to be systematically communicated and supported by key regulation measures (e.g., cannabis product labeling, content regulation) to be effective. All of these measures are concretely possible under emerging legalization regimes, and should be actively implemented by regulatory authorities. The population-level impact of the LRCUG toward reducing cannabis use-related health risks should be evaluated. Public health implications. Cannabis control regimes are evolving, including legalization in North America, with uncertain impacts on public health. Evidence-based LRCUG offer a potentially valuable population-level tool to reduce the risk of adverse health outcomes from cannabis use among (especially young) users in legalization contexts, and hence to contribute to improved public health outcomes.
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Affiliation(s)
- Benedikt Fischer
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Cayley Russell
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Pamela Sabioni
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Wim van den Brink
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Bernard Le Foll
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Wayne Hall
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Jürgen Rehm
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Robin Room
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Allendorfer JB, Szaflarski JP. Neuroimaging studies towards understanding the central effects of pharmacological cannabis products on patients with epilepsy. Epilepsy Behav 2017; 70:349-354. [PMID: 28109780 DOI: 10.1016/j.yebeh.2016.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 02/04/2023]
Abstract
Recent interest for the use of cannabis-derived products as therapeutic agents in the treatment of epilepsies has necessitated a reevaluation of their effects on brain and behavior. Overall, prolonged cannabis use is thought to result in functional and structural brain alterations. These effects may be dependent on a number of factors: e.g., which phytocannabinoid is used (e.g., cannabidiol (CBD) vs. tetrahyrocannabinol (THC)), the frequency of use (occasional vs. heavy), and at what age (prenatal, childhood, adulthood) the use began. However, due to the fact that there are over seven hundred constituents that make up the Cannabis sativa plant, it is difficult to determine which compound or combination of compounds is responsible for specific effects when studying recreational users. Therefore, this review focuses only on the functional MRI studies investigating the effects of specific pharmacological preparations of cannabis compounds, specifically THC, tetrahydrocannabivarin (THCV), and CBD, on brain function in healthy individuals and persons with epilepsy with references to non-epilepsy studies only to underline the gaps in research that need to be filled before cannabis-derived products are considered for a wide use in the treatment of epilepsy. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy".
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Affiliation(s)
- Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
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Lange EH, Nerland S, Jørgensen KN, Mørch-Johnsen L, Nesvåg R, Hartberg CB, Haukvik UK, Osnes K, Melle I, Andreassen OA, Agartz I. Alcohol use is associated with thinner cerebral cortex and larger ventricles in schizophrenia, bipolar disorder and healthy controls. Psychol Med 2017; 47:655-668. [PMID: 27830632 DOI: 10.1017/s0033291716002920] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Excessive alcohol use is associated with brain damage but less is known about brain effects from moderate alcohol use. Previous findings indicate that patients with severe mental illness, particularly schizophrenia, are vulnerable to alcohol-related brain damage. We investigated the association between levels of alcohol consumption and cortical and subcortical brain structures in schizophrenia and bipolar disorder patients and healthy controls, and investigated for group differences for this association. METHOD 1.5 T structural magnetic resonance images were acquired of 609 alcohol-using participants (165 schizophrenia patients, 172 bipolar disorder patients, 272 healthy controls), mean (s.d.) age 34.2 (9.9) years, 52% men. Past year alcohol use was assessed with the Alcohol Use Disorder Identification Test - Consumption part (AUDIT-C). General linear models were used to investigate associations between AUDIT-C score and cortical thickness, surface area, and total brain and subcortical volumes. RESULTS Increasing AUDIT-C score was linearly associated with thinner cortex in medial and dorsolateral frontal and parieto-occipital regions, and with larger left lateral ventricle volume. There was no significant interaction between AUDIT-C score and diagnostic group. The findings remained significant after controlling for substance use disorders, antipsychotic medication and illness severity. CONCLUSION The results show a dose-dependent relationship between alcohol use and thinner cortex and ventricular expansion. The findings are present also at lower levels of alcohol consumption and do not differ between schizophrenia or bipolar disorder patients compared to healthy controls. Our results do not support previous findings of increased vulnerability for alcohol-related brain damage in severe mental illness.
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Affiliation(s)
- E H Lange
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - S Nerland
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K N Jørgensen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - L Mørch-Johnsen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - R Nesvåg
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - C B Hartberg
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - U K Haukvik
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K Osnes
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - I Melle
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - O A Andreassen
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - I Agartz
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
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30
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Jakabek D, Yücel M, Lorenzetti V, Solowij N. An MRI study of white matter tract integrity in regular cannabis users: effects of cannabis use and age. Psychopharmacology (Berl) 2016; 233:3627-37. [PMID: 27503373 DOI: 10.1007/s00213-016-4398-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/23/2016] [Indexed: 11/27/2022]
Abstract
RATIONALE Conflicting evidence exists on the effects of cannabis use on brain white matter integrity. The extant literature has exclusively focused on younger cannabis users, with no studies sampling older cannabis users. OBJECTIVES We recruited a sample with a broad age range to examine the integrity of major white matter tracts in association with cannabis use parameters and neurodevelopmental stage. METHODS Regular cannabis users (n = 56) and non-users (n = 20) with a mean age of 32 (range 18-55 years) underwent structural and diffusion MRI scans. White matter was examined using voxel-based statistics and via probabilistic tract reconstruction. The integrity of tracts was assessed using average fractional anisotropy, axial diffusivity and radial diffusivity. Diffusion measures were compared between users and non-users and as group-by-age interactions. Correlations between diffusion measures and age of onset, duration, frequency and dose of current cannabis use were examined. RESULTS Cannabis users overall had lower fractional anisotropy than healthy non-users in the forceps minor tract only (p = .015, partial eta = 0.07), with no voxel-wise differences observed. Younger users showed predominantly reduced axial diffusivity, whereas older users had higher radial diffusivity in widespread tracts. Higher axial diffusivity was associated with duration of cannabis use in the cingulum angular bundle (beta = 5.00 × 10(-5), p = .003). Isolated higher AD in older cannabis users was also observed. CONCLUSIONS The findings suggest that exogenous cannabinoids alter normal brain maturation, with differing effects at various neurodevelopmental stages of life. These age-related differences are posited to account for the disparate results described in the literature.
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Affiliation(s)
- David Jakabek
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Valentina Lorenzetti
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
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31
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Hill SY, Sharma V, Jones BL. Lifetime use of cannabis from longitudinal assessments, cannabinoid receptor (CNR1) variation, and reduced volume of the right anterior cingulate. Psychiatry Res 2016; 255:24-34. [PMID: 27500453 PMCID: PMC5025865 DOI: 10.1016/j.pscychresns.2016.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 04/07/2016] [Accepted: 05/25/2016] [Indexed: 01/25/2023]
Abstract
Lifetime measures of cannabis use and co-occurring exposures were obtained from a longitudinal cohort followed an average of 13 years at the time they received a structural MRI scan. MRI scans were analyzed for 88 participants (mean age=25.9 years), 34 of whom were regular users of cannabis. Whole brain voxel based morphometry analyses (SPM8) were conducted using 50 voxel clusters at p=0.005. Controlling for age, familial risk, and gender, we found reduced volume in Regular Users compared to Non-Users, in the lingual gyrus, anterior cingulum (right and left), and the rolandic operculum (right). The right anterior cingulum reached family-wise error statistical significance at p=0.001, controlling for personal lifetime use of alcohol and cigarettes and any prenatal exposures. CNR1 haplotypes were formed from four CNR1 SNPs (rs806368, rs1049353, rs2023239, and rs6454674) and tested with level of cannabis exposure to assess their interactive effects on the lingual gyrus, cingulum (right and left) and rolandic operculum, regions showing cannabis exposure effects in the SPM8 analyses. These analyses used mixed model analyses (SPSS) to control for multiple potentially confounding variables. Level of cannabis exposure was associated with decreased volume of the right anterior cingulum and showed interaction effects with haplotype variation.
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Affiliation(s)
- Shirley Y Hill
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Vinod Sharma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Bobby L Jones
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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32
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Koenders L, Cousijn J, Vingerhoets WAM, van den Brink W, Wiers RW, Meijer CJ, Machielsen MWJ, Veltman DJ, Goudriaan AE, de Haan L. Grey Matter Changes Associated with Heavy Cannabis Use: A Longitudinal sMRI Study. PLoS One 2016; 11:e0152482. [PMID: 27224247 PMCID: PMC4880314 DOI: 10.1371/journal.pone.0152482] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/15/2016] [Indexed: 11/30/2022] Open
Abstract
Cannabis is the most frequently used illicit drug worldwide. Cross-sectional neuroimaging studies suggest that chronic cannabis exposure and the development of cannabis use disorders may affect brain morphology. However, cross-sectional studies cannot make a conclusive distinction between cause and consequence and longitudinal neuroimaging studies are lacking. In this prospective study we investigate whether continued cannabis use and higher levels of cannabis exposure in young adults are associated with grey matter reductions. Heavy cannabis users (N = 20, age baseline M = 20.5, SD = 2.1) and non-cannabis using healthy controls (N = 22, age baseline M = 21.6, SD = 2.45) underwent a comprehensive psychological assessment and a T1- structural MRI scan at baseline and 3 years follow-up. Grey matter volumes (orbitofrontal cortex, anterior cingulate cortex, insula, striatum, thalamus, amygdala, hippocampus and cerebellum) were estimated using the software package SPM (VBM-8 module). Continued cannabis use did not have an effect on GM volume change at follow-up. Cross-sectional analyses at baseline and follow-up revealed consistent negative correlations between cannabis related problems and cannabis use (in grams) and regional GM volume of the left hippocampus, amygdala and superior temporal gyrus. These results suggests that small GM volumes in the medial temporal lobe are a risk factor for heavy cannabis use or that the effect of cannabis on GM reductions is limited to adolescence with no further damage of continued use after early adulthood. Long-term prospective studies starting in early adolescence are needed to reach final conclusions.
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Affiliation(s)
- Laura Koenders
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Janna Cousijn
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Developmental Psychology and Psychonomics, Utrecht University, Utrecht, The Netherlands
| | - Wilhelmina A. M. Vingerhoets
- Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Carin J. Meijer
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marise W. J. Machielsen
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Dick J. Veltman
- University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anneke E. Goudriaan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Lorenzetti V, Solowij N, Yücel M. The Role of Cannabinoids in Neuroanatomic Alterations in Cannabis Users. Biol Psychiatry 2016; 79:e17-31. [PMID: 26858212 DOI: 10.1016/j.biopsych.2015.11.013] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 10/28/2015] [Accepted: 11/01/2015] [Indexed: 01/18/2023]
Abstract
The past few decades have seen a marked change in the composition of commonly smoked cannabis. These changes primarily involve an increase of the psychoactive compound ∆(9)-tetrahydrocannabinol (THC) and a decrease of the potentially therapeutic compound cannabidiol (CBD). This altered composition of cannabis may be linked to persistent neuroanatomic alterations typically seen in regular cannabis users. In this review, we summarize recent findings from human structural neuroimaging investigations. We examine whether neuroanatomic alterations are 1) consistently observed in samples of regular cannabis users, particularly in cannabinoid receptor-high areas, which are vulnerable to the effects of high circulating levels of THC, and 2) associated either with greater levels of cannabis use (e.g., higher dosage, longer duration, and earlier age of onset) or with distinct cannabinoid compounds (i.e., THC and CBD). Across the 31 studies selected for inclusion in this review, neuroanatomic alterations emerged across regions that are high in cannabinoid receptors (i.e., hippocampus, prefrontal cortex, amygdala, cerebellum). Greater dose and earlier age of onset were associated with these alterations. Preliminary evidence shows that THC exacerbates, whereas CBD protects from, such harmful effects. Methodologic differences in the quantification of levels of cannabis use prevent accurate assessment of cannabis exposure and direct comparison of findings across studies. Consequently, the field lacks large "consortium-style" data sets that can be used to develop reliable neurobiological models of cannabis-related harm, recovery, and protection. To move the field forward, we encourage a coordinated approach and suggest the urgent development of consensus-based guidelines to accurately and comprehensively quantify cannabis use and exposure in human studies.
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Affiliation(s)
- Valentina Lorenzetti
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne; Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne
| | - Nadia Solowij
- School of Psychology, Centre for Health Initiatives and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne; Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne.
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Broyd SJ, van Hell HH, Beale C, Yücel M, Solowij N. Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic Review. Biol Psychiatry 2016; 79:557-67. [PMID: 26858214 DOI: 10.1016/j.biopsych.2015.12.002] [Citation(s) in RCA: 400] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 01/05/2023]
Abstract
Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistence or recovery across all cognitive domains remains underresearched. Associations between poorer performance and a range of cannabis use parameters, including a younger age of onset, are frequently reported. Little further evidence has emerged for the development of tolerance to the acutely impairing effects of cannabis. Evidence for potential protection from harmful effects by cannabidiol continues to increase but is not definitive. In light of increasing trends toward legalization of cannabis, the knowledge gained from this body of research needs to be incorporated into strategies to minimize harm.
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Affiliation(s)
- Samantha J Broyd
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Hendrika H van Hell
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Camilla Beale
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong.
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35
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Rigucci S, Marques TR, Di Forti M, Taylor H, Dell'Acqua F, Mondelli V, Bonaccorso S, Simmons A, David AS, Girardi P, Pariante CM, Murray RM, Dazzan P. Effect of high-potency cannabis on corpus callosum microstructure. Psychol Med 2016; 46:841-854. [PMID: 26610039 PMCID: PMC4754829 DOI: 10.1017/s0033291715002342] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND The use of cannabis with higher Δ9-tetrahydrocannabinol content has been associated with greater risk, and earlier onset, of psychosis. However, the effect of cannabis potency on brain morphology has never been explored. Here, we investigated whether cannabis potency and pattern of use are associated with changes in corpus callosum (CC) microstructural organization, in patients with first-episode psychosis (FEP) and individuals without psychosis, cannabis users and non-users. METHOD The CC of 56 FEP (37 cannabis users) and 43 individuals without psychosis (22 cannabis users) was virtually dissected and segmented using diffusion tensor imaging tractography. The diffusion index of fractional anisotropy, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity was calculated for each segment. RESULTS Across the whole sample, users of high-potency cannabis had higher total CC MD and higher total CC AD than both low-potency users and those who never used (p = 0.005 and p = 0.004, respectively). Daily users also had higher total CC MD and higher total CC AD than both occasional users and those who never used (p = 0.001 and p < 0.001, respectively). However, there was no effect of group (patient/individuals without psychosis) or group x potency interaction for either potency or frequency of use. The within-group analysis showed in fact that the effects of potency and frequency were similar in FEP users and in users without psychosis. CONCLUSIONS Frequent use of high-potency cannabis is associated with disturbed callosal microstructural organization in individuals with and without psychosis. Since high-potency preparations are now replacing traditional herbal drugs in many European countries, raising awareness about the risks of high-potency cannabis is crucial.
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Affiliation(s)
- S. Rigucci
- Department of Neurosciences,
Mental Health and Sensory Organs, Sapienza University
of Rome, Rome, Italy
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - T. R. Marques
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - M. Di Forti
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - H. Taylor
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - F. Dell'Acqua
- Centre for Neuroimaging Sciences,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - V. Mondelli
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - S. Bonaccorso
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - A. Simmons
- Centre for Neuroimaging Sciences,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - A. S. David
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - P. Girardi
- Department of Neurosciences,
Mental Health and Sensory Organs, Sapienza University
of Rome, Rome, Italy
| | - C. M. Pariante
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - R. M. Murray
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - P. Dazzan
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
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36
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Uhlmann A, Fouche JP, Koen N, Meintjes EM, Wilson D, Stein DJ. Fronto-temporal alterations and affect regulation in methamphetamine dependence with and without a history of psychosis. Psychiatry Res Neuroimaging 2016; 248:30-38. [PMID: 26792587 DOI: 10.1016/j.pscychresns.2016.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 10/26/2015] [Accepted: 01/03/2016] [Indexed: 02/02/2023]
Abstract
Methamphetamine (MA) has been shown to have neurotoxic effects associated with brain structure changes and schizophrenia-like psychotic symptoms. Although these abnormalities may in turn be related to cognitive impairment and increased aggression, their association with affect dysregulation is less well studied. We investigated cortical thickness and subcortical volumes in 21 participants with MA dependence, 19 patients with MA-associated psychosis (MAP), and 19 healthy controls. Participants' affect regulation abilities were assessed through self-report scales on emotion reactivity (ERS) and difficulties in emotion regulation (DERS) and correlated with differences in cortical thickness. MAP patients showed thinner cortices in the fusiform and inferior temporal gyrus (ITG), orbitofrontal (OFC) and inferior frontal gyrus (IFG), and insula, compared to the MA group. MAP also showed significantly lower hippocampal volumes relative to MA and CTRL. Both clinical groups showed impairment in affect regulation, but only in MAP was this dysfunction associated with thinner cortices in ITG, OFC and IFG. Our findings suggest significant differences in cortical thickness in MA dependence with and without psychosis. Lower fronto-temporal cortical thickness and smaller hippocampal volumes in MAP are consistent with neuroimaging findings in other psychotic disorders, supporting the notion of MAP being a useful model of psychosis.
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Affiliation(s)
- Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Don Wilson
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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37
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Gilman JM, Curran MT, Calderon V, Schuster RM, Evins AE. Altered Neural Processing to Social Exclusion in Young Adult Marijuana Users. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2015; 1:152-159. [PMID: 26977454 DOI: 10.1016/j.bpsc.2015.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous studies have reported that peer groups are one of the most important predictors of adolescent and young adult marijuana use, and yet the neural correlates of social processing in marijuana users have not yet been studied. In the current study, marijuana-using young adults (n = 20) and non-using controls (n = 22) participated in a neuroimaging social exclusion task called Cyberball, a computerized ball-tossing game in which the participant is excluded from the game after a pre-determined number of ball tosses. Controls, but not marijuana users, demonstrated significant activation in the insula, a region associated with negative emotion, when being excluded from the game. Both groups demonstrated activation of the ventral anterior cingulate cortex (vACC), a region associated with affective monitoring, during peer exclusion. Only the marijuana group showed a correlation between vACC activation and scores on a self-report measure of peer conformity. This study indicates that marijuana users show atypical neural processing of social exclusion, which may be either caused by, or the result of, regular marijuana use.
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Affiliation(s)
- Jodi M Gilman
- Center for Addiction Medicine, Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA; Athinoula A. Martinos Center in Biomedical Imaging, Department of Radiology, MGH, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Max T Curran
- Center for Addiction Medicine, Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA
| | - Vanessa Calderon
- Center for Addiction Medicine, Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA
| | - Randi M Schuster
- Center for Addiction Medicine, Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA; Harvard Medical School, Boston, MA, USA
| | - A Eden Evins
- Center for Addiction Medicine, Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA; Harvard Medical School, Boston, MA, USA
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38
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Filbey FM, McQueeny T, DeWitt SJ, Mishra V. Preliminary findings demonstrating latent effects of early adolescent marijuana use onset on cortical architecture. Dev Cogn Neurosci 2015; 16:16-22. [PMID: 26507433 PMCID: PMC4691364 DOI: 10.1016/j.dcn.2015.10.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 09/09/2015] [Accepted: 10/02/2015] [Indexed: 01/12/2023] Open
Abstract
Early onset MJ use was associated with different patterns of cortical architecture. Early vs. late onset divergence was in brain regions underlying higher-order cognition. Findings were above and beyond effects of alcohol and current age.
Background As the most commonly used illicit substance during early adolescence, long-term or latent effects of early adolescent marijuana use across adolescent developmental processes remain to be determined. Methods We examined cortical thickness, gray/white matter border contrast (GWR) and local gyrification index (LGI) in 42 marijuana (MJ) users. Voxelwise regressions assessed early-onset (age <16) vs. late-onset (≥16 years-old) differences and relationships to continued use while controlling for current age and alcohol use. Results Although groups did not differ by onset status, groups diverged in their correlations between cannabis use and cortical architecture. Among early-onset users, continued years of MJ use and current MJ consumption were associated with thicker cortex, increased GWR and decreased LGI. Late-onset users exhibited the opposite pattern. This divergence was observed in all three morphological measures in the anterior dorsolateral frontal cortex (p < .05, FWE-corrected). Conclusions Divergent patterns between current MJ use and elements of cortical architecture were associated with early MJ use onset. Considering brain development in early adolescence, findings are consistent with disruptions in pruning. However, divergence with continued use for many years thereafter suggests altered trajectories of brain maturation during late adolescence and beyond.
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Affiliation(s)
- Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, United States.
| | - Tim McQueeny
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, United States
| | - Samuel J DeWitt
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, United States
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Pagliaccio D, Barch DM, Bogdan R, Wood PK, Lynskey MT, Heath AC, Agrawal A. Shared Predisposition in the Association Between Cannabis Use and Subcortical Brain Structure. JAMA Psychiatry 2015; 72:994-1001. [PMID: 26308883 PMCID: PMC4624286 DOI: 10.1001/jamapsychiatry.2015.1054] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Prior neuroimaging studies have suggested that alterations in brain structure may be a consequence of cannabis use. Siblings discordant for cannabis use offer an opportunity to use cross-sectional data to disentangle such causal hypotheses from shared effects of genetics and familial environment on brain structure and cannabis use. OBJECTIVES To determine whether cannabis use is associated with differences in brain structure in a large sample of twins/siblings and to examine sibling pairs discordant for cannabis use to separate potential causal and predispositional factors linking lifetime cannabis exposure to volumetric alterations. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional diagnostic interview, behavioral, and neuroimaging data were collected from community sampling and established family registries from August 2012 to September 2014. This study included data from 483 participants (22-35 years old) enrolled in the ongoing Human Connectome Project, with 262 participants reporting cannabis exposure (ie, ever used cannabis in their lifetime). MAIN OUTCOMES AND MEASURES Cannabis exposure was measured with the Semi-Structured Assessment for the Genetics of Alcoholism. Whole-brain, hippocampus, amygdala, ventral striatum, and orbitofrontal cortex volumes were related to lifetime cannabis use (ever used, age at onset, and frequency of use) using linear regressions. Genetic (ρg) and environmental (ρe) correlations between cannabis use and brain volumes were estimated. Linear mixed models were used to examine volume differences in sex-matched concordant unexposed (n = 71 pairs), exposed (n = 81 pairs), or exposure discordant (n = 89 pairs) sibling pairs. RESULTS Among 483 study participants, cannabis exposure was related to smaller left amygdala (approximately 2.3%; P = .007) and right ventral striatum (approximately 3.5%; P < .005) volumes. These volumetric differences were within the range of normal variation. The association between left amygdala volume and cannabis use was largely owing to shared genetic factors (ρg = -0.43; P = .004), while the origin of the association with right ventral striatum volumes was unclear. Importantly, brain volumes did not differ between sex-matched siblings discordant for use (fixed effect = -7.43; t = -0.93, P = .35). Both the exposed and unexposed siblings in pairs discordant for cannabis exposure showed reduced amygdala volumes relative to members of concordant unexposed pairs (fixed effect = 12.56; t = 2.97; P = .003). CONCLUSIONS AND RELEVANCE In this study, differences in amygdala volume in cannabis users were attributable to common predispositional factors, genetic or environmental in origin, with little support for causal influences. Causal influences, in isolation or in conjunction with predispositional factors, may exist for other brain regions (eg, ventral striatum) or at more severe levels of cannabis involvement and deserve further study.
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Affiliation(s)
- David Pagliaccio
- The Program in Neuroscience Washington University in St. Louis, St. Louis, MO, United States
,Corresponding author: Washington University in St Louis, Campus Box 1125, One Brookings Drive, St Louis, MO 63130, USA,
| | - Deanna M. Barch
- Department of Psychiatry Washington University in St. Louis, St. Louis, MO, United States
,Department of Psychology Washington University in St. Louis, St. Louis, MO, United States
,Department of Radiology Washington University in St. Louis, St. Louis, MO, United States
| | - Ryan Bogdan
- Department of Psychology Washington University in St. Louis, St. Louis, MO, United States
| | | | - Michael T. Lynskey
- Institute of Psychiatry, Psychology & Neuroscience, Department of Addictions, Kings College, London, UK
| | - Andrew C. Heath
- Department of Psychiatry Washington University in St. Louis, St. Louis, MO, United States
| | - Arpana Agrawal
- Department of Psychiatry Washington University in St. Louis, St. Louis, MO, United States
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Abstract
There is extensive research on the safety, toxicology, potency, and therapeutic potential of cannabis. However, uncertainty remains facilitating continued debate on medical and recreational cannabis policies at the state and federal levels. This review will include a brief description of cannabinoids and the endocannabinoid system; a summary of the acute and long-term effects of cannabis; and a discussion of the therapeutic potential of cannabis. The conclusions about safety and efficacy will then be compared with the current social and political climate to suggest future policy directions and general guidelines.
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Affiliation(s)
- Jane Sachs
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA.
| | - Erin McGlade
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA
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Abstract
Adolescence is characterized by heightened risk-taking, including substance misuse. These behavioral patterns are influenced by ontogenic changes in neurotransmitter systems, particularly the dopamine system, which is fundamentally involved in the neural coding of reward and motivated approach behavior. During adolescence, this system evidences a peak in activity. At the same time, the dopamine (DA) system is neuroplastically altered by substance abuse, impacting subsequent function. Here, we describe properties of the dopamine system that change with typical adolescent development and that are altered with substance abuse. Much of this work has been gleaned from animal models due to limitations in measuring dopamine in pediatric samples. Structural and functional neuroimaging techniques have been used to examine structures that are heavily DA-innervated; they measure morphological and functional changes with age and with drug exposure. Presenting marijuana abuse as an exemplar, we consider recent findings that support an adolescent peak in DA-driven reward-seeking behavior and related deviations in motivational systems that are associated with marijuana abuse/dependence. Clinicians are advised that (1) chronic adolescent marijuana use may lead to deficiencies in incentive motivation, (2) that this state is due to marijuana's interactions with the developing DA system, and (3) that treatment strategies should be directed to remediating resultant deficiencies in goal-directed activity.
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Price JS, McQueeny T, Shollenbarger S, Browning EL, Wieser J, Lisdahl KM. Effects of marijuana use on prefrontal and parietal volumes and cognition in emerging adults. Psychopharmacology (Berl) 2015; 232:2939-50. [PMID: 25921032 PMCID: PMC4533900 DOI: 10.1007/s00213-015-3931-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/26/2015] [Indexed: 12/17/2022]
Abstract
RATIONALE Chronic marijuana (MJ) use among adolescents has been associated with structural and functional abnormalities, particularly in developing regions responsible for higher order cognition. OBJECTIVES This study investigated prefrontal (PFC) and parietal volumes and executive function in emerging adult MJ users and explored potential gender differences. METHODS Participants (ages 18-25) were 27 MJ users and 32 controls without neurologic or psychiatric disorders or heavy other drug use. A series of multiple regressions examined whether group status, past year MJ use, and their interactions with gender predicted ROI volumes. Post hoc analyses consisted of brain-behavior correlations between volumes and cognitive variables and Fisher's z tests to assess group differences. RESULTS MJ users demonstrated significantly smaller medial orbitofrontal (mOFC; p = 0.004, FDR p = 0.024) and inferior parietal volumes (p = 0.04, FDR p = 0.12); follow-up regressions found that increased past year MJ use did not significantly dose-dependently predict smaller mOFC volume in a sub-sample of individuals with at least one past year MJ use. There were no significant gender interactions. There was a significant brain-behavior difference by group, such that smaller mOFC volumes were associated with poorer complex attention for MJ users (p < 0.05). CONCLUSIONS Smaller mOFC volumes among MJ users suggest disruption of typical neurodevelopmental processes associated with regular MJ use for both genders. These results highlight the need for longitudinal, multi-modal imaging studies providing clearer information on timing of neurodevelopmental processes and neurocognitive impacts of youth MJ initiation.
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Affiliation(s)
- Jenessa S. Price
- Department of Psychiatry, Harvard Medical School – McLean Hospital, Belmont, MA
| | - Tim McQueeny
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio
| | - Skyler Shollenbarger
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Erin L. Browning
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Jon Wieser
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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43
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Filbey FM, McQueeny T, Kadamangudi S, Bice C, Ketcherside A. Combined effects of marijuana and nicotine on memory performance and hippocampal volume. Behav Brain Res 2015; 293:46-53. [PMID: 26187691 DOI: 10.1016/j.bbr.2015.07.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 06/24/2015] [Accepted: 07/07/2015] [Indexed: 11/30/2022]
Abstract
Combined use of marijuana (MJ) and tobacco is highly prevalent in today's population. Individual use of either substance is linked to structural brain changes and altered cognitive function, especially with consistent reports of hippocampal volume deficits and poorer memory performance. However, the combined effects of MJ and tobacco on hippocampal structure and on learning and memory processes remain unknown. In this study, we examined both the individual and combined effects of MJ and tobacco on hippocampal volumes and memory performance in four groups of adults taken from two larger studies: MJ-only users (n=36), nicotine-only (Nic-only, n=19), combined marijuana and nicotine users (MJ+Nic, n=19) and non-using healthy controls (n=16). Total bilateral hippocampal volumes and memory performance (WMS-III logical memory) were compared across groups controlling for total brain size and recent alcohol use. Results found MJ and MJ+Nic groups had smaller total hippocampal volumes compared to Nic-only and controls. No significant difference between groups was found between immediate and delayed story recall. However, the controls showed a trend for larger hippocampal volumes being associated with better memory scores, while MJ+Nic users showed a unique inversion, whereby smaller hippocampal volume was associated with better memory. Overall, results suggest abnormalities in the brain-behavior relationships underlying memory processes with combined use of marijuana and nicotine use. Further research will need to address these complex interactions between MJ and nicotine.
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Affiliation(s)
- Francesca M Filbey
- The Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States.
| | - Tim McQueeny
- The Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States
| | - Shrinath Kadamangudi
- The Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States
| | - Collette Bice
- The Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States
| | - Ariel Ketcherside
- The Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States
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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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45
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Koenders L, Machielsen MW, van der Meer FJ, van Gasselt AC, Meijer CJ, van den Brink W, Koeter MW, Caan MW, Cousijn J, den Braber A, van ‘t Ent D, Rive MM, Schene AH, van de Giessen E, Huyser C, de Kwaasteniet BP, Veltman DJ, de Haan L. Brain volume in male patients with recent onset schizophrenia with and without cannabis use disorders. J Psychiatry Neurosci 2015; 40:197-206. [PMID: 25510948 PMCID: PMC4409437 DOI: 10.1503/jpn.140081] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Schizophrenia is highly comorbid with cannabis use disorders (CUDs), and this comorbidity is associated with an unfavourable course. Early onset or frequent cannabis use may influence brain structure. A key question is whether comorbid CUDs modulate brain morphology alterations associated with schizophrenia. METHODS We used surface-based analysis to measure the brain volume, cortical thickness and cortical surface area of a priori-defined brain regions (hippocampus, amygdala, thalamus, caudate, putamen, orbitofrontal cortex, anterior cingulate cortex, insula, parahippocampus and fusiform gyrus) in male patients with schizophrenia or related disorders with and without comorbid CUDs and matched healthy controls. Associations between age at onset and frequency of cannabis use with regional grey matter volume were explored. RESULTS We included 113 patients with (CUD, n = 80) and without (NCUD, n = 33) CUDs and 84 controls in our study. As expected, patients with schizophrenia (with or without a CUD) had smaller volumes of most brain regions (amygdala, putamen, insula, parahippocampus and fusiform gyrus) than healthy controls, and differences in cortical volume were mainly driven by cortical thinning. Compared with the NCUD group, the CUD group had a larger volume of the putamen, possibly driven by polysubstance use. No associations between age at onset and frequency of use with regional grey matter volumes were found. LIMITATIONS We were unable to correct for possible confounding effects of smoking or antipsychotic medication. CONCLUSION Patients with psychotic disorders and comorbid CUDs have larger putamen volumes than those without CUDs. Future studies should elaborate whether a large putamen represents a risk factor for the development of CUDs or whether (poly)substance use causes changes in putamen volume.
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Affiliation(s)
- Laura Koenders
- Correspondence to: L. Koenders, AMC, Academic Psychiatric Centre, Meibergdreef 9 1105, AZ Amsterdam, The Netherlands;
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46
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Wrege J, Schmidt A, Walter A, Smieskova R, Bendfeldt K, Radue EW, Lang UE, Borgwardt S. Effects of cannabis on impulsivity: a systematic review of neuroimaging findings. Curr Pharm Des 2015; 20:2126-37. [PMID: 23829358 PMCID: PMC4052819 DOI: 10.2174/13816128113199990428] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 06/10/2013] [Indexed: 01/18/2023]
Abstract
We conducted a systematic review to assess the evidence for specific effects of cannabis on impulsivity, disinhibition and motor
control. The review had a specific focus on neuroimaging findings associated with acute and chronic use of the drug and covers literature
published up until May 2012. Seventeen studies were identified, of which 13 met the inclusion criteria; three studies investigated
acute effects of cannabis (1 fMRI, 2 PET), while six studies investigated non-acute functional effects (4 fMRI, 2 PET), and four studies
investigated structural alterations. Functional imaging studies of impulsivity studies suggest that prefrontal blood flow is lower in chronic
cannabis users than in controls. Studies of acute administration of THC or marijuana report increased brain metabolism in several brain
regions during impulsivity tasks. Structural imaging studies of cannabis users found differences in reduced prefrontal volumes and white
matter integrity that might mediate the abnormal impulsivity and mood observed in marijuana users. To address the question whether impulsivity
as a trait precedes cannabis consumption or whether cannabis aggravates impulsivity and discontinuation of usage more longitudinal
study designs are warranted.
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Affiliation(s)
| | | | | | | | | | | | | | - Stefan Borgwardt
- Department of Psychiatry UPK, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.
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47
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Abstract
Questions surrounding the effects of chronic marijuana use on brain structure continue to increase. To date, however, findings remain inconclusive. In this comprehensive study that aimed to characterize brain alterations associated with chronic marijuana use, we measured gray matter (GM) volume via structural MRI across the whole brain by using voxel-based morphology, synchrony among abnormal GM regions during resting state via functional connectivity MRI, and white matter integrity (i.e., structural connectivity) between the abnormal GM regions via diffusion tensor imaging in 48 marijuana users and 62 age- and sex-matched nonusing controls. The results showed that compared with controls, marijuana users had significantly less bilateral orbitofrontal gyri volume, higher functional connectivity in the orbitofrontal cortex (OFC) network, and higher structural connectivity in tracts that innervate the OFC (forceps minor) as measured by fractional anisotropy (FA). Increased OFC functional connectivity in marijuana users was associated with earlier age of onset. Lastly, a quadratic trend was observed suggesting that the FA of the forceps minor tract initially increased following regular marijuana use but decreased with protracted regular use. This pattern may indicate differential effects of initial and chronic marijuana use that may reflect complex neuroadaptive processes in response to marijuana use. Despite the observed age of onset effects, longitudinal studies are needed to determine causality of these effects.
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48
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Kober H, DeVito EE, DeLeone CM, Carroll KM, Potenza MN. Cannabis abstinence during treatment and one-year follow-up: relationship to neural activity in men. Neuropsychopharmacology 2014; 39:2288-98. [PMID: 24705568 PMCID: PMC4138744 DOI: 10.1038/npp.2014.82] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/09/2022]
Abstract
Cannabis is among the most frequently abused substances in the United States. Cognitive control is a contributory factor in the maintenance of substance-use disorders and may relate to treatment response. Therefore, we assessed whether cognitive-control-related neural activity before treatment differs between treatment-seeking cannabis-dependent and healthy individuals and relates to cannabis-abstinence measures during treatment and 1-year follow-up. Cannabis-dependent males (N=20) completed a functional magnetic resonance imaging (fMRI) cognitive-control (Stroop) task before a 12-week randomized controlled trial of cognitive-behavioral therapy and/or contingency management. A healthy-comparison group (N=20) also completed the fMRI task. Cannabis use was assessed by urine toxicology and self-report during treatment, and by self-report across a 1-year follow-up period (N=18). The cannabis-dependent group displayed diminished Stroop-related neural activity relative to the healthy-comparison group in multiple regions, including those strongly implicated in cognitive-control and addiction-related processes (eg, dorsolateral prefrontal cortex and ventral striatum). The groups did not differ significantly in response times (cannabis-dependent, N=12; healthy-comparison, N=14). Within the cannabis-dependent group, greater Stroop-related activity in regions including the dorsal anterior cingulate cortex was associated with less cannabis use during treatment. Greater activity in regions including the ventral striatum was associated with less cannabis use during 1-year posttreatment follow-up. These data suggest that lower cognitive-control-related neural activity in classic 'control' regions (eg, dorsolateral prefrontal cortex and dorsal anterior cingulate) and classic 'salience/reward/learning' regions (eg, ventral striatum) differentiates cannabis-dependent individuals from healthy individuals and relates to less abstinence within-treatment and during long-term follow-up. Clinically, results suggest that treatment development efforts that focus on enhancing cognitive control in addition to abstinence may improve treatment outcomes in cannabis dependence.
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Affiliation(s)
- Hedy Kober
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | | | | | - Marc N Potenza
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Departments of Neurobiology and Child Study Center, Yale University, New Haven, CT, USA
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49
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Long-term effects of cannabis on brain structure. Neuropsychopharmacology 2014; 39:2041-8. [PMID: 24633558 PMCID: PMC4104335 DOI: 10.1038/npp.2014.67] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/22/2014] [Accepted: 03/06/2014] [Indexed: 12/29/2022]
Abstract
The dose-dependent toxicity of the main psychoactive component of cannabis in brain regions rich in cannabinoid CB1 receptors is well known in animal studies. However, research in humans does not show common findings across studies regarding the brain regions that are affected after long-term exposure to cannabis. In the present study, we investigate (using Voxel-based Morphometry) gray matter changes in a group of regular cannabis smokers in comparison with a group of occasional smokers matched by the years of cannabis use. We provide evidence that regular cannabis use is associated with gray matter volume reduction in the medial temporal cortex, temporal pole, parahippocampal gyrus, insula, and orbitofrontal cortex; these regions are rich in cannabinoid CB1 receptors and functionally associated with motivational, emotional, and affective processing. Furthermore, these changes correlate with the frequency of cannabis use in the 3 months before inclusion in the study. The age of onset of drug use also influences the magnitude of these changes. Significant gray matter volume reduction could result either from heavy consumption unrelated to the age of onset or instead from recreational cannabis use initiated at an adolescent age. In contrast, the larger gray matter volume detected in the cerebellum of regular smokers without any correlation with the monthly consumption of cannabis may be related to developmental (ontogenic) processes that occur in adolescence.
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50
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Batalla A, Soriano-Mas C, López-Solà M, Torrens M, Crippa JA, Bhattacharyya S, Blanco-Hinojo L, Fagundo AB, Harrison BJ, Nogué S, de la Torre R, Farré M, Pujol J, Martín-Santos R. Modulation of brain structure by catechol-O-methyltransferase Val(158) Met polymorphism in chronic cannabis users. Addict Biol 2014; 19:722-32. [PMID: 23311613 DOI: 10.1111/adb.12027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Neuroimaging studies have shown that chronic consumption of cannabis may result in alterations in brain morphology. Recent work focusing on the relationship between brain structure and the catechol-O-methyltransferase (COMT) gene polymorphism suggests that functional COMT variants may affect brain volume in healthy individuals and in schizophrenia patients. We measured the influence of COMT genotype on the volume of four key regions: the prefrontal cortex, neostriatum (caudate-putamen), anterior cingulate cortex and hippocampus-amygdala complex, in chronic early-onset cannabis users and healthy control subjects. We selected 29 chronic cannabis users who began using cannabis before 16 years of age and matched them to 28 healthy volunteers in terms of age, educational level and IQ. Participants were male, Caucasians aged between 18 and 30 years. All were assessed by a structured psychiatric interview (PRISM) to exclude any lifetime Axis-I disorder according to Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition. COMT genotyping was performed and structural magnetic resonance imaging data was analyzed by voxel-based morphometry. The results showed that the COMT polymorphism influenced the volume of the bilateral ventral caudate nucleus in both groups, but in an opposite direction: more copies of val allele led to lesser volume in chronic cannabis users and more volume in controls. The opposite pattern was found in left amygdala. There were no effects of COMT genotype on volumes of the whole brain or the other selected regions. Our findings support recent reports of neuroanatomical changes associated with cannabis use and, for the first time, reveal that these changes may be influenced by the COMT genotype.
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Affiliation(s)
- Albert Batalla
- Department of Psychiatry; Clinical Institute of Neuroscience; Hospital Clínic, IDIBAPS, CIBERSAM; Spain
- Department of Psychiatry and Clinical Psychobiology; University of Barcelona; Spain
| | - Carles Soriano-Mas
- CRC Mar; Hospital del Mar; Spain
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL, CIBERSAM; Spain
| | | | - Marta Torrens
- Neuroscience Program; IMIM (Hospital del Mar Medical Research Institute)-INAD-Parc de Salut Mar, Autonomous University of Barcelona and Pompeu Fabra University; Spain
- Red de Trastornos Adictivos (RETIC); IMIM-INAD-Parc de Salut Mar; Spain
| | - José A. Crippa
- Neuroscience and Cognitive Behavior Department; University of Sao Paulo; Brazil
- INCT Translational Medicine (INCT-TM, CNPq); Brazil
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies; King's College London, Institute of Psychiatry; UK
| | | | - Ana B. Fagundo
- Neuroscience Program; IMIM (Hospital del Mar Medical Research Institute)-INAD-Parc de Salut Mar, Autonomous University of Barcelona and Pompeu Fabra University; Spain
| | - Ben J. Harrison
- CRC Mar; Hospital del Mar; Spain
- Melbourne Neuropsychiatry Centre; Department of Psychiatry; The University of Melbourne & Melbourne Health; Australia
| | - Santiago Nogué
- Clinical Toxicology Unit; Emergency Department; Hospital Clínic, IDIBAPS, University of Barcelona; Spain
| | - Rafael de la Torre
- Neuroscience Program; IMIM (Hospital del Mar Medical Research Institute)-INAD-Parc de Salut Mar, Autonomous University of Barcelona and Pompeu Fabra University; Spain
- CIBEROBN; Spain
| | - Magí Farré
- Neuroscience Program; IMIM (Hospital del Mar Medical Research Institute)-INAD-Parc de Salut Mar, Autonomous University of Barcelona and Pompeu Fabra University; Spain
- Red de Trastornos Adictivos (RETIC); IMIM-INAD-Parc de Salut Mar; Spain
| | | | - Rocío Martín-Santos
- Department of Psychiatry; Clinical Institute of Neuroscience; Hospital Clínic, IDIBAPS, CIBERSAM; Spain
- Department of Psychiatry and Clinical Psychobiology; University of Barcelona; Spain
- Neuroscience Program; IMIM (Hospital del Mar Medical Research Institute)-INAD-Parc de Salut Mar, Autonomous University of Barcelona and Pompeu Fabra University; Spain
- Neuroscience and Cognitive Behavior Department; University of Sao Paulo; Brazil
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