Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study

Delvecchio, Giuseppe; Oldani, Lucio; Mandolini, Gian Mario; Pigoni, Alessandro; Ciappolino, Valentina; Schiena, Giandomenico; Lazzaretti, Matteo; Caletti, Elisabetta; Barbieri, Valentina; Cinnante, Claudia; Triulzi, Fabio; Brambilla, Paolo

doi:10.3791/60881

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…It is, however, likely that a part of their observed excess mortality may be attributable to a continued use of alcohol and illicit substances. Regarding suicide, the excess mortality may also, in part, be because of psychological sequelae of the substance‐induced psychosis [12–14]. Regardless of the mediating pathway, our results make it abundantly clear that people with substance‐induced psychosis have a highly increased risk of both all‐cause and cause‐specific mortality, even if they do not progress to being diagnosed with schizophrenia.…”

Section: Discussionmentioning

confidence: 88%

Mortality in substance‐induced psychosis: a register‐based national cohort study

et al. 2021

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Aims We aimed to analyze whether people with substance‐induced psychosis (SIP), both those who convert and do not convert to schizophrenia, have higher all‐cause and cause‐specific mortality when compared to the general population. Design Prospective cohort study. Setting Nationwide Danish registers. Participants/Cases We included all people born in Denmark, living in Denmark on their 15th birthday, and age 15 or more during the study period from January 1, 1994, and August 10, 2017. Measurements Exposure was categorized as: (i) neither SIP nor schizophrenia; (ii) SIP without preceding schizophrenia; (iii) SIP converted to schizophrenia; and (iv) schizophrenia without preceding SIP. Any SIP and substance‐specific SIPS were examined regarding all‐cause and cause‐specific mortality. Findings The study included a total of 5 619 691 individuals. Compared to people with neither schizophrenia nor SIP, people with SIP without preceding schizophrenia had an increased risk of dying (hazard ratio [HR] = 6.23, 95% CI = 5.96–6.50), as had those with SIP converting to schizophrenia (HR = 9.77, 95% CI = 8.84–10.79) and those with only schizophrenia (HR = 3.07, 95% CI = 3.03–3.13). A similar pattern, albeit with higher HRs, was observed for suicides and accidental deaths. Other cause‐specific‐mortality groups also generally showed the same pattern, as did types of individual substances. Conclusions Substance‐induced psychosis was strongly associated with an increased risk of both all‐cause and cause‐specific mortality, even among cases who did not convert to schizophrenia. This provides a strong rationale for monitoring people with previous diagnosis of substance‐induced psychosis and developing and implementing interventions to reduce this excess mortality.

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Section: Discussionmentioning

confidence: 88%

Mortality in substance‐induced psychosis: a register‐based national cohort study

et al. 2021

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Psychotropic Effects of Cannabis

Ross

2023

Plant-Based Therapeutics, Volume 1

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Measuring white matter microstructure in 1,457 cannabis users and 1,441 controls: A systematic review of diffusion-weighted MRI studies

Robinson

Gleeson²,

Arun³

et al. 2023

Front. Neuroimaging

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IntroductionCannabis is the most widely used regulated substance by youth and adults. Cannabis use has been associated with psychosocial problems, which have been partly ascribed to neurobiological changes. Emerging evidence to date from diffusion-MRI studies shows that cannabis users compared to controls show poorer integrity of white matter fibre tracts, which structurally connect distinct brain regions to facilitate neural communication. However, the most recent evidence from diffusion-MRI studies thus far has yet to be integrated. Therefore, it is unclear if white matter differences in cannabis users are evident consistently in selected locations, in specific diffusion-MRI metrics, and whether these differences in metrics are associated with cannabis exposure levels.MethodsWe systematically reviewed the results from diffusion-MRI imaging studies that compared white matter differences between cannabis users and controls. We also examined the associations between cannabis exposure and other behavioral variables due to changes in white matter. Our review was pre-registered in PROSPERO (ID: 258250; https://www.crd.york.ac.uk/prospero/).ResultsWe identified 30 diffusion-MRI studies including 1,457 cannabis users and 1,441 controls aged 16-to-45 years. All but 6 studies reported group differences in white matter integrity. The most consistent differences between cannabis users and controls were lower fractional anisotropy within the arcuate/superior longitudinal fasciculus (7 studies), and lower fractional anisotropy of the corpus callosum (6 studies) as well as higher mean diffusivity and trace (4 studies). Differences in fractional anisotropy were associated with cannabis use onset (4 studies), especially in the corpus callosum (3 studies).DiscussionThe mechanisms underscoring white matter differences are unclear, and they may include effects of cannabis use onset during youth, neurotoxic effects or neuro adaptations from regular exposure to tetrahydrocannabinol (THC), which exerts its effects by binding to brain receptors, or a neurobiological vulnerability predating the onset of cannabis use. Future multimodal neuroimaging studies, including recently developed advanced diffusion-MRI metrics, can be used to track cannabis users over time and to define with precision when and which region of the brain the white matter changes commence in youth cannabis users, and whether cessation of use recovers white matter differences.Systematic review registrationwww.crd.york.ac.uk/prospero/, identifier: 258250.

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Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study

Cited by 3 publications

References 22 publications

Mortality in substance‐induced psychosis: a register‐based national cohort study

Mortality in substance‐induced psychosis: a register‐based national cohort study

Psychotropic Effects of Cannabis

Measuring white matter microstructure in 1,457 cannabis users and 1,441 controls: A systematic review of diffusion-weighted MRI studies

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