Excessive Brain Volume Loss Over Time in Cannabis-Using First-Episode Schizophrenia Patients

Rais, Monica; Cahn, Wiepke; Haren, Neeltje van; Schnack, Hugo G.; Caspers, Esther; Pol, Hilleke Hulshoff; Kahn, René S.

doi:10.1176/appi.ajp.2007.07071110

Cited by 181 publications

(109 citation statements)

References 41 publications

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“…Our findings support an interpretation of dosedependent neurotoxic effects, broadly across the hippocampus, as evidenced also by animal studies (see Solowij et al, 2012). The combined effects of comorbid chronic cannabis use and schizophrenia appear to exceed those of either condition occurring in isolation, consistent with other recent studies (Habets et al, 2011;Rais et al, 2008;Solowij et al, 2011). Future studies with larger samples could examine further gender effects and the functional, clinical and neuropsychological correlates of this neuropathology.…”

Section: Discussionsupporting

confidence: 91%

Alteration to hippocampal shape in cannabis users with and without schizophrenia

Solowij

Walterfang

Lubman

et al. 2013

Schizophrenia Research

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Abnormalities in hippocampal morphology are characteristic of schizophrenia and have also been reported in chronic cannabis users. There is a paucity of research investigating potential additive effects of cannabis use on brain pathology associated with schizophrenia. In this study, we performed hippocampal shape analysis in cannabis-using and non-using patients with schizophrenia, healthy cannabis users and healthy non-using controls. Hippocampal shape changes were observed in each group relative to controls, with the greatest degree of alterations (i.e., deflations across the hippocampus, and with an anterior predisposition), in cannabis-using schizophrenia patients. These alterations were associated with cannabis use patterns and psychotic symptoms. AbstractAbnormalities in hippocampal morphology are characteristic of schizophrenia and have also been reported in chronic cannabis users. There is a paucity of research investigating potential additive effects of cannabis use on brain pathology associated with schizophrenia. In this study we performed hippocampal shape analysis in cannabis-using and non-using patients with schizophrenia, healthy cannabis users and healthy non-using controls. Hippocampal shape changes were observed in each group relative to controls, with the greatest degree of alterations (i.e., deflations across the hippocampus, and with an anterior predisposition), in cannabis-using schizophrenia patients. These alterations were associated with cannabis use patterns and psychotic symptoms.

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Section: Discussionsupporting

confidence: 91%

Alteration to hippocampal shape in cannabis users with and without schizophrenia

Solowij

Walterfang

Lubman

et al. 2013

Schizophrenia Research

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“…Consistent with this hypothesis, cannabis use was found to be associated with reduced hippocampal and amygdala volume in healthy controls (Yücel et al, 2008) and with excessive cortical thinning in patients with a psychotic disorder compared with cannabisusing healthy controls (Habets et al, 2011). In addition, cannabis-using patients with schizophrenia were found to have larger reductions of gray matter volume than nonusing schizophrenia patients (Rais et al, 2008), especially in areas with high expression of cannabinoid type 1 (CB1) receptors (Rais et al, 2010). The relationship between cannabis and cognition in patients with schizophrenia may be more complex, however, as recent meta-analyses found that in patients with schizophrenia, lifetime cannabis use is associated with better rather than worse cognitive performance (Rabin et al, 2011;Yücel et al, 2010).…”

Section: Introductionmentioning

confidence: 70%

AKT1 Moderation of Cannabis-Induced Cognitive Alterations in Psychotic Disorder

Winkel

Beveren

Simons

2011

Neuropsychopharmacol

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Genetic variation in AKT1 may be associated with sensitivity to the psychotomimetic effects of cannabis as well as with increased risk for psychotic disorder following cannabis use. Investigation of the effect of this interaction on relevant intermediate phenotypes for psychosis, such as cognition, may help to clarify the underlying mechanism. Thus, verbal memory (visually presented Word Learning Task), sustained attention (Continuous Performance Test, CPT), AKT1 rs2494732 genotype, and cannabis use were examined in a large cohort of patients with psychotic disorder. No evidence was found for AKT1 Â cannabis interaction on verbal memory. Cannabis use preceding onset of psychotic disorder did interact significantly with AKT1 rs2494732 genotype to affect CPT reaction time (b ¼ 8.0, SE 3.9, p ¼ 0.037) and CPT accuracy (b ¼ À1.2, SE 0.4, p ¼ 0.003). Cannabis-using patients with the a priori vulnerability C/C genotype were slower and less accurate on the CPT, whereas cannabis-using patients with the T/T genotype had similar or better performance than non-using patients with psychotic disorder. The interaction was also apparent in patients with psychotic disorder who had not used cannabis in the 12 months preceding assessment, but was absent in the unaffected siblings of these patients and in healthy controls. In conclusion, cannabis use before onset of psychosis may have long-lasting effects on measures of sustained attention, even in the absence of current use, contingent on AKT1 rs2494732 genotype. The results suggest that long-term changes in cognition may mediate the risk-increasing effect of the AKT1 Â cannabis interaction on psychotic disorder.

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“…Die graue Substanz war jedoch nur bei starkem Tabakkonsum (>25 Zigaretten/Tag) signifikant reduziert [82]. Auch exzessiver Alkoholkonsum [83,84] und intensiver Cannabisgebrauch [85,86] können zur Hirnvolumenminderung beitragen. So wurde beobachtet, dass bei Vorhandensein spezifischer Cannabinoid-1-Rezeptor-Genotypen (CB1/CNR1) Cannabis zur Verminderung der weißen Substanz und kognitiven Defiziten führ-te [87].…”

Section: Genetische Effekte Und Auswirkungen Von Tabak Und Cannabisunclassified

Frontale Hirnvolumenminderung durch Antipsychotika?

et al. 2014

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Zusammenfassung In dieser Übersicht werden die Ergebnisse longitudinaler Studien zur frontalen Hirnvolumenminderung bei Menschen mit einer Erkrankung aus dem Spektrum schizophrener Psychosen dargestellt und zur Behandlung mit Antipsychotika in Beziehung gesetzt. Nach einer systematischen Literaturrecherche wurden alle Studien ausgewertet, in denen an einer größeren Population Ergebnisse bildgebender Diagnostik zur Veränderung der Hirnstruktur im Langzeitverlauf mit Daten zur antipsychotischen Behandlung und zur Schwere der Erkrankung korreliert wurden. Die Ergebnisse zeigen, dass es eine Evidenz für eine Volumenminderung grauer und weißer Substanz des Frontalhirns gibt, die sich nicht alleine durch die Erkrankung selbst und ihre Krankheitsschwere erklären lässt, sondern mit hoher Wahrscheinlichkeit auch Ausdruck einer langfristigen Antipsychotikawirkung auf das Gehirn ist. Ob sog. „Second-generation“-Antipsychotika hier einen mittel- bis längerfristigen Vorteil gegenüber „First-generation“-Antipsychotika besitzen, ist derzeit unklar. Angesichts des Beitrags von Antipsychotika zu den hirnstrukturellen Veränderungen, die offenbar kumulativ dosisabhängig sind und negative Auswirkungen für die Neurokognition, die Positiv- und Negativsymptomatik und das soziale Anpassungsniveau mit sich bringen können, sollten die Empfehlungen zur antipsychotischen Langzeitbehandlung neu überdacht werden. Vor dem Hintergrund der neurobiologischen Befunde empfehlen wir und andere, möglichst niedrige antipsychotische Dosierungen zur Symptomkontrolle einzusetzen. Bei psychiatrischen Störungen außerhalb des Schizophreniespektrums sollten Antipsychotika ebenfalls nur mit Vorsicht und nach sorgfältiger Abwägung von Risiken und Nutzen angewandt werden. In diesem Kontext werden zunehmend auch Behandlungsansätze relevant, welche die antipsychotische Medikation minimieren oder sogar einen nur selektiven Einsatz erlauben.

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Excessive Brain Volume Loss Over Time in Cannabis-Using First-Episode Schizophrenia Patients

Abstract: First-episode schizophrenia patients who use cannabis show a more pronounced brain volume reduction over a 5-year follow-up than patients with schizophrenia who do not use cannabis. These results may help explain some of the detrimental effects of cannabis use in schizophrenia.

Cited by 181 publications

References 41 publications

Alteration to hippocampal shape in cannabis users with and without schizophrenia

Alteration to hippocampal shape in cannabis users with and without schizophrenia

AKT1 Moderation of Cannabis-Induced Cognitive Alterations in Psychotic Disorder

Frontale Hirnvolumenminderung durch Antipsychotika?

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