Ghaffar Omar, Feinstein Anthony
Department of Psychiatry, Sunnybrook Health Sciences Centre, FG08-2075 Bayview Avenue, Toronto, ON, Canada.
Neurology. 2008 Jul 15;71(3):164-9. doi: 10.1212/01.wnl.0000304046.23960.25. Epub 2008 Feb 13.
A significant minority of patients with multiple sclerosis (MS) use cannabis, yet no study has examined the possible effects on mentation. Here, we report the emotional and cognitive correlates of street cannabis use in patients with MS.
A sample of 140 consecutive patients with MS were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Axis I disorders (SCID-IV) from which details of cannabis use were recorded. Cognition was assessed using the Neuropsychological Battery for MS supplemented with the Symbol Digit Modalities Test (SDMT), an index of information processing speed, working memory, and sustained attention.
Ten subjects (7.7%) were defined as current cannabis users based on use within the last month. Compared to non-cannabis users (n = 130), they were younger (p = 0.001). Each of the 10 current cannabis users was matched on demographic and disease variables to four subjects with MS who did not use cannabis (total control sample n = 40). Group comparisons revealed that the proportion of patients meeting DSM-IV criteria for a psychiatric diagnosis was higher in cannabis users (p = 0.04). In addition, on the SDMT, cannabis users had a slower mean performance time (p = 0.006) and a different pattern of response compared to matched controls (group x time interaction; p = 0.001).
Inhaled cannabis is associated with impaired mentation in patients with multiple sclerosis, particularly with respect to cognition. Future studies are required to clarify the direction of this relationship.
相当一部分多发性硬化症（MS）患者使用大麻，但尚无研究探讨其对精神状态可能产生的影响。在此，我们报告MS患者使用街头大麻与情绪和认知之间的关联。
对连续140例MS患者进行访谈，采用《精神障碍诊断与统计手册》（DSM-IV）轴I障碍的结构化临床访谈（SCID-IV），记录大麻使用细节。使用MS神经心理成套测验并补充符号数字模态测验（SDMT）评估认知，SDMT是信息处理速度、工作记忆和持续注意力的一项指标。
根据过去一个月内的使用情况，10名受试者（7.7%）被确定为当前大麻使用者。与非大麻使用者（n = 130）相比，他们更年轻（p = 0.001）。将10名当前大麻使用者中的每一位在人口统计学和疾病变量方面与4名未使用大麻的MS患者进行匹配（总对照样本n = 40）。组间比较显示，大麻使用者中符合DSM-IV精神疾病诊断标准的患者比例更高（p = 0.04）。此外，在SDMT上，大麻使用者的平均表现时间较慢（p = 0.006），且与匹配的对照组相比，反应模式不同（组×时间交互作用；p = 0.001）。
吸入大麻与多发性硬化症患者的精神状态受损有关，尤其是在认知方面。需要进一步研究以阐明这种关系的方向。
