Gudlowski Y, Lautenschlager M
Früherkennungs- und Therapiezentrum für beginnende Psychosen Berlin/Brandenburg, Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin (Mitte).
Gesundheitswesen. 2008 Nov;70(11):653-7. doi: 10.1055/s-0028-1100396. Epub 2008 Nov 27.
Cannabis consumption has varying effects over the whole life span, especially on achievements in the areas of schooling, professional life and performance in a social environment. Data from studies on remission from neurocognitive deficits following chronic cannabis consumption are ambiguous. The outcome range included everything from complete remission over considerable lasting deficits up to even chronic psychotic disorders. The data seem to be consistent however, when a differentiation between early begin of consumption (before the age of 16) and late begin of consumption is taken into account. Mainly those cannabis users with an early begin of consumption are prone to developing lasting neurocognitive deficits and even a decrease in grey substance volume, as well as an increase in the risk of psychosis. The correlation of this outcome with cannabis consumption during a phase of brain development that includes the consolidation of higher cognitive functions, awareness of social cues, planning of concepts and motivation as well as tools of functional control, is highly convincing. The endocannabinoid system reaches the point of highest receptor density during this age of 16/17 years, and many of the above-mentioned developmental processes are modulated by this system. A chronic damage to this system (e.g., down-regulation or desensitisation of CB1 receptors by exogenous cannabinoids) therefore holds the potential for permanent neurophysiological as well as neurocognitive deficits, and also for the development of psychotic disorders.
大麻消费在整个生命周期中会产生不同的影响,尤其是对学业、职业生涯以及社交环境中的表现等方面的成就。关于长期吸食大麻后神经认知缺陷缓解情况的研究数据并不明确。结果范围涵盖了从完全缓解到相当持久的缺陷,甚至到慢性精神障碍等所有情况。然而,当考虑到消费开始的早晚差异(16岁之前和之后)时,数据似乎是一致的。主要是那些在早年开始吸食大麻的人容易出现持久的神经认知缺陷,甚至灰质体积减少,以及患精神病风险增加。这种结果与在大脑发育阶段吸食大麻之间的关联极具说服力,该阶段包括高级认知功能的巩固、社会线索意识、概念规划和动机以及功能控制工具。内源性大麻素系统在16/17岁这个年龄段达到受体密度的最高点,上述许多发育过程都受该系统调节。因此,该系统的慢性损伤(例如,外源性大麻素导致CB1受体下调或脱敏)有可能导致永久性神经生理和神经认知缺陷,以及精神障碍的发展。