Department of Psychiatry, University of Basel, c/o University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
Curr Pharm Des. 2012;18(32):5070-80. doi: 10.2174/138161212802884861.
It is unclear yet whether cannabis use is a moderating or causal factor contributing to grey matter alterations in schizophrenia and the development of psychotic symptoms. We therefore systematically reviewed structural brain imaging and post mortem studies addressing the effects of cannabis use on brain structure in psychosis. Studies with schizophrenia (SCZ) and first episode psychosis (FEP) patients as well as individuals at genetic (GHR) or clinical high risk for psychosis (ARMS) were included. We identified 15 structural magnetic resonance imaging (MRI) (12 cross sectional / 3 longitudinal) and 4 post mortem studies. The total number of subjects encompassed 601 schizophrenia or first episode psychosis patients, 255 individuals at clinical or genetic high risk for psychosis and 397 healthy controls. We found evidence for consistent brain structural abnormalities in cannabinoid 1 (CB1) receptor enhanced brain areas as the cingulate and prefrontal cortices and the cerebellum. As these effects have not consistently been reported in studies examining nonpsychotic and healthy samples, psychosis patients and subjects at risk for psychosis might be particularly vulnerable to brain volume loss due to cannabis exposure.
目前尚不清楚大麻使用是导致精神分裂症灰质改变和精神病症状发展的调节因素还是因果因素。因此，我们系统地综述了结构脑成像和死后研究，以探讨大麻使用对精神病患者大脑结构的影响。研究对象包括精神分裂症（SCZ）和首发精神病（FEP）患者以及遗传（GHR）或临床精神病高危（ARMS）个体。我们共确定了 15 项结构磁共振成像（MRI）（12 项横断面/3 项纵向）和 4 项尸体研究。研究对象总数包括 601 名精神分裂症或首发精神病患者、255 名临床或遗传精神病高危个体和 397 名健康对照者。我们发现证据表明，大麻素 1（CB1）受体增强的大脑区域，如扣带回和前额叶皮层以及小脑，存在一致的大脑结构异常。由于这些效应在检查非精神病和健康样本的研究中并未一致报告，因此精神病患者和精神病高危个体可能特别容易因接触大麻而导致脑容量损失。
