Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Georg-August-University, Germany.
Eur Arch Psychiatry Clin Neurosci. 2013 Feb;263(1):3-13. doi: 10.1007/s00406-012-0346-3. Epub 2012 Aug 21.
Substance abuse is the most prevalent comorbid psychiatric condition associated with schizophrenia, and cannabis is the illicit drug most often abused. Apart from worsening the course of schizophrenia, frequent cannabis use especially at an early age seems to be an important risk factor for developing schizophrenia. Although a large body of neuroimaging studies gives evidence for structural alterations in many different brain regions in schizophrenia patients, there is still limited knowledge of the impact of cannabis abuse on brain structure in schizophrenia. We performed a systematic review including structural magnetic resonance imaging studies comparing high-risk and schizophrenia patients with and without cannabis abuse and found inconclusive results. While there is some evidence that chronic cannabis abuse could alter brain morphology in schizophrenia in patients continuing their cannabis consumption, there is no convincing evidence that this alteration takes place before the onset of schizophrenia when looking at first-episode patients. There is some weak evidence that cannabis abuse could affect brain structures in high-risk subjects, but replication of these studies is needed.
物质滥用是与精神分裂症相关的最常见共病精神疾病，大麻是最常被滥用的非法药物。除了使精神分裂症的病程恶化外，频繁使用大麻（尤其是在早期）似乎是导致精神分裂症的一个重要危险因素。尽管大量的神经影像学研究为精神分裂症患者许多不同脑区的结构改变提供了证据，但对于大麻滥用对精神分裂症患者大脑结构的影响仍知之甚少。我们进行了一项系统综述，纳入了比较有高风险和精神分裂症且有和无大麻滥用的患者的结构磁共振成像研究，结果尚无定论。虽然有一些证据表明，慢性大麻滥用可能会改变继续吸食大麻的精神分裂症患者的大脑形态，但在观察首发患者时，没有令人信服的证据表明这种改变发生在精神分裂症发病之前。有一些微弱的证据表明大麻滥用可能会影响高风险人群的大脑结构，但需要对这些研究进行复制。
