Epstein Katherine A, Kumra Sanjiv
Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, United States.
Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, United States.
Schizophr Res. 2015 Mar;162(1-3):143-52. doi: 10.1016/j.schres.2014.11.029. Epub 2015 Jan 15.
During late adolescence, progressive cortical thinning occurs in heteromodal association cortex (HASC) that is thought to subserve cognitive development. However, the impact of cannabis use disorder (CUD) upon cortical gray matter development in both healthy adolescents and adolescents with early-onset schizophrenia (EOS) is unclear. T1-weighted magnetic resonance images were acquired from 79 adolescents at baseline and after an 18-month follow-up: 17 with EOS, 17 with CUD, 11 with EOS+CUD, and 34 healthy controls (HC). Mean age at baseline was 16.4years (CUD+) and 17.0years (CUD-). Using FreeSurfer, measures of cortical thickness for ROIs within HASC were obtained. A 2 (EOS versus no EOS)×2 (CUD versus no CUD) multivariate analysis of covariance was applied to change scores from baseline to follow-up to test for main effects of EOS and CUD and an interaction effect. After adjusting for covariates, a significant main effect of CUD was observed. Adolescents with CUD showed an attenuated loss of cortical thickness in the left and right supramarginal, left and right inferior parietal, right pars triangularis, left pars opercularis, left superior frontal, and left superior temporal regions compared to non-using subjects. Stepwise linear regression analysis indicated that greater cumulative cannabis exposure predicted greater cortical thickness in both the left (p=.008) and right (p=.04) superior frontal gyri at study endpoint after adjusting for baseline cortical thickness for the entire sample. These preliminary longitudinal data demonstrate an atypical pattern of cortical development in HASC in adolescents with CUD relative to non-using subjects, across diagnostic groups. Additional studies are needed to replicate these data and to clarify the clinical significance of these findings.
在青春期后期，异模态联合皮层（HASC）会出现渐进性皮质变薄，这被认为有助于认知发展。然而，大麻使用障碍（CUD）对健康青少年和早发性精神分裂症（EOS）青少年皮质灰质发育的影响尚不清楚。在基线期和18个月随访后，对79名青少年进行了T1加权磁共振成像：17名患有EOS，17名患有CUD，11名患有EOS + CUD，以及34名健康对照（HC）。基线时的平均年龄为16.4岁（CUD +）和17.0岁（CUD -）。使用FreeSurfer获得了HASC内感兴趣区域（ROI）的皮质厚度测量值。应用2（EOS与无EOS）×2（CUD与无CUD）多变量协方差分析来检验从基线到随访的变化分数，以测试EOS和CUD的主要效应以及交互效应。在调整协变量后，观察到CUD有显著的主要效应。与未使用大麻的受试者相比，患有CUD的青少年在左右缘上回、左右下顶叶、右侧三角部、左侧 opercular部、左侧额上回和左侧颞上回区域的皮质厚度变薄程度减弱。逐步线性回归分析表明，在调整整个样本的基线皮质厚度后，更大的累积大麻暴露量在研究终点时预测左侧（p = .008）和右侧（p = .04）额上回有更大的皮质厚度。这些初步的纵向数据表明，与未使用大麻的受试者相比，患有CUD的青少年在不同诊断组中HASC的皮质发育模式具有非典型性。需要进一步的研究来重复这些数据并阐明这些发现的临床意义。
