大麻二酚对认知功能影响的系统评价：与精神分裂症的相关性。
A systematic review of the effect of cannabidiol on cognitive function: Relevance to schizophrenia.
机构信息
Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, University of Wollongong, 2522, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, 2522, NSW, Australia; Centre for Medical and Molecular Biosciences, Faculty of Science, Medicine and Health, University of Wollongong, 2522, NSW, Australia.
School of Psychology, Faculty of Social Sciences, University of Wollongong, 2522, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, 2522, NSW, Australia.
出版信息
Neurosci Biobehav Rev. 2017 Jan;72:310-324. doi: 10.1016/j.neubiorev.2016.11.012. Epub 2016 Nov 22.
BACKGROUND AND OBJECTIVES
Cognitive impairment is a core symptom domain of schizophrenia, neurological disorders and substance abuse. It is characterised by deficits in learning, memory, attention and executive functioning and can severely impact daily living. Antipsychotic drugs prescribed to treat schizophrenia provide limited cognitive benefits and novel therapeutic targets are required. Cannabidiol (CBD), a component of the cannabis plant, has anti-inflammatory and antipsychotic-like properties; however, its ability to improve cognitive impairment has not been thoroughly explored. The aim of this systematic review was to evaluate preclinical and clinical literature on the effects of CBD in cognitive domains relevant to schizophrenia.
METHODS
A systematic literature search was performed across numerous electronic databases for English language articles (January 1990-March 2016), with 27 articles (18 preclinical and 9 clinical studies) included in the present review.
RESULTS
CBD improves cognition in multiple preclinical models of cognitive impairment, including models of neuropsychiatric (schizophrenia), neurodegenerative (Alzheimer's disease), neuro-inflammatory (meningitis, sepsis and cerebral malaria) and neurological disorders (hepatic encephalopathy and brain ischemia). To date, there is one clinical investigation into the effects of CBD on cognition in schizophrenia patients, with negative results for the Stroop test. CBD attenuates Δ-THC-induced cognitive deficits.
CONCLUSIONS
The efficacy of CBD to improve cognition in schizophrenia cannot be elucidated due to lack of clinical evidence; however, given the ability of CBD to restore cognition in multiple studies of impairment, further investigation into its efficacy in schizophrenia is warranted. Potential mechanisms underlying the efficacy of CBD to improve cognition are discussed.
背景与目的
认知障碍是精神分裂症、神经紊乱和药物滥用的核心症状领域。其特征为学习、记忆、注意力和执行功能缺陷，并会严重影响日常生活。用于治疗精神分裂症的抗精神病药物只能提供有限的认知益处，因此需要新的治疗靶点。大麻素（CBD）是大麻植物的一种成分，具有抗炎和类抗精神病特性；然而，其改善认知障碍的能力尚未得到充分探索。本系统综述的目的是评估 CBD 对与精神分裂症相关的认知领域的影响的临床前和临床文献。
方法
通过多个电子数据库对英文文献进行了系统的文献检索（1990 年 1 月至 2016 年 3 月），本综述纳入了 27 篇文章（18 项临床前研究和 9 项临床研究）。
结果
CBD 改善了多种认知障碍的临床前模型中的认知功能，包括神经精神疾病（精神分裂症）、神经退行性疾病（阿尔茨海默病）、神经炎症（脑膜炎、败血症和脑疟疾）和神经疾病（肝性脑病和脑缺血）。迄今为止，有一项关于 CBD 对精神分裂症患者认知影响的临床研究，Stroop 测试结果为阴性。CBD 可减轻 Δ-THC 引起的认知障碍。
结论
由于缺乏临床证据，无法阐明 CBD 改善精神分裂症认知的疗效；然而，鉴于 CBD 在多项损伤认知研究中恢复认知的能力，有必要进一步研究其在精神分裂症中的疗效。讨论了 CBD 改善认知的潜在机制。
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