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大麻对艾滋病毒阳性和阴性成年人脑结构及认知功能变化的影响。

Marijuana effects on changes in brain structure and cognitive function among HIV+ and HIV- adults.

作者信息

Thames April D, Kuhn Taylor P, Williamson Timothy J, Jones Jacob D, Mahmood Zanjbeel, Hammond Andrea

机构信息

Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza 28-263, Los Angeles, CA 90095, USA.

Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza 28-263, Los Angeles, CA 90095, USA.

出版信息

Drug Alcohol Depend. 2017 Jan 1;170:120-127. doi: 10.1016/j.drugalcdep.2016.11.007. Epub 2016 Nov 14.

Abstract

BACKGROUND

The current study examined the independent and interactive effects of HIV and marijuana (MJ) use on brain structure and cognitive function among a sample of HIV-positive (HIV+) and HIV-negative (HIV-) individuals.

METHODS

Participants (HIV+, n=48; HIV-, n=29) individuals underwent cognitive testing, questionnaires about substance use, and brain MRI. The HIV+ group was clinically stable based upon current plasma CD4 count, 50% had undetectable viral load (i.e.,<20 copies/mL), and all were on a stable regimen of cART.

RESULTS

For HIV+ and HIV- participants, higher levels of MJ use were associated with smaller volumes in the entorhinal cortex and fusiform gyrus. HIV status (but not MJ use) was associated with cingulate thickness, such that HIV+ participants evidenced smaller thickness of the cingulate, as compared to HIV- controls. Regarding neurocognitive functioning, there was a HIV*MJ interactive effect on global cognition, such that when the amount of MJ use was less than 1.43g per week, the HIV- group displayed significantly better neurocognitive performance than the HIV+ group (t=3.14, p=0.002). However, when MJ use reached 1.43g per week, there were no significant HIV group differences in global cognitive performance (t=1.39, p=0.168).

CONCLUSIONS

Our results show independent and interactive effects of HIV and MJ on brain structure and cognition. However, our results do not support that HIV+ MJ users are at greater risk for adverse brain or cognitive outcomes compared to HIV- MJ users.

摘要

背景

本研究调查了在一组HIV阳性(HIV+)和HIV阴性(HIV-)个体样本中,HIV感染与大麻(MJ)使用对脑结构和认知功能的独立及交互作用。

方法

参与者(HIV+组,n = 48;HIV-组,n = 29)接受了认知测试、关于物质使用的问卷调查以及脑部MRI检查。根据当前血浆CD4计数,HIV+组临床状况稳定,50%的患者病毒载量不可检测(即<20拷贝/毫升),且所有患者均接受稳定的抗逆转录病毒治疗(cART)方案。

结果

对于HIV+和HIV-参与者,较高水平的MJ使用与内嗅皮质和梭状回体积减小有关。HIV感染状况(而非MJ使用情况)与扣带回厚度有关,与HIV-对照组相比,HIV+参与者的扣带回厚度较小。关于神经认知功能,在整体认知方面存在HIV*MJ交互作用,即当MJ使用量低于每周1.43克时,HIV-组的神经认知表现显著优于HIV+组(t = 3.14,p = 0.002)。然而,当MJ使用量达到每周1.43克时,HIV组在整体认知表现上无显著差异(t = 1.39,p = 0.168)。

结论

我们的结果显示HIV和MJ对脑结构和认知存在独立及交互作用。然而,我们的结果并不支持与HIV- MJ使用者相比,HIV+ MJ使用者出现不良脑或认知结局的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1135/5240153/a711295b58c4/nihms839689f1.jpg

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