Schwitzer Thomas, Schwan Raymund, Albuisson Eliane, Giersch Anne, Lalanne Laurence, Angioi-Duprez Karine, Laprevote Vincent
Pôle Hospitalo-Universitaire de Psychiatrie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France2EA7298 Interactions gènes-risques environnementaux et effets sur la santé, Université de Lorraine, Vandœuvre-lès-Nancy, Nancy, France3Institut National de la Santé et de la Recherche Médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
Pôle Hospitalo-Universitaire de Psychiatrie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France2EA7298 Interactions gènes-risques environnementaux et effets sur la santé, Université de Lorraine, Vandœuvre-lès-Nancy, Nancy, France4Maison des Addictions, Centre Hospitalier Régional Universitaire Nancy, Nancy, France.
JAMA Ophthalmol. 2017 Jan 1;135(1):54-60. doi: 10.1001/jamaophthalmol.2016.4761.
Because cannabis use is a major public health concern and cannabis is known to act on central neurotransmission, studying the retinal ganglion cells in individuals who regularly use cannabis is of interest.
To determine whether the regular use of cannabis could alter the function of retinal ganglion cells in humans.
DESIGN, SETTING, AND PARTICIPANTS: For this case-control study, individuals who regularly use cannabis, as well as healthy controls, were recruited, and data were collected from February 11 to October 28, 2014. Retinal function was used as a direct marker of brain neurotransmission abnormalities in complex mental phenomena.
Amplitude and implicit time of the N95 wave on results of pattern electroretinography.
Twenty-eight of the 52 participants were regular cannabis users (24 men and 4 women; median age, 22 years [95% CI, 21-24 years]), and the remaining 24 were controls (20 men and 4 women; median age, 24 years [95% CI, 23-27 years]). There was no difference between groups in terms of age (P = .13) or sex (P = .81). After adjustment for the number of years of education and alcohol use, there was a significant increase for cannabis users of the N95 implicit time on results of pattern electroretinography (median, 98.6 milliseconds [95% CI, 93.4-99.5]) compared with controls (median, 88.4 milliseconds [95% CI, 85.0-91.1]), with 8.4 milliseconds as the median of the differences (95% CI, 4.9-11.5; P < .001, Wald logistic regression). A receiver operating characteristic curve analysis (area under the curve, 0.84 [95% CI, 0.73-0.95]; P < .001) revealed, for a cutoff value of 91.13 milliseconds, a sensitivity of 78.6% (95% CI, 60.5%-89.8%) and a specificity of 75.0% (95% CI, 55.1%-88.0%) for correctly classifying both cannabis users and controls in their corresponding group. The positive predictive value was 78.6% (95% CI, 60.5%-89.8%), and the negative predictive value was 75.0% (95% CI, 55.1%-88.0%).
Our results demonstrate a delay in transmission of action potentials by the ganglion cells in regular cannabis users, which could support alterations in vision. Our findings may be important from a public health perspective since they could highlight the neurotoxic effects of cannabis use on the central nervous system as a result of how it affects retinal processing.
由于大麻使用是一个主要的公共卫生问题，且已知大麻作用于中枢神经传递，因此研究经常使用大麻的个体的视网膜神经节细胞具有重要意义。
确定经常使用大麻是否会改变人类视网膜神经节细胞的功能。
设计、地点和参与者：在这项病例对照研究中，招募了经常使用大麻的个体以及健康对照者，并于2014年2月11日至10月28日收集数据。视网膜功能被用作复杂心理现象中大脑神经传递异常的直接指标。
图形视网膜电图结果中N95波的振幅和隐含时间。
52名参与者中有28名是经常使用大麻者（24名男性和4名女性；中位年龄22岁[95%CI，21 - 24岁]），其余24名是对照者（20名男性和4名女性；中位年龄24岁[95%CI，23 - 27岁]）。两组在年龄（P = 0.13）或性别（P = 0.81）方面无差异。在调整教育年限和酒精使用情况后，与对照者（中位时间88.4毫秒[95%CI，85.0 - 91.1]）相比，经常使用大麻者在图形视网膜电图结果中的N95隐含时间显著增加（中位时间98.6毫秒[95%CI，93.4 - 99.5]），差异的中位数为8.4毫秒（95%CI，4.9 - 11.5；P < 0.001，Wald逻辑回归）。曲线下面积为0.84（95%CI，0.73 - 0.95；P < 0.001）的受试者工作特征曲线分析显示，对于截断值91.13毫秒，正确将经常使用大麻者和对照者分类到相应组别的灵敏度为78.6%（95%CI，60.5% - 89.8%），特异度为75.0%（95%CI，55.1% - 88.0%）。阳性预测值为78.6%（95%CI，60.5% - 89.8%），阴性预测值为75.0%（95%CI，55.1% - 88.0%）。
我们的结果表明，经常使用大麻者的神经节细胞动作电位传递延迟，这可能支持视力改变。从公共卫生角度来看，我们的发现可能很重要，因为它们可能突出了大麻使用对中枢神经系统的神经毒性作用，这是由于其对视网膜处理的影响。
