Department of Geriatric Psychiatry, Diakonhjemmet Hospital, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway.
Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway.
Eur Neuropsychopharmacol. 2018 Jan;28(1):37-47. doi: 10.1016/j.euroneuro.2017.11.019. Epub 2017 Dec 15.
Cannabis is associated with increased risk for severe mental illness and is commonly used among individuals with schizophrenia or bipolar disorder. In this study we investigated associations between cannabis use and brain structures among patients with schizophrenia or bipolar disorders. Magnetic resonance imaging scans were obtained for 77 schizophrenia and 55 bipolar patients with a history of cannabis use (defined as lifetime use >10 times during one month or abuse/dependence), and 97 schizophrenia, 85 bipolar disorder patients and 277 healthy controls without any previous cannabis use. Cortical thickness, cortical surface area and subcortical volumes were compared between groups. Both hypothesis-driven region-of-interest analyses from 11 preselected brain regions in each hemisphere and exploratory point-by-point analyses were performed. We tested for diagnostic interactions and controlled for potential confounders. After controlling for confounders such as tobacco use and alcohol use disorders we found reduced cortical thickness in the caudal middle frontal gyrus compared to non-user patients and healthy controls. The findings were not significant when patients with co-morbid alcohol and illicit drug use were excluded from the analyses, but onset of cannabis use before illness onset was associated with cortical thinning in the caudal middle frontal gyrus. To conclude, we found no structural brain changes associated with cannabis use among patients with severe mental illness, but the findings indicate excess cortical thinning among those who use cannabis before illness onset. The present findings support the understanding that cannabis use is associated with limited brain effects in schizophrenia as well as bipolar disorder.
大麻与严重精神疾病的风险增加有关，并且在精神分裂症或双相情感障碍患者中普遍使用。在这项研究中，我们研究了大麻使用与精神分裂症或双相情感障碍患者大脑结构之间的关系。对 77 名精神分裂症和 55 名有大麻使用史（定义为在一个月内使用 10 次以上或滥用/依赖）的双相情感障碍患者、97 名精神分裂症、85 名双相情感障碍患者和 277 名没有任何既往大麻使用史的健康对照者进行了磁共振成像扫描。比较了各组之间的皮质厚度、皮质表面积和皮质下体积。进行了假设驱动的半球 11 个预先选定脑区的区域分析和探索性的逐点分析。我们测试了诊断的相互作用，并控制了潜在的混杂因素。在控制了烟草使用和酒精使用障碍等混杂因素后，与非使用者患者和健康对照组相比，我们发现尾侧中额回的皮质厚度降低。当将同时患有酒精和非法药物使用障碍的患者从分析中排除时，这些发现并不显著，但在疾病发病前开始使用大麻与尾侧中额回的皮质变薄有关。总之，我们没有发现严重精神疾病患者中与大麻使用相关的结构性脑变化，但这些发现表明，在疾病发病前开始使用大麻的患者皮质变薄过多。目前的研究结果支持这样一种理解，即大麻使用与精神分裂症和双相情感障碍中的大脑影响有限有关。
