Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
Neuropsychopharmacology. 2021 Jul;46(8):1484-1493. doi: 10.1038/s41386-021-00977-9. Epub 2021 Mar 3.
Cannabis use during adolescence is associated with an increased risk of developing psychosis. According to a current hypothesis, this results from detrimental effects of early cannabis use on brain maturation during this vulnerable period. However, studies investigating the interaction between early cannabis use and brain structural alterations hitherto reported inconclusive findings. We investigated effects of age of cannabis initiation on psychosis using data from the multicentric Personalized Prognostic Tools for Early Psychosis Management (PRONIA) and the Cannabis Induced Psychosis (CIP) studies, yielding a total sample of 102 clinically-relevant cannabis users with recent onset psychosis. GM covariance underlies shared maturational processes. Therefore, we performed source-based morphometry analysis with spatial constraints on structural brain networks showing significant alterations in schizophrenia in a previous multisite study, thus testing associations of these networks with the age of cannabis initiation and with confounding factors. Earlier cannabis initiation was associated with more severe positive symptoms in our cohort. Greater gray matter volume (GMV) in the previously identified cerebellar schizophrenia-related network had a significant association with early cannabis use, independent of several possibly confounding factors. Moreover, GMV in the cerebellar network was associated with lower volume in another network previously associated with schizophrenia, comprising the insula, superior temporal, and inferior frontal gyrus. These findings are in line with previous investigations in healthy cannabis users, and suggest that early initiation of cannabis perturbs the developmental trajectory of certain structural brain networks in a manner imparting risk for psychosis later in life.
青少年时期使用大麻与发展为精神病的风险增加有关。根据目前的假设，这是由于早期大麻使用对这段脆弱时期大脑成熟的不利影响。然而，迄今为止，研究早期大麻使用与大脑结构改变之间的相互作用的研究报告结果尚无定论。我们使用多中心个体化早期精神病管理预后工具（PRONIA）和大麻引起的精神病（CIP）研究的数据，调查了大麻使用起始年龄对精神病的影响，共纳入了 102 名有近期发病的临床相关大麻使用者。GM 协方差是共同成熟过程的基础。因此，我们对结构脑网络进行了基于源的形态测量分析，该网络对先前多地点研究中精神分裂症的结构改变进行了空间限制，从而测试了这些网络与大麻使用起始年龄和混杂因素的相关性。在我们的队列中，大麻使用起始年龄越早，阳性症状越严重。在先前确定的与小脑精神分裂症相关的网络中，更大的灰质体积（GMV）与早期大麻使用有显著关联，独立于几个可能的混杂因素。此外，小脑网络中的 GMV 与另一个以前与精神分裂症相关的网络中的体积减少有关，该网络包括岛叶、颞上回和额下回。这些发现与以前在健康大麻使用者中的研究一致，表明早期开始使用大麻会以一种增加以后生活中精神病风险的方式干扰某些结构脑网络的发育轨迹。
