Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Medical University of South Carolina, Charleston, SC, USA.
Neuropsychopharmacology. 2022 Apr;47(5):1000-1028. doi: 10.1038/s41386-021-01226-9. Epub 2021 Nov 27.
Cannabis use peaks in adolescence, and adolescents may be more vulnerable to the neural effects of cannabis and cannabis-related harms due to ongoing brain development during this period. In light of ongoing cannabis policy changes, increased availability, reduced perceptions of harm, heightened interest in medicinal applications of cannabis, and drastic increases in cannabis potency, it is essential to establish an understanding of cannabis effects on the developing adolescent brain. This systematic review aims to: (1) synthesize extant literature on functional and structural neural alterations associated with cannabis use during adolescence and emerging adulthood; (2) identify gaps in the literature that critically impede our ability to accurately assess the effect of cannabis on adolescent brain function and development; and (3) provide recommendations for future research to bridge these gaps and elucidate the mechanisms underlying cannabis-related harms in adolescence and emerging adulthood, with the long-term goal of facilitating the development of improved prevention, early intervention, and treatment approaches targeting adolescent cannabis users (CU). Based on a systematic search of Medline and PsycInfo and other non-systematic sources, we identified 90 studies including 9441 adolescents and emerging adults (n = 3924 CU, n = 5517 non-CU), which provide preliminary evidence for functional and structural alterations in frontoparietal, frontolimbic, frontostriatal, and cerebellar regions among adolescent cannabis users. Larger, more rigorous studies are essential to reconcile divergent results, assess potential moderators of cannabis effects on the developing brain, disentangle risk factors for use from consequences of exposure, and elucidate the extent to which cannabis effects are reversible with abstinence. Guidelines for conducting this work are provided.
大麻的使用在青少年时期达到高峰，由于在此期间大脑仍在发育，青少年可能更容易受到大麻及其相关危害对神经的影响。鉴于正在进行的大麻政策变化、可用性增加、对大麻危害的认知降低、对大麻药用应用的兴趣增加以及大麻效力的急剧增加，了解大麻对发育中青少年大脑的影响至关重要。本系统综述旨在：（1）综合现有的关于青少年和成年早期使用大麻相关的功能和结构神经改变的文献；（2）确定文献中的空白点，这些空白点严重阻碍了我们准确评估大麻对青少年大脑功能和发育影响的能力；（3）为未来的研究提供建议，以弥合这些空白，并阐明青少年和成年早期与大麻相关的危害的机制，长期目标是促进制定针对青少年大麻使用者的改进预防、早期干预和治疗方法。基于对 Medline 和 PsycInfo 及其他非系统来源的系统搜索，我们确定了 90 项研究，其中包括 9441 名青少年和成年早期参与者（n=3924 名大麻使用者，n=5517 名非大麻使用者），这些研究为青少年大麻使用者前额顶叶、额眶额、额纹状体和小脑区域的功能和结构改变提供了初步证据。更大、更严格的研究对于调和分歧的结果、评估大麻对发育中大脑影响的潜在调节因素、理清使用的风险因素与暴露的后果以及阐明大麻影响在多大程度上可以通过戒断来逆转至关重要。提供了进行这项工作的指导方针。
