Roberts-West Lucy, Baxendale Sallie
University College Hospital, London, United Kingdom.
UCL Queen Square Institute of Neurology, Department of Clinical and Experimental Epilepsy, United Kingdom.
Epilepsy Behav Rep. 2023 Oct 26;24:100630. doi: 10.1016/j.ebr.2023.100630. eCollection 2023.
Cannabis use is associated with neuropsychological impairments in the general population, but little is known about the impact on cognitive function in people with epilepsy who are already at increased risk of difficulties due to the essential comorbidities of the disease. We compared the performance of 42 people with epilepsy (PWE) who reported regular cannabis use with 254 age matched, non-cannabis-using PWE. Patients completed tests of intellectual reserve, memory, language and processing speed. Approximately one in 17 patients (5.9 %) reported current cannabis use. Cannabis use was not associated with epilepsy type. Males were 1.8 times more likely to report cannabis use compared to females. Cannabis use was associated with lower intellectual reserve (Reading IQ: t = 2.8, p < 0.01, Cohen's d = 0.49), reduced encoding of new information (List Learning: t = 3.3, p < 0.001, Cohen's d = 0.56) and enhanced susceptibility to distraction on a subsequent recall task (t = 3.07, p < 0.01, Cohen's d = 0.51. In regression models cannabis use was significantly associated with impairments in learning and recall after controlling for elevated levels of anxiety and depression. Our data indicates that recreational cannabis use in people with epilepsy amplifies deficits in new learning and enhances susceptibility to distraction in the retention of newly learnt material. Recreational cannabis use should be considered when interpreting the significance of these cognitive impairments when they are recorded in a clinical assessment.
在普通人群中,使用大麻与神经心理损伤有关,但对于已经因癫痫的基本合并症而面临认知困难风险增加的癫痫患者,大麻对其认知功能的影响却知之甚少。我们比较了42名报告经常使用大麻的癫痫患者(PWE)与254名年龄匹配、不使用大麻的PWE的表现。患者完成了智力储备、记忆、语言和处理速度测试。约每17名患者中有1名(5.9%)报告目前正在使用大麻。大麻使用与癫痫类型无关。与女性相比,男性报告使用大麻的可能性高1.8倍。大麻使用与较低的智力储备相关(阅读智商:t = 2.8,p < 0.01,科恩d值 = 0.49),新信息编码减少(列表学习:t = 3.3,p < 0.001,科恩d值 = 0.56),并且在随后的回忆任务中更容易受到干扰(t = 3.07,p < 0.01,科恩d值 = 0.51)。在回归模型中,在控制焦虑和抑郁水平升高后,大麻使用与学习和回忆障碍显著相关。我们的数据表明,癫痫患者使用消遣性大麻会加剧新学习方面的缺陷,并增加在保留新学材料时受到干扰的易感性。在临床评估中记录到这些认知障碍的重要性时,应考虑消遣性大麻的使用情况。