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Macedo I, Paiva TO, Pasion R, Daedelow L, Heinz A, Magalhães A, Banaschewski T, Bokde ALW, Desrivières S, Flor H, Grigis A, Garavan H, Gowland P, Brühl R, Martinot JL, Martinot MLP, Artiges E, Nees F, Orfanos DP, Paus T, Poustka L, Hohmann S, Holz N, Fröhner JH, Smolka MN, Vaidya N, Walter H, Whelan R, Schumann G, Barbosa F. Light Cannabis Use and the Adolescent Brain: An 8-years Longitudinal Assessment of Mental Health, Cognition, and Reward Processing. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06575-z. [PMID: 38532040 DOI: 10.1007/s00213-024-06575-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
RATIONALE For decades, cannabis has been the most widely used illicit substance in the world, particularly among youth. Research suggests that mental health problems associated with cannabis use may result from its effect on reward brain circuit, emotional processes, and cognition. However, findings are mostly derived from correlational studies and inconsistent, particularly in adolescents. OBJECTIVES AND METHODS Using data from the IMAGEN study, participants (non-users, persistent users, abstinent users) were classified according to their cannabis use at 19 and 22 years-old. All participants were cannabis-naïve at baseline (14 years-old). Psychopathological symptoms, cognitive performance, and brain activity while performing a Monetary Incentive Delay task were used as predictors of substance use and to analyze group differences over time. RESULTS Higher scores on conduct problems and lower on peer problems at 14 years-old (n = 318) predicted a greater likelihood of transitioning to cannabis use within 5 years. At 19 years of age, individuals who consistently engaged in low-frequency (i.e., light) cannabis use (n = 57) exhibited greater conduct problems and hyperactivity/inattention symptoms compared to non-users (n = 52) but did not differ in emotional symptoms, cognitive functioning, or brain activity during the MID task. At 22 years, those who used cannabis at both 19 and 22 years-old n = 17), but not individuals that had been abstinent for ≥ 1 month (n = 19), reported higher conduct problems than non-users (n = 17). CONCLUSIONS Impairments in reward-related brain activity and cognitive functioning do not appear to precede or succeed cannabis use (i.e., weekly, or monthly use). Cannabis-naïve adolescents with conduct problems and more socially engaged with their peers may be at a greater risk for lighter yet persistent cannabis use in the future.
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Affiliation(s)
- Inês Macedo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences (Laboratory of Neuropsychophysiology), University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
- Addiction Biology Group, i3S-Instituto de Investigação E Inovação Em Saúde, Porto, Portugal.
| | | | - Rita Pasion
- HEI-LAB, Lusófona University, Porto, Portugal
| | - Laura Daedelow
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin, Institute of Health, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin, Institute of Health, Berlin, Germany
| | - Ana Magalhães
- Addiction Biology Group, i3S-Instituto de Investigação E Inovação Em Saúde, Porto, Portugal
- Instituto de Biologia Molecular E Celular (IBMC), University of Porto, Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, UK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, 68131, Mannheim, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, 91191, Gif-Sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, 05405, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, UK
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt, Braunschweig und Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de La Santé Et de La Recherche Médicale, INSERM U 1299 Trajectoires Développementales & Psychiatrie, CNRS; EcoleNormaleSupérieure Paris-Saclay, Centre Borelli, University Paris-Saclay, Gif-Sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de La Santé Et de La Recherche Médicale, INSERM U 1299 Trajectoires Développementales & Psychiatrie, University Paris-Saclay, CNRS; Ecole Normale Supérieure Paris-Saclay, Centre Borelli; Gif-Sur-Yvette, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, and AP-HP. Sorbonne University, Paris, France
| | - Eric Artiges
- Institut National de La Santé Et de La Recherche Médicale, INSERM U 1299 Trajectoires Développementales & Psychiatrie, CNRS; EcoleNormaleSupérieure Paris-Saclay, Centre Borelli; Gif-Sur-Yvette; and Psychiatry Department, EPS Barthélémy Durand, University Paris-Saclay, Etampes, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | | | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hosptalier, Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, ON, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin, Berlin, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin, Institute of Health, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin, Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences (Laboratory of Neuropsychophysiology), University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
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2
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Beyer E, Poudel G, Antonopoulos S, Thomson H, Lorenzetti V. Brain reward function in people who use cannabis: a systematic review. Front Behav Neurosci 2024; 17:1323609. [PMID: 38379938 PMCID: PMC10877725 DOI: 10.3389/fnbeh.2023.1323609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 02/22/2024] Open
Abstract
Rationale Cannabis is one of the most widely used psychoactive substances globally. Cannabis use can be associated with alterations of reward processing, including affective flattening, apathy, anhedonia, and lower sensitivity to natural rewards in conjunction with higher sensitivity to cannabis-related rewards. Such alterations have been posited to be driven by changes in underlying brain reward pathways, as per prominent neuroscientific theories of addiction. Functional neuroimaging (fMRI) studies have examined brain reward function in cannabis users via the monetary incentive delay (MID) fMRI task; however, this evidence is yet to be systematically synthesised. Objectives We aimed to systematically integrate the evidence on brain reward function in cannabis users examined by the MID fMRI task; and in relation to metrics of cannabis exposure (e.g., dosage, frequency) and other behavioural variables. Method We pre-registered the review in PROSPERO and reported it using PRISMA guidelines. Literature searches were conducted in PsycINFO, PubMed, Medline, CINAHL, and Scopus. Results Nine studies were included, comprising 534 people with mean ages 16-to-28 years, of which 255 were people who use cannabis daily or almost daily, and 279 were controls. The fMRI literature to date led to largely non-significant group differences. A few studies reported group differences in the ventral striatum while participants anticipated rewards and losses; and in the caudate while participants received neutral outcomes. A few studies examined correlations between brain function and withdrawal, dosage, and age of onset; and reported inconsistent findings. Conclusions There is emerging but inconsistent evidence of altered brain reward function in cannabis users examined with the MID fMRI task. Future fMRI studies are required to confirm if the brain reward system is altered in vulnerable cannabis users who experience a Cannabis Use Disorder, as postulated by prominent neuroscientific theories of addiction.
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Affiliation(s)
- Emillie Beyer
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Braincast Neurotechnologies, Melbourne, VIC, Australia
| | - Stephanie Antonopoulos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Hannah Thomson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Demidenko MI, Mumford JA, Ram N, Poldrack RA. A multi-sample evaluation of the measurement structure and function of the modified monetary incentive delay task in adolescents. Dev Cogn Neurosci 2024; 65:101337. [PMID: 38160517 PMCID: PMC10801229 DOI: 10.1016/j.dcn.2023.101337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/11/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
Interpreting the neural response elicited during task functional magnetic resonance imaging (fMRI) remains a challenge in neurodevelopmental research. The monetary incentive delay (MID) task is an fMRI reward processing task that is extensively used in the literature. However, modern psychometric tools have not been used to evaluate measurement properties of the MID task fMRI data. The current study uses data for a similar task design across three adolescent samples (N = 346 [Agemean 12.0; 44 % Female]; N = 97 [19.3; 58 %]; N = 112 [20.2; 38 %]) to evaluate multiple measurement properties of fMRI responses on the MID task. Confirmatory factor analysis (CFA) is used to evaluate an a priori theoretical model for the task and its measurement invariance across three samples. Exploratory factor analysis (EFA) is used to identify the data-driven measurement structure across the samples. CFA results suggest that the a priori model is a poor representation of these MID task fMRI data. Across the samples, the data-driven EFA models consistently identify a six-to-seven factor structure with run and bilateral brain region factors. This factor structure is moderately-to-highly congruent across the samples. Altogether, these findings demonstrate a need to evaluate theoretical frameworks for popular fMRI task designs to improve our understanding and interpretation of brain-behavior associations.
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Affiliation(s)
| | | | - Nilam Ram
- Department of Psychology, Stanford University, Stanford, United States
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Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Psychiatr Clin North Am 2023; 46:655-676. [PMID: 37879830 DOI: 10.1016/j.psc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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Chaplin TM, Curby TW, Gonçalves SF, Kisner MA, Niehaus CE, Thompson JC. Sex Differences in Emotion- and Reward-Related Neural Responses Predicting Increases in Substance Use in Adolescence. Behav Brain Res 2023; 450:114499. [PMID: 37201893 DOI: 10.1016/j.bbr.2023.114499] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023]
Abstract
Adolescent substance use is a significant public health problem and there is a need for effective substance use preventions. To develop effective preventions, it is important to identify neurobiological risk factors that predict increases in substance use in adolescence and to understand potential sex differences in risk mechanisms. The present study used functional magnetic resonance imaging and hierarchical linear modeling to examine negative emotion- and reward-related neural responses in early adolescence predicting growth in substance use to middle adolescence in 81 youth, by sex. Adolescent neural responses to negative emotional stimuli and monetary reward receipt were assessed at age 12-14. Adolescents reported on substance use at age 12-14 and at 6 month, and 1, 2, and 3 year follow-ups. Adolescent neural responses did not predict initiation of substance use (yes/no), but, among users, neural responses predicted growth in substance use frequency. For girls, heightened right amygdala responses to negative emotional stimuli in early adolescence predicted growth in substance use frequency through middle adolescence. For boys, blunted left nucleus accumbens and bilateral ventromedial prefrontal cortex responses to monetary reward predicted growth in substance use frequency. Findings suggest different emotion and reward-related predictors of the development of substance use for adolescent girls versus boys.
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Affiliation(s)
- Tara M Chaplin
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030.
| | - Timothy W Curby
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030.
| | - Stefanie F Gonçalves
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030.
| | - Mallory A Kisner
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030.
| | - Claire E Niehaus
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030; Department of Pediatrics, University of Louisville, 571 S Floyd Street, Louisville, KY 40202.
| | - James C Thompson
- Department of Psychology, George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030.
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Skumlien M, Mokrysz C, Freeman TP, Valton V, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Giugliano M, Clisu D, Langley C, Sahakian BJ, Curran HV, Lawn W. Anhedonia, Apathy, Pleasure, and Effort-Based Decision-Making in Adult and Adolescent Cannabis Users and Controls. Int J Neuropsychopharmacol 2023; 26:9-19. [PMID: 35999024 PMCID: PMC9850660 DOI: 10.1093/ijnp/pyac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cannabis use may be linked with anhedonia and apathy. However, previous studies have shown mixed results, and few have examined the association between cannabis use and specific reward sub-processes. Adolescents may be more vulnerable than adults to harmful effects of cannabis. This study investigated (1) the association between non-acute cannabis use and apathy, anhedonia, pleasure, and effort-based decision-making for reward; and (2) whether these relationships were moderated by age group. METHODS We used data from the "CannTeen" study. Participants were 274 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 d/wk use in the past 3 months) and gender- and age-matched controls. Anhedonia was measured with the Snaith-Hamilton Pleasure Scale (n = 274), and apathy was measured with the Apathy Evaluation Scale (n = 215). Effort-based decision-making for reward was measured with the Physical Effort task (n = 139), and subjective wanting and liking of rewards was measured with the novel Real Reward Pleasure task (n = 137). RESULTS Controls had higher levels of anhedonia than cannabis users (F1,258 = 5.35, P = .02, η p2 = .02). There were no other significant effects of user-group and no significant user-group*age-group interactions. Null findings were supported by post hoc Bayesian analyses. CONCLUSION Our results suggest that cannabis use at a frequency of 3 to 4 d/wk is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents. Cannabis users had lower anhedonia than controls, albeit at a small effect size. These findings are not consistent with the hypothesis that non-acute cannabis use is associated with amotivation.
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Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Vincent Valton
- Institute of Cognitive Neuroscience, Division of Psychology and Language Sciences, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | | | - Rachel Lees
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Manuela Giugliano
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Denisa Clisu
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
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7
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Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Child Adolesc Psychiatr Clin N Am 2023; 32:21-42. [PMID: 36410904 DOI: 10.1016/j.chc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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8
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Skumlien M, Mokrysz C, Freeman TP, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Carson J, Coughlan T, Ofori S, Langley C, Sahakian BJ, Curran HV, Lawn W. Neural responses to reward anticipation and feedback in adult and adolescent cannabis users and controls. Neuropsychopharmacology 2022; 47:1976-1983. [PMID: 35388175 PMCID: PMC9485226 DOI: 10.1038/s41386-022-01316-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022]
Abstract
Chronic use of drugs may alter the brain's reward system, though the extant literature concerning long-term cannabis use and neural correlates of reward processing has shown mixed results. Adolescents may be more vulnerable to the adverse effects of cannabis than adults; however, this has not been investigated for reward processing. As part of the 'CannTeen' study, in the largest functional magnetic resonance imaging study of reward processing and cannabis use to date, we investigated reward anticipation and feedback in 125 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 days/week cannabis use) and gender- and age-matched controls, using the Monetary Incentive Delay task. Blood-oxygen-level-dependent responses were examined using region of interest (ROI) analyses in the bilateral ventral striatum for reward anticipation and right ventral striatum and left ventromedial prefrontal cortex for feedback, and exploratory whole-brain analyses. Results showed no User-Group or User-Group × Age-Group effects during reward anticipation or feedback in pre-defined ROIs. These null findings were supported by post hoc Bayesian analyses. However, in the whole-brain analysis, cannabis users had greater feedback activity in the prefrontal and inferior parietal cortex compared to controls. In conclusion, cannabis users and controls had similar neural responses during reward anticipation and in hypothesised reward-related regions during reward feedback. The whole-brain analysis revealed tentative evidence of greater fronto-parietal activity in cannabis users during feedback. Adolescents showed no increased vulnerability compared with adults. Overall, reward anticipation and feedback processing appear spared in adolescent and adult cannabis users, but future longitudinal studies are needed to corroborate this.
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Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK.
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Invicro, London, UK
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | | | - Rachel Lees
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - James Carson
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Tiernan Coughlan
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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9
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Gonçalves SF, Ryan M, Niehaus CE, Chaplin TM. Affect-Related Brain Activity and Adolescent Substance Use: A Systematic Review. Curr Behav Neurosci Rep 2022; 9:11-26. [PMID: 37009067 PMCID: PMC10062006 DOI: 10.1007/s40473-021-00241-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
Purpose of review This review aims to summarize the research on brain activity during affective processing (i.e., reward, negative emotional stimuli, loss) and adolescent substance use (SU). Recent findings Most research revealed links between altered neural activity in midcingulo-insular, frontoparietal and other network regions and adolescent SU. Increased recruitment of midcingulo-insular regions-particularly the striatum-to positive affective stimuli (e.g., monetary reward) was most often associated with initiation and low-level use of substances, whereas decreased recruitment of these regions was most often associated with SUD and higher risk SU. In regards to negative affective stimuli, most research demonstrated increased recruitment of midcingulo-insular network regions. There is also evidence that these associations may be sex-specific. Summary Future research should employ longitudinal designs that assess affect-related brain activity prior to and following SU initiation and escalation. Moreover, examining sex as as moderating variable may help clarify if affective neural risk factors are sex-specific.
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Affiliation(s)
- Stefanie F. Gonçalves
- Department of Psychology, George Mason University,
Fairfax, Virginia, 22030, United States
| | - Mary Ryan
- Department of Psychology, George Mason University,
Fairfax, Virginia, 22030, United States
| | - Claire E. Niehaus
- Department of Psychology, George Mason University,
Fairfax, Virginia, 22030, United States
| | - Tara M. Chaplin
- Department of Psychology, George Mason University,
Fairfax, Virginia, 22030, United States
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10
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The Effects of Alcohol and Cannabis Co-Use on Neurocognitive Function, Brain Structure, and Brain Function. Curr Behav Neurosci Rep 2021; 8:134-149. [PMID: 36908333 PMCID: PMC9997650 DOI: 10.1007/s40473-021-00243-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose of review Given increases in the rates of alcohol and cannabis co-use among adolescents and young adults, this review aims to summarize literature on the effects of alcohol and cannabis co-use on neurocognitive functioning, brain structure, and brain function. Recent findings The limited existing studies examining concurrent, recent, and lifetime alcohol and cannabis co-use suggest effects on the brain are likely multifaceted. The majority of studies report that co-use is associated with negative outcomes such as impaired cognitive function and significant alterations in key structural and functional regions of the brain, while others report null effects of co-use compared to non-substance using control and single-substance use groups. Summary Current studies lack a general consensus on methodology, definitions of concurrent and simultaneous use, and neuroimaging approaches, which makes it challenging to draw strong conclusions about the effects of co-use. More studies are needed to explore the effects of co-use in the context of simultaneous alcohol and cannabis use.
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11
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Skumlien M, Langley C, Lawn W, Voon V, Curran HV, Roiser JP, Sahakian BJ. The acute and non-acute effects of cannabis on reward processing: A systematic review. Neurosci Biobehav Rev 2021; 130:512-528. [PMID: 34509513 DOI: 10.1016/j.neubiorev.2021.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/11/2021] [Accepted: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Cannabis use has historically been thought to cause amotivation, but the relationship between cannabis and apathy, anhedonia, and reward processing remains poorly characterised. In this systematic review, we evaluated whether cannabis exposure acutely and/or non-acutely was associated with altered reward processing using questionnaire, behavioural, or functional neuroimaging measures. Questionnaire studies demonstrated greater anhedonia in adolescent cannabis users, and some indication of greater apathy in young adult cannabis users. Behavioural studies yielded some evidence of reduced reward learning in adolescent cannabis users, though there were too few studies in this category for reliable conclusions. Finally, longitudinal and acute functional neuroimaging studies showed an association between cannabis and blunted neural responses to reward, which did not emerge consistently in cross-sectional studies. The current results suggest that cannabis use is associated with specific impairments in reward and motivation. Future large-scale, longitudinal studies which use multiple behavioural and neuroimaging measures of reward processing may further clarify the impact of cannabis use on motivational and reward processes, and neural networks.
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Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | | | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
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12
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Metzak PD, Addington J, Hassel S, Goldstein BI, MacIntosh BJ, Lebel C, Wang JL, Kennedy SH, MacQueen GM, Bray S. Functional imaging in youth at risk for transdiagnostic serious mental illness: Initial results from the PROCAN study. Early Interv Psychiatry 2021; 15:1276-1291. [PMID: 33295151 DOI: 10.1111/eip.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/29/2020] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND In their early stages, serious mental illnesses (SMIs) are often indistinguishable from one another, suggesting that studying alterations in brain activity in a transdiagnostic fashion could help to understand the neurophysiological origins of different SMI. The purpose of this study was to examine brain activity in youth at varying stages of risk for SMI using functional magnetic resonance imaging tasks (fMRI) that engage brain systems believed to be affected. METHODS Two hundred and forty three participants at different stages of risk for SMI were recruited to the Canadian Psychiatric Risk and Outcome (PROCAN) study, however only 179 were scanned. Stages included asymptomatic participants at no elevated risk, asymptomatic participants at elevated risk due to family history, participants with undifferentiated general symptoms of mental illness, and those experiencing attenuated versions of diagnosable psychiatric illnesses. The fMRI tasks included: (1) a monetary incentive delay task; (2) an emotional Go-NoGo and (3) an n-back working memory task. RESULTS Strong main effects with each of the tasks were found in brain regions previously described in the literature. However, there were no significant differences in brain activity between any of the stages of risk for SMI for any of the task contrasts, after accounting for site, sex and age. Furthermore, results indicated no significant differences even when participants were dichotomized as asymptomatic or symptomatic. CONCLUSIONS These results suggest that univariate BOLD responses during typical fMRI tasks are not sensitive markers of SMI risk and that further study, particularly longitudinal designs, will be necessary to understand brain changes underlying the early stages of SMI.
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Affiliation(s)
- Paul D Metzak
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean Addington
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Stefanie Hassel
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Benjamin I Goldstein
- Center for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Jian Li Wang
- Work & Mental Health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada.,Arthur Somner Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Signe Bray
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
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13
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Fish S, Christidi F, Karavasilis E, Velonakis G, Kelekis N, Klein C, Stefanis NC, Smyrnis N. Interaction of schizophrenia and chronic cannabis use on reward anticipation sensitivity. NPJ SCHIZOPHRENIA 2021; 7:33. [PMID: 34135344 PMCID: PMC8209034 DOI: 10.1038/s41537-021-00163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/28/2021] [Indexed: 11/09/2022]
Abstract
Chronic cannabis use and schizophrenia are both thought to affect reward processing. While behavioural and neural effects on reward processing have been investigated in both conditions, their interaction has not been studied, although chronic cannabis use is common among these patients. In the present study eighty-nine participants divided into four groups (control chronic cannabis users and non-users; schizophrenia patient cannabis users and non-users) performed a two-choice decision task, preceded by monetary cues (high/low reward/punishment or neutral), while being scanned using functional magnetic resonance imaging. Reward and punishment anticipation resulted in activation of regions of interest including the thalamus, striatum, amygdala and insula. Chronic cannabis use and schizophrenia had opposing effects on reward anticipation sensitivity. More specifically control users and patient non-users showed faster behavioural responses and increased activity in anterior/posterior insula for high magnitude cues compared to control non-users and patient users. The same interaction pattern was observed in the activation of the right thalamus for reward versus punishment cues. This study provided evidence for interaction of chronic cannabis use and schizophrenia on reward processing and highlights the need for future research addressing the significance of this interaction for the pathophysiology of these conditions and its clinical consequences.
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Affiliation(s)
- Simon Fish
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece.,1st Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens, Greece
| | - Foteini Christidi
- Department of Medical Physics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Efstratios Karavasilis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Nikolaos Kelekis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Christoph Klein
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Freiburg, Germany.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nicholas C Stefanis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens, Greece
| | - Nikolaos Smyrnis
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece. .,2nd Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece.
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14
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Subtypes of inhibitory and reward activation associated with substance use variation in adolescence: A latent profile analysis of brain imaging data. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1101-1114. [PMID: 33973159 DOI: 10.3758/s13415-021-00907-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/08/2022]
Abstract
The present study identified subgroups based on inhibitory and reward activation, two key neural functions involved in risk-taking behavior, and then tested the extent to which subgroup differences varied by age, sex, behavioral and familial risk, and substance use. Participants were 145 young adults (18-21 years old; 40.0% female) from the Michigan Longitudinal Study. Latent profile analysis (LPA) was used to establish subgroups using task-based brain activations. Demographic and substance use differences between subgroups were then examined in logistic regression analyses. Whole-brain task activations during a functional magnetic resonance imaging go/no-go task and monetary incentive delay task were used to identify beta weights as input for LPA modeling. A four-class model showed the best fit with the data. Subgroups were categorized as: (1) low inhibitory activation/moderate reward activation (39.7%), (2) moderate inhibitory activation/low reward activation (22.7%), (3) moderate inhibitory activation/high reward activation (25.2%), and (4) high inhibitory activation/high reward activation (12.4%). Compared with the other subgroups, Class 2 was older, less likely to have parental alcohol use disorder, and had less alcohol use. Class 4 was the youngest and had greater marijuana use. Classes 1 and 3 did not differ significantly from the other subgroups. These findings demonstrate that LPA applied to brain activations can be used to identify distinct neural profiles that may explain heterogeneity in substance use outcomes and may inform more targeted substance use prevention and intervention efforts.
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15
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Demidenko MI, Weigard AS, Ganesan K, Jang H, Jahn A, Huntley ED, Keating DP. Interactions between methodological and interindividual variability: How Monetary Incentive Delay (MID) task contrast maps vary and impact associations with behavior. Brain Behav 2021; 11:e02093. [PMID: 33750042 PMCID: PMC8119872 DOI: 10.1002/brb3.2093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Phenomena related to reward responsiveness have been extensively studied in their associations with substance use and socioemotional functioning. One important task in this literature is the Monetary Incentive Delay (MID) task. By cueing and delivering performance-contingent reward, the MID task has been demonstrated to elicit robust activation of neural circuits involved in different phases of reward responsiveness. However, systematic evaluations of common MID task contrasts have been limited to between-study comparisons of group-level activation maps, limiting their ability to directly evaluate how researchers' choice of contrasts impacts conclusions about individual differences in reward responsiveness or brain-behavior associations. METHODS In a sample of 104 participants (Age Mean = 19.3, SD = 1.3), we evaluate similarities and differences between contrasts in: group- and individual-level activation maps using Jaccard's similarity index, region of interest (ROI) mean signal intensities using Pearson's r, and associations between ROI mean signal intensity and psychological measures using Bayesian correlation. RESULTS Our findings demonstrate more similarities than differences between win and loss cues during the anticipation contrast, dissimilarity between some win anticipation contrasts, an apparent deactivation effect in the outcome phase, likely stemming from the blood oxygen level-dependent undershoot, and behavioral associations that are less robust than previously reported. CONCLUSION Consistent with recent empirical findings, this work has practical implications for helping researchers interpret prior MID studies and make more informed a priori decisions about how their contrast choices may modify results.
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Affiliation(s)
| | - Alexander S Weigard
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.,Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Hyesue Jang
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Jahn
- The Functional MRI Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Edward D Huntley
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Daniel P Keating
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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16
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Morie KP, Potenza MN. A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory. Front Psychiatry 2021; 12:657371. [PMID: 33967859 PMCID: PMC8100188 DOI: 10.3389/fpsyt.2021.657371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 01/26/2023] Open
Abstract
Cannabis is commonly used, and use may be increasing in the setting of increasing legalization and social acceptance. The scope of the effects of cannabis products, including varieties with higher or lower levels of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD), on domains related to addictive behavior deserves attention, particularly as legalization continues. Cannabis use may impact neural underpinnings of cognitive functions linked to propensities to engage in addictive behaviors. Here we consider these neurocognitive processes within the framework of the dual-process model of addictions. In this mini-review, we describe data on the relationships between two main constituents of cannabis (THC and CBD) and neural correlates of reward processing, inhibitory control and working memory.
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Affiliation(s)
- Kristen P. Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
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17
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Hammond CJ, Wu J, Krishnan-Sarin S, Mayes LC, Potenza MN, Crowley MJ. Co-occurring tobacco and cannabis use in adolescents: Dissociable relationships with mediofrontal electrocortical activity during reward feedback processing. Neuroimage Clin 2021; 30:102592. [PMID: 33667977 PMCID: PMC7932890 DOI: 10.1016/j.nicl.2021.102592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/11/2020] [Accepted: 02/05/2021] [Indexed: 12/01/2022]
Abstract
Differences in corticostriatal neural activity during feedback processing of rewards and losses have been separately related to cannabis and tobacco use but remain understudied relative to co-use in adolescents. Using high-density EEG (128 electrode system, 1000 Hz sampling), we examined event-related potentials (ERPs) elicited by monetary reward, neutral, and loss feedback during performance on a non-learning four-choice guessing task in a sample of non-deprived daily-cigarette-smoking adolescents (n = 36) who used tobacco and cannabis regularly (TC adolescents), and non-smoking healthy control adolescents (HCs) (n = 29). Peak amplitudes and latencies of mediofrontal ERPs indexing feedback-related negativities (FRNs) were used as outcomes in repeated-measures ANOVAs. No differences in FRNs were observed between TC and HC adolescents. Within TC adolescents, cannabis-use and tobacco-use variables had distinct relationships with the FRN, with cannabis-related problem severity being positively correlated with FRN amplitude during reward feedback and tobacco-related problem severity being negatively correlated with FRN latency during non-loss feedback (i.e., reward and neutral). These findings suggest that co-occurring cannabis and tobacco use may have dissociable relationships with feedback processing relating to each drug and support an incentive salience model of addiction severity related to cannabis use in adolescents.
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Affiliation(s)
- Christopher J Hammond
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
| | - Jia Wu
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | | | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neuroscience, Yale University, New Haven, CT, United States; Connecticut Council on Problem Gambling, Wethersfield, CT, United States; Connecticut Mental Health Center, New Haven, CT, United States
| | - Michael J Crowley
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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18
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Hernandez Mejia M, Wade NE, Baca R, Diaz VG, Jacobus J. The Influence of Cannabis and Nicotine Co-use on Neuromaturation: A Systematic Review of Adolescent and Young Adult Studies. Biol Psychiatry 2021; 89:162-171. [PMID: 33334432 PMCID: PMC7749265 DOI: 10.1016/j.biopsych.2020.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that the use of cannabis and nicotine and tobacco-related products (NTPs) during the adolescent years has harmful effects on the developing brain. Yet, few studies have focused on the developing brain as it relates to the co-administration of cannabis and NTPs, despite the high prevalence rates of co-use in adolescence. This review aims to synthesize the existing literature on neurocognitive, structural neuroimaging, and functional neuroimaging outcomes associated with cannabis and NTP co-use. A systematic search of peer-reviewed articles resulted in a pool of 1107 articles. Inclusion criteria were 1) data-based study; 2) age range of 13 to 35 years or, for preclinical studies, nonadult subjects; 3) cannabis and NTP group jointly considered; and 4) neurocognitive, structural neuroimaging, or functional neuroimaging as an outcome measure. Twelve studies met inclusion criteria. Consistent with the literature, cannabis and nicotine were found to have independent effects on cognition. The available research on the co-use of cannabis and NTPs demonstrates a potential nicotine-related masking effect on cognitive deficits associated with cannabis use, yet there is little research on co-use and associations with neuroimaging indices. In neuroimaging studies, there is preliminary evidence for hippocampal volume differences in co-users and a lack of evidence for co-use differences related to nucleus accumbens activity during reward processing. Notably, no structural neuroimaging studies were found to examine the combined effects of nicotine and cannabis in adolescent-only populations. Further research, including longitudinal studies, is warranted to investigate the influence of cannabis and NTP co-use on maturation.
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Affiliation(s)
- Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California
| | - Natasha E Wade
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Vanessa G Diaz
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, San Diego, California.
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19
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Allick A, Park G, Kim K, Vintimilla M, Rathod K, Lebo R, Nanavati J, Hammond CJ. Age- and Sex-Related Cortical Gray Matter Volume Differences in Adolescent Cannabis Users: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies. Front Psychiatry 2021; 12:745193. [PMID: 34925090 PMCID: PMC8671465 DOI: 10.3389/fpsyt.2021.745193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Adolescent-onset cannabis use is rising in the era of marijuana legalization. Recent imaging studies have identified neuroanatomical differences between adult cannabis users and controls that are more prominent in early-onset users. Other studies point to sex-dependent effects of cannabis. Methods: A systematic review following PRISMA guidelines and subsequent effect-size seed-based d mapping (SDM) meta-analyses were conducted to investigate relationships between age (across the 12-to-21-year-old developmental window), sex, and gray matter volume (GMV) differences between cannabis using (CU) and typically developing (TD) youth. Results: Our search identified 1,326 citations, 24 of which were included in a qualitative analysis. A total of 6 whole-brain voxel-based morphometry (VBM) studies comparing regional GMV between 357 CU [mean (SD) age = 16.68 (1.28); 71% male] and 404 TD [mean (SD) age = 16.77 (1.36); 63% male] youth were included in the SDM-meta-analysis. Meta-analysis of whole-brain VBM studies identified no regions showing significant GMV difference between CU and TD youth. Meta-regressions showed divergent effects of age and sex on cortical GMV differences in CU vs. TD youth. Age effects were seen in the superior temporal gyrus (STG), with older-aged CU youth showing decreased and younger-aged CU youth showing increased STG GMV compared to age-matched TD youth. Parallel findings in the STG were also observed in relation to duration of CU (years) in supplemental meta-regressions. Regarding sex effects, a higher proportion of females in studies was associated with increased GMV in the middle occipital gyrus in CU vs. TD youth. Conclusions: These findings suggest that GMV differences between CU and TD youth, if present, are subtle, and may vary as a function of age, cumulative cannabis exposure, and sex in young people. Whether age- and sex-related GMV differences are attributable to common predispositional factors, cannabis-induced neuroadaptive changes, or both warrant further investigation.
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Affiliation(s)
- Aliyah Allick
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Grace Park
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kwon Kim
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michelle Vintimilla
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Krutika Rathod
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rachael Lebo
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,I.D. Weeks Library, Health Sciences Department, University of South Dakota, Vermillion, SD, United States
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christopher J Hammond
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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20
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Hamidullah S, Thorpe HHA, Frie JA, Mccurdy RD, Khokhar JY. Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates. Front Hum Neurosci 2020; 14:298. [PMID: 32848673 PMCID: PMC7418456 DOI: 10.3389/fnhum.2020.00298] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/03/2020] [Indexed: 12/11/2022] Open
Abstract
Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.
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Affiliation(s)
| | - Hayley H A Thorpe
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Richard D Mccurdy
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
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21
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Tong TT, Vaidya JG, Kramer JR, Kuperman S, Langbehn DR, O’Leary DS. Behavioral inhibition and reward processing in college binge drinkers with and without marijuana use. Drug Alcohol Depend 2020; 213:108119. [PMID: 32599494 PMCID: PMC7736054 DOI: 10.1016/j.drugalcdep.2020.108119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 12/22/2022]
Abstract
AIM Binge drinking is common during college, and studies have shown that many college students drink in quantities that far exceed the standard binge drinking threshold. Previous research has noted personality differences in individuals who engage in binge drinking, but few studies have examined neurobiological differences in both standard bingers (4/5 drinks in two hours for females/males; sBinge) and extreme binge drinkers (8+/10+ drinks in two hours for females/males; eBinge). METHOD The current study of 221 college students used functional magnetic resonance imaging (fMRI) to study neural activation on a stop signal task (SST) to assess behavioral inhibition and a monetary incentive delay (MID) task to assess activation to rewards and losses. Non-bingeing controls, sBinge, and eBinge freshmen and sophomores were recruited. In addition, because binge/extreme binge drinking is often associated with marijuana (MJ) use, MJ + sBinge and MJ + eBinge groups were also included. RESULTS All five groups showed strong activation in expected key cortical and striatal regions on both the SST and the MID. However, there were no significant differences between groups either at the whole-brain level or in specific regions of interest. Behavioral performance on the fMRI tasks also did not differ between groups. CONCLUSIONS These results suggest that our sample of individuals who engage in binge or extreme binge drinking with or without MJ co-use do not differ in brain activity on reward and inhibitory tasks. Neural differences may be present on other cognitive tasks or may emerge later after more sustained use of alcohol, MJ, and other drugs.
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Affiliation(s)
- Tien T. Tong
- Interdisciplinary Graduate Program in Neuroscience, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA
| | - Jatin G. Vaidya
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA
| | - John R. Kramer
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA
| | - Samuel Kuperman
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA.
| | - Douglas R. Langbehn
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA
| | - Daniel S. O’Leary
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, USA
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22
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Associations of Cannabis- and Tobacco-Related Problem Severity with Reward and Punishment Sensitivity and Impulsivity in Adolescent Daily Cigarette Smokers. Int J Ment Health Addict 2020; 19:1963-1979. [DOI: 10.1007/s11469-020-00292-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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23
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Neural correlates of delay discount alterations in addiction and psychiatric disorders: A systematic review of magnetic resonance imaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109822. [PMID: 31751662 DOI: 10.1016/j.pnpbp.2019.109822] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/05/2019] [Accepted: 11/14/2019] [Indexed: 12/20/2022]
Abstract
Delay discounting (DD) represents decreased subjective value for delayed reward relative to the same reward at present. The concept of DD has been applied for pathophysiology of addiction and psychiatric disorders. However, the detailed neuroimaging correlates of DD underlying pathophysiology still remain unclear. Thus, we conducted a systematic review to investigate neural correlates of DD on magnetic resonance imaging studies among addiction and psychiatric disorders. Specific search terms were set on PubMed to identify relevant articles. Initial search identified 551 records and 31 studies met the inclusion criteria. The present review revealed that greater DD was correlated with increased activity in areas related to reward evaluation and prediction as well as decreased activity in areas related to cognitive control. Healthy controls showed smaller changes in activities of these areas associated with DD when compared to patient groups. As the neural basis related to DD, three neural networks have been proposed that are associated with the actions of short-term interests and long-term benefits. Among the three potential neural networks on DD, the first one included the ventromedial prefrontal cortex and ventral striatum and implicated in evaluating reward values, the second network included the anterior cingulate cortex and linked to cognitive control, and the third network included the middle temporal gyrus and was involved in predictions and affection. This review generated consistent findings on the neural basis of DD among patients with addiction and psychiatric disorders, which may represent the pathophysiology related to DD and impulsivity of mental illness.
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Aloi J, Blair KS, Crum KI, Bashford-Largo J, Zhang R, Lukoff J, Carollo E, White SF, Hwang S, Filbey FM, Dobbertin M, Blair RJR. Alcohol Use Disorder, But Not Cannabis Use Disorder, Symptomatology in Adolescents Is Associated With Reduced Differential Responsiveness to Reward Versus Punishment Feedback During Instrumental Learning. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:610-618. [PMID: 32299790 DOI: 10.1016/j.bpsc.2020.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The two most commonly used illegal substances by adolescents in the United States are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with dysfunction in decision-making processes in adolescents. One potential mechanism for these impairments is thought to be related to abnormalities in reward and punishment processing. However, very little work has directly examined potential differential relationships between AUD and CUD symptom severity and neural dysfunction during decision making in adolescents. METHODS In the current study, 154 youths participated in a passive avoidance learning task during functional magnetic resonance imaging to investigate the relationship between relative severity of AUD/CUD and dysfunction in processing reward and punishment feedback. RESULTS Increasing Alcohol Use Disorder Identification Test scores were associated with reduced neural differentiation between reward and punishment feedback within regions of striatum, posterior cingulate cortex, and parietal cortex. However, increasing Cannabis Use Disorder Identification Test scores were not associated with any neural dysfunction during the passive avoidance task. CONCLUSIONS These data expand on emerging literature that relative severity of AUD is associated with reduced responsivity to rewards in adolescents and that there are differential associations between AUD and CUD symptoms and neurocircuitry dysfunction in the developing adolescent brain.
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Affiliation(s)
- Joseph Aloi
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska; MD/PhD Scholars Program, University of Nebraska Medical Center, Omaha, Nebraska.
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Kathleen I Crum
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Erin Carollo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Stuart F White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - R James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
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25
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Thayer RE, Hansen NS, Prashad S, Karoly HC, Filbey FM, Bryan AD, Feldstein Ewing SW. Recent tobacco use has widespread associations with adolescent white matter microstructure. Addict Behav 2020; 101:106152. [PMID: 31639638 DOI: 10.1016/j.addbeh.2019.106152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 09/01/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
IMPORTANCE Given the prevalence of alcohol, cannabis, and tobacco use during adolescence, it is important to explore the relative relationship of these three substances with brain structure. OBJECTIVE To determine associations between recent alcohol, cannabis, and tobacco use and white and gray matter in a large sample of adolescents. DESIGN, SETTING, AND PARTICIPANTS MRI data were collected in N = 200 adolescents ages 14-18 (M = 15.82 years; 67% male; 61% Hispanic/Latino). On average, during the past month, participants reported consuming 2.05 drinks per 1.01 drinking day, 0.64 g per 6.98 cannabis use days, and 2.49 cigarettes per 12.32 smoking days. MAIN OUTCOMES AND MEASURES General linear models were utilized to examine past 30-day average quantities of alcohol, cannabis, and tobacco use, age, sex, and sex by substance interactions in skeletonized white matter (fractional anisotropy and axial, radial, and mean diffusivity) and voxel-based morphometry of gray matter (volume/density). RESULTS Tobacco use was negatively associated with white matter integrity (radial and mean diffusivity) with peak effects in inferior and superior longitudinal fasciculi. Cannabis use was negatively associated with white matter integrity (axial diffusivity) in a small cluster in the left superior longitudinal fasciculus. No associations were observed between recent alcohol use and white or gray matter overall, but interactions showed significant negative associations between alcohol use and white matter in females. CONCLUSIONS AND RELEVANCE It is important to note that recent tobacco use, particularly given the popularity of e-tobacco/vaping in this age group, had widespread associations with brain structure in this sample of adolescents.
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Karoly HC, Ross JM, Ellingson JM, Feldstein Ewing SW. Exploring Cannabis and Alcohol Co-Use in Adolescents: A Narrative Review of the Evidence. J Dual Diagn 2020; 16:58-74. [PMID: 31519143 PMCID: PMC7007306 DOI: 10.1080/15504263.2019.1660020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Amidst the evolving policy surrounding cannabis legalization in the United States, cannabis use is becoming increasingly prevalent as perceptions of harm decrease, particularly among adolescents. Cannabis and alcohol are commonly used by adolescents and are often used together. However, developmental research has historically taken a "single substance" approach to examine the association of substance use and adolescent brain and behavior rather than examining co-(or poly-substance) use of multiple substances, such as cannabis and alcohol. Thus, the acute effects of cannabis and alcohol, and the impact of co-use of cannabis and alcohol on the adolescent brain, cognitive function and subsequent psychosocial outcomes remains understudied. This narrative review aims to examine the effects of cannabis and alcohol on adolescents across a number of behavioral and neurobiological outcomes. Methods: The PubMed and Google Scholar databases were searched for the last 10 years to identify articles reporting on acute effects of cannabis and alcohol administration, and the effects of cannabis and alcohol on neuropsychological, neurodevelopmental, neural (e.g., structural and functional neuroimaging), and psychosocial outcomes in adolescents. When adolescent data were not available, adult studies were included as support for potential areas of future direction in adolescent work. Results: Current studies of the impact of cannabis and alcohol on adolescent brain and behavior have yielded a complicated pattern. Some suggest that the use of cannabis in addition to alcohol during adolescence may have a "protective" effect, yielding neuropsychological and structural brain outcomes that are better than those for adolescents who use only alcohol. However, other adolescent studies suggest that cannabis and alcohol co-use is associated with negative health and social outcomes such as poorer academic performance and impaired driving. Conclusion: Variation in study methodologies, policy-level limitations and our limited understanding of the developmental neurobiological effects of cannabis preclude the straightforward interpretation of the existing data on adolescent cannabis and alcohol use. Further research on this topic is requisite to inform the development of effective intervention and prevention programs for adolescent substance users, which hinge on a more comprehensive understanding of how cannabis-and its intersection with alcohol-impacts the developing brain and behavior.
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Affiliation(s)
- Hollis C Karoly
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - J Megan Ross
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Jarrod M Ellingson
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sarah W Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
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27
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Abstract
Objective: Shifting policies and widespread acceptance of cannabis for medical and/or recreational purposes have fueled worries of increased cannabis initiation and use in adolescents. In particular, the adolescent period is thought to be associated with an increased susceptibility to the potential harms of repeated cannabis use, due to being a critical period for neuromaturational events in the brain. This review investigates the neuroimaging evidence of brain harms attributable to adolescent cannabis use. Methods: PubMed and Scopus searches were conducted for empirical articles that examined neuroimaging effects in both adolescent cannabis users and adult user studies that explored the effect of age at cannabis use onset on the brain. Results: We found 43 studies that examined brain effect (structural and functional magnetic resonance imaging) in adolescent cannabis users and 20 that examined the link between onset age of cannabis use and brain effects in adult users. Studies on adolescent cannabis users relative to nonusers mainly implicate frontal and parietal regions and associated brain activation in relation to inhibitory control, reward, and memory. However, studies in adults are more mixed, many of which did not observe an effect of onset age of cannabis use on brain imaging metrics. Conclusions: While there is some evidence of compromised frontoparietal structure and function in adolescent cannabis use, it remains unclear whether the observed effects are specifically attributable to adolescent onset of use or general cannabis use-related factors such as depressive symptoms. The relative contribution of adolescent onset of cannabis use and use chronicity will have to be more comprehensively examined in prospective, longitudinal studies with more rigorous measures of cannabis use (dosage, exposure, dependence, constituent compounds such as the relative cannabinoid levels).
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Affiliation(s)
- Yann Chye
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Erynn Christensen
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Murat Yücel
- Brain Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
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Müller-Oehring EM, Le Berre AP, Serventi M, Kalon E, Haas AL, Padula CB, Schulte T. Brain activation to cannabis- and alcohol-related words in alcohol use disorder. Psychiatry Res Neuroimaging 2019; 294:111005. [PMID: 31715379 PMCID: PMC6886708 DOI: 10.1016/j.pscychresns.2019.111005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 12/18/2022]
Abstract
Cannabis abuse commonly co-occurs with alcohol use disorder (AUD). With increased acceptance and accessibility to cannabis in the US, it is imperative to understand the psychological and neural mechanisms of concurrent alcohol and cannabis use. We hypothesized that neural alcohol-cue conditioning may extent to other drug-related stimuli, such as cannabis, and underwrite the loss of control over reward-driven behavior. Task-activated fMRI examined the neural correlates of alcohol- and cannabis-related word cues in 21 abstinent AUD and 18 control subjects. Relative to controls, AUD showed behavioral attentional biases and frontal hypoactivation to both alcohol- and cannabis-related words. This cue-elicited prefrontal hypoactivation was related to higher lifetime alcohol consumption (pcorrected < 0.02) and modulated by past cannabis use histories (p ≦ 0.001). In particular, frontal hypoactivation to both alcohol and cannabis cues was pronounced in AUD without prior cannabis exposure. Overall, frontal control mechanisms in abstinent AUD were not sufficiently engaged to override automatic alcohol and cannabis-related intrusions, enhancing the risk for relapse and potentially for alcohol and cannabis co-use with the increased social acceptance and accessibility in the US.
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Affiliation(s)
- Eva M Müller-Oehring
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Anne-Pascale Le Berre
- Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Matthew Serventi
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Ember Kalon
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Amie L Haas
- Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Claudia B Padula
- Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States; VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Tilman Schulte
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States.
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Feldstein Ewing SW, Hudson KA, Caouette J, Mayer AR, Thayer RE, Ryman SG, Bryan AD. Sexual risk-taking and subcortical brain volume in adolescence. Ann Behav Med 2019; 52:393-405. [PMID: 29659656 DOI: 10.1093/abm/kax027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The developmental period of adolescence marks the initiation of new socioemotional and physical behaviors, including sexual intercourse. However, little is known about neurodevelopmental influences on adolescent sexual decision-making. Purpose We sought to determine how subcortical brain volume correlated with condom use, and whether those associations differed by gender and pubertal development. Methods We used FreeSurfer to extract subcortical volume among N = 169 sexually experienced youth (mean age 16.07 years; 31.95% female). We conducted multiple linear regressions to examine the relationship between frequency of condom use and subcortical volume, and whether these associations would be moderated by gender and pubertal development. Results We found that the relationship between brain volume and condom use was better accounted for by pubertal development than by gender, and moderated the association between limbic brain volume and condom use. No significant relationships were observed in reward areas (e.g., nucleus accumbens) or prefrontal cortical control areas. Conclusions These data highlight the potential relevance of subcortical socioemotional processing structures in adolescents' sexual decision-making.
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Affiliation(s)
- Sarah W Feldstein Ewing
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, M/C DC7P, Portland, OR
| | - Karen A Hudson
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, M/C DC7P, Portland, OR
| | - Justin Caouette
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, M/C DC7P, Portland, OR
| | | | - Rachel E Thayer
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | | | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
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Flannery JS, Riedel MC, Poudel R, Laird AR, Ross TJ, Salmeron BJ, Stein EA, Sutherland MT. Habenular and striatal activity during performance feedback are differentially linked with state-like and trait-like aspects of tobacco use disorder. SCIENCE ADVANCES 2019; 5:eaax2084. [PMID: 31633021 PMCID: PMC6785263 DOI: 10.1126/sciadv.aax2084] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/14/2019] [Indexed: 05/15/2023]
Abstract
The habenula, an epithalamic nucleus involved in reward and aversive processing, may contribute to negative reinforcement mechanisms maintaining nicotine use. We used a performance feedback task that differentially activates the striatum and habenula and administered nicotine and varenicline (versus placebos) to overnight-abstinent smokers and nonsmokers to delineate feedback-related functional brain alterations both as a function of smoking trait (smokers versus nonsmokers) and drug administration state (drug versus placebo). Smokers showed less striatal responsivity to positive feedback, an alteration not mitigated by drug administration, but rather correlated with trait-level addiction severity. Conversely, nicotine administration reduced habenula activity following both positive and negative feedback among abstinent smokers, but not nonsmokers, and increased habenula activity among smokers correlated with elevated state-level tobacco cravings. These outcomes highlight a dissociation between neurobiological processes linked with the dependence severity trait and the nicotine withdrawal state. Interventions simultaneously targeting both aspects may improve currently poor cessation outcomes.
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Affiliation(s)
| | - Michael C. Riedel
- Department of Physics, Florida International University, Miami, FL, USA
| | - Ranjita Poudel
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R. Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Thomas J. Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse–Intramural Research Program, NIH/DHHS, Baltimore, MD, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse–Intramural Research Program, NIH/DHHS, Baltimore, MD, USA
| | - Elliot A. Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse–Intramural Research Program, NIH/DHHS, Baltimore, MD, USA
| | - Matthew T. Sutherland
- Department of Psychology, Florida International University, Miami, FL, USA
- Corresponding author.
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31
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Pacheco-Colón I, Ramirez AR, Gonzalez R. Effects of Adolescent Cannabis Use on Motivation and Depression: A Systematic Review. CURRENT ADDICTION REPORTS 2019; 6:532-546. [PMID: 34079688 DOI: 10.1007/s40429-019-00274-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of review This article reviews recent behavioral and neuroimaging studies to elucidate whether adolescent cannabis use is related to reduced motivation and increased risk of depression. Recent findings Recent work suggests that heavy adolescent cannabis use predicts poorer educational outcomes, often presumed to reflect reduced academic motivation, as well as increased levels of depressive symptoms. However, evidence of a link between cannabis use and general motivation was lacking. Factors such as concurrent alcohol and tobacco use, trajectories of cannabis use during adolescence, and cannabis-related changes in underlying neurocircuitry may impact associations among cannabis use, motivation, and depression. Summary Heavy adolescent cannabis use is associated with poorer educational outcomes and increased levels of depressive symptoms. The role of depression in how cannabis may affect motivation, broadly, is not yet clear, as most studies have not examined associations among all three constructs. Future work should explore possible overlap between cannabis effects on motivation and depression, and clarify the temporality of these associations.
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Affiliation(s)
- Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University
| | - Ana Regina Ramirez
- Center for Children and Families, Department of Psychology, Florida International University
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University
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Papalini S, Lange I, Bakker J, Michielse S, Marcelis M, Wichers M, Vervliet B, van Os J, Van Amelsvoort T, Goossens L, Schruers K. The predictive value of neural reward processing on exposure therapy outcome: Results from a randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:339-346. [PMID: 30763673 DOI: 10.1016/j.pnpbp.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Exposure is the gold standard treatment for phobic anxiety and is thought to represent the clinical application of extinction learning. Reward sensitivity might however also represent a predictive factor for exposure therapy outcome, as this therapy promotes positive experiences and involves positive comments by the therapist. We hypothesized that high reward sensitivity, as expressed by elevated reward expectancy and reward value, can be associated with better outcome to exposure therapy specifically. METHODS Forty-four participants with a specific phobia for spiders were included in the current study. Participants were randomly assigned to exposure therapy (n = 25) or progressive muscle relaxation (PMR) (n = 19). Treatment outcome was defined as pre- versus post-therapy phobia symptoms. Before treatment, functional brain responses and behavioral responses (i.e. reaction time and accuracy) during reward anticipation and consumption were assessed with the Monetary Incentive Delay task (MID). Behavioral and neural responses in regions of interest (i.e. nucleus accumbens, ventromedial prefrontal cortex and the ventral tegmental area) as well as across the whole-brain were subsequently regressed on treatment outcomes. RESULTS Exposure therapy was more effective in reducing phobia symptoms than PMR. Longer reaction times to reward cues and lower activation in the left posterior cingulate cortex during reward consumption were selectively associated with symptoms reductions following exposure therapy but not following PMR. Only within the exposure therapy group, greater symptom reduction was related to increased activation in the ventrolateral prefrontal cortex during reward anticipation, and decreased activation in the medial prefrontal cortex during reward consumption. CONCLUSION Results indicate that individual differences in reward sensitivity can specifically predict exposure therapy outcome. Although activation in regions of interest were not related to therapy outcome, regions involved in attentional processing of reward cues were predictive of phobic symptom change following exposure therapy but not PMR.
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Affiliation(s)
- Silvia Papalini
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Iris Lange
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Jindra Bakker
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bram Vervliet
- Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Therese Van Amelsvoort
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Liesbet Goossens
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Koen Schruers
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
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Silvers JA, Squeglia LM, Rømer Thomsen K, Hudson KA, Feldstein Ewing SW. Hunting for What Works: Adolescents in Addiction Treatment. Alcohol Clin Exp Res 2019; 43:578-592. [PMID: 30779445 PMCID: PMC6443447 DOI: 10.1111/acer.13984] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/08/2019] [Indexed: 12/11/2022]
Abstract
Although adolescents are developmentally distinct from adults, they often receive addiction treatment based on adult models. This is problematic because adolescents face significantly different conditions in addiction treatment, including distinct basic biological and neurodevelopmental stages, unique sociodevelopmental concerns, distinctive addiction trajectories, and, in turn, disparate treatment goals and outcomes. In sum, it can be difficult for even savvy clinicians to know how to approach addiction treatment with this important age group. In an effort to help clinicians and researchers consider substance use via a neurodevelopmental lens, we approached this review with 4 goals: (i) characterize the prevalence, and related health and safety implications of substance use within this age group; (ii) identify the nature of the adolescent brain, including characteristic features of this phase of neurodevelopment relevant to adolescent substance use treatment; (iii) provide an overview of current adolescent addiction interventions and avenues to improve clinical treatment and clinical research efforts for adolescents; and (iv) examine the intersection between the nature of the developing brain and adolescent substance use, and utilize that information to inform alternative routes and directions for substance use treatment in this critical age group. This review concludes by offering a novel neurodevelopmental model and framework to examine substance use interventions, along with a series of recommendations to optimize adolescent substance use treatment and clinical research.
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Affiliation(s)
- Jennifer A. Silvers
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA;
| | - Lindsay M. Squeglia
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President St., MSC 861, Charleston, SC 29425, USA;
| | - Kristine Rømer Thomsen
- Aarhus University, Department of Psychology and Behavioral Sciences, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark;
| | - Karen A. Hudson
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, 3181 SW Sam Jackson Park Rd, M/C UHN80R1, Portland, OR 97239, USA,
| | - Sarah W. Feldstein Ewing
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, 3181 SW Sam Jackson Park Rd, M/C UHN80R1, Portland, OR 97239, USA,
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Differential dysfunctions related to alcohol and cannabis use disorder symptoms in reward and error-processing neuro-circuitries in adolescents. Dev Cogn Neurosci 2019; 36:100618. [PMID: 30710868 PMCID: PMC6613939 DOI: 10.1016/j.dcn.2019.100618] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 02/06/2023] Open
Abstract
Alcohol and cannabis are two of the most commonly used substances by adolescents and are associated with adverse medical and psychiatric outcomes. These adverse psychiatric outcomes may reflect the negative impact of alcohol and/or cannabis abuse on neural systems mediating reward and/or error detection. However, work indicative of this has mostly been conducted in adults with Alcohol and/or Cannabis Use Disorder (i.e., AUD and CUD), with relatively little work in adolescent patients. Furthermore, of the work that has been conducted in adolescents, groups were based on categorical diagnoses of AUD and/or CUD, so the relationship between AUD and/or CUD symptom severity in adolescents and neural dysfunction is unclear. We used a Monetary Incentive Delay (MID) task to examine the relationship between AUDIT and/or CUDIT scores and functional integrity of neuro-circuitries mediating reward processing and error detection within 150 adolescents. Our findings indicate that AUDIT score is negatively related to activity in reward processing neuro-circuitry in adolescents. However, CUDIT score is negatively related to activity in brain regions involved in error detection. Each of these relationships reflected a medium effect size (Partial-η2 0.09-0.14). These data suggest differential impacts of AUD and CUD on reward versus error detection neuro-circuitries within the adolescent brain.
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35
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Sutherland MT, Stein EA. Functional Neurocircuits and Neuroimaging Biomarkers of Tobacco Use Disorder. Trends Mol Med 2018; 24:129-143. [PMID: 29398401 DOI: 10.1016/j.molmed.2017.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/07/2017] [Accepted: 12/10/2017] [Indexed: 12/30/2022]
Abstract
Drug abuse and addiction remain major public health issues, exemplified by the opioid epidemic currently devastating the United States. Treatment outcomes across substance use disorders remain unacceptably poor, wherein drug discovery/development for this multifaceted neuropsychiatric disorder focuses on single molecular-level targets. Rather, our opinion is that a systems-level neuroimaging perspective is crucial for identifying novel therapeutic targets, biomarkers to stratify patients, and individualized treatment strategies. Focusing on tobacco use disorder, we advocate a brain systems-level perspective linking two abuse-related facets (i.e., statelike withdrawal and traitlike addiction severity) with specific neurocircuitry (insula- and striatum-centered networks). To the extent that precise neurocircuits mediate distinct facets of abuse, treatment development must adopt not only a systems-level perspective, but also multi-intervention rather than mono-intervention practices.
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Affiliation(s)
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, NIH/DHHS, Baltimore, MD, USA.
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36
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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37
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Cao Z, Bennett M, Orr C, Icke I, Banaschewski T, Barker GJ, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Desrivières S, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Nees F, Orfanos DP, Paus T, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Walter H, Schumann G, Whelan R. Mapping adolescent reward anticipation, receipt, and prediction error during the monetary incentive delay task. Hum Brain Mapp 2018; 40:262-283. [PMID: 30240509 DOI: 10.1002/hbm.24370] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 07/13/2018] [Accepted: 08/11/2018] [Indexed: 12/25/2022] Open
Abstract
The functional neuroanatomy and connectivity of reward processing in adults are well documented, with relatively less research on adolescents, a notable gap given this developmental period's association with altered reward sensitivity. Here, a large sample (n = 1,510) of adolescents performed the monetary incentive delay (MID) task during functional magnetic resonance imaging. Probabilistic maps identified brain regions that were reliably responsive to reward anticipation and receipt, and to prediction errors derived from a computational model. Psychophysiological interactions analyses were used to examine functional connections throughout reward processing. Bilateral ventral striatum, pallidum, insula, thalamus, hippocampus, cingulate cortex, midbrain, motor area, and occipital areas were reliably activated during reward anticipation. Bilateral ventromedial prefrontal cortex and bilateral thalamus exhibited positive and negative activation, respectively, during reward receipt. Bilateral ventral striatum was reliably active following prediction errors. Previously, individual differences in the personality trait of sensation seeking were shown to be related to individual differences in sensitivity to reward outcome. Here, we found that sensation seeking scores were negatively correlated with right inferior frontal gyrus activity following reward prediction errors estimated using a computational model. Psychophysiological interactions demonstrated widespread cortical and subcortical connectivity during reward processing, including connectivity between reward-related regions with motor areas and the salience network. Males had more activation in left putamen, right precuneus, and middle temporal gyrus during reward anticipation. In summary, we found that, in adolescents, different reward processing stages during the MID task were robustly associated with distinctive patterns of activation and of connectivity.
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Affiliation(s)
- Zhipeng Cao
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Marc Bennett
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Catherine Orr
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont
| | - Ilknur Icke
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gareth J Barker
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Erin Burke Quinlan
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | | | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Braunschweig, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry", University Paris Sud - Paris Saclay, University Paris Descartes, Service Hospitalier Frédéric Joliot, Orsay, and Maison de Solenn, Paris, France
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Tomáš Paus
- Rotman Research Institute, Baycrest and Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany.,Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Robert Whelan
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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38
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Filbey FM, Gohel S, Prashad S, Biswal BB. Differential associations of combined vs. isolated cannabis and nicotine on brain resting state networks. Brain Struct Funct 2018; 223:3317-3326. [PMID: 29882015 PMCID: PMC6286234 DOI: 10.1007/s00429-018-1690-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/26/2018] [Indexed: 01/30/2023]
Abstract
Concomitant cannabis and nicotine use is more prevalent than cannabis use alone; however, to date, most of the literature has focused on associations of isolated cannabis and nicotine use limiting the generalizability of existing research. To determine differential associations of concomitant use of cannabis and nicotine, isolated cannabis use and isolated nicotine use on brain network connectivity, we examined systems-level neural functioning via independent components analysis (ICA) on resting state networks (RSNs) in cannabis users (CAN, n = 53), nicotine users (NIC, n = 28), concomitant nicotine and cannabis users (NIC + CAN, n = 26), and non-users (CTRL, n = 30). Our results indicated that the CTRL group and NIC + CAN users had the greatest functional connectivity relative to CAN users and NIC users in 12 RSNs: anterior default mode network (DMN), posterior DMN, left frontal parietal network, lingual gyrus, salience network, right frontal parietal network, higher visual network, insular cortex, cuneus/precuneus, posterior cingulate gyrus/middle temporal gyrus, dorsal attention network, and basal ganglia network. Post hoc tests showed no significant differences between (1) CTRL and NIC + CAN and (2) NIC and CAN users. These findings of differential associations of isolated vs. combined nicotine and cannabis use demonstrate an interaction between cannabis and nicotine use on RSNs. These unique and combined mechanisms through which cannabis and nicotine influence cortical network functional connectivity are important to consider when evaluating the neurobiological pathways associated with cannabis and nicotine use.
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Affiliation(s)
- Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
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39
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Pacheco-Colón I, Limia JM, Gonzalez R. Nonacute effects of cannabis use on motivation and reward sensitivity in humans: A systematic review. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:497-507. [PMID: 29963875 PMCID: PMC6062456 DOI: 10.1037/adb0000380] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Reduced motivation is often noted as a consequence of cannabis use. However, prior studies examining this association have suboptimally operationalized motivation and have yielded mixed findings. This review discusses motivation and the closely related construct of reward sensitivity. We summarize the available literature examining associations between motivation and cannabis use, addressing the following questions: (a) Is there evidence for decreased motivation among cannabis users? (b) Is there evidence that lack of motivation among cannabis users is specific to their use of cannabis (rather than to use of other addictive drugs)? and (c) Is there evidence suggesting a causal relationship between cannabis use and motivation? Using PubMed, PsycINFO, and WebofScience, we conducted a literature search of studies examining nonacute effects of cannabis use on motivation, apathy, amotivation, effort, and reward sensitivity in humans. This search yielded 22 studies, which were reviewed in detail. We conclude that, although cross-sectional evidence of a cannabis-specific effect on motivation is equivocal, there is partial support from longitudinal studies for a causal link between cannabis use and reduced motivation. Additionally, we propose that reward sensitivity and motivation represent distinct yet related constructs and that reductions in one may not always lead to reductions in the other. Future work should longitudinally examine associations between cannabis use, motivation, and reward sensitivity; carefully define and operationalize these constructs; and control for the influence of potential confounding factors. (PsycINFO Database Record
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Affiliation(s)
| | - Jorge M Limia
- Department of Psychology, Florida International University
| | - Raul Gonzalez
- Department of Psychology, Florida International University
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40
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Gardiner CK, Karoly HC, Thayer RE, Gillman AS, Sabbineni A, Bryan AD. Neural activation during delay discounting is associated with 6-month change in risky sexual behavior in adolescents. Ann Behav Med 2018; 52:356-366. [PMID: 29684133 DOI: 10.1093/abm/kax028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Identifying cognitive and neural mechanisms of decision making in adolescence can enhance understanding of, and interventions to reduce, risky health behaviors in adolescence. Delay discounting, or the propensity to discount the magnitude of temporally distal rewards, has been associated with diverse health risk behaviors, including risky sex. This cognitive process involves recruitment of reward and cognitive control brain regions, which develop on different trajectories in adolescence and are also implicated in real-world risky decision making. However, no extant research has examined how neural activation during delay discounting is associated with adolescents' risky sexual behavior. Purpose To determine whether a relationship exists between adolescents' risky sexual behavior and neural activation during delay discounting. Methods Adolescent participants completed a delay discounting paradigm during functional magnetic resonance imaging (fMRI) scanning, and they reported risky sexual behavior at baseline, 3-, 6-, 9-, and 12-month follow-up time points. Latent growth curve models were employed to determine relationships between brain activation during delay discounting and change in risky sexual behavior over time. Results Greater activation in brain regions associated with reward and cognitive control (caudate, putamen, nucleus accumbens, anterior cingulate, insula, orbitofrontal cortex, inferior frontal gyrus, dorsolateral prefrontal cortex) during delay discounting was associated with lower mean levels of risky sexual behavior but greater growth over the period from baseline to 6 months. Conclusions Neural activation during delay discounting is cross-sectionally and prospectively associated with risky sexual behavior in adolescence, highlighting a neural basis of risky decision-making as well as opportunities for early identification and intervention.
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Affiliation(s)
- Casey K Gardiner
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
| | - Hollis C Karoly
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
| | - Rachel E Thayer
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
| | - Arielle S Gillman
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
| | - Amithrupa Sabbineni
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB, Boulder, CO
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Thayer RE, YorkWilliams S, Karoly HC, Sabbineni A, Ewing SF, Bryan AD, Hutchison KE. Structural neuroimaging correlates of alcohol and cannabis use in adolescents and adults. Addiction 2017. [PMID: 28646566 PMCID: PMC5673530 DOI: 10.1111/add.13923] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Chronic alcohol use is associated with lower gray matter volume, and we reported recently that alcohol use showed negative associations with widespread gray matter (GM) volume even among young adults. The current study aimed to test the strength of association between (1) alcohol use and GM volume; (2) alcohol use and white matter (WM) integrity; (3) cannabis use and GM volume; and (4) cannabis use and WM integrity among adults and adolescents. DESIGN AND SETTING General linear models within large pooled cross-sectional samples of adolescents and adults who had participated in studies collecting substance use and neuroimaging data in the southwestern United States. PARTICIPANTS The current analysis included adults aged 18-55 years (n = 853) and adolescents aged 14-18 years (n = 439) with a range of alcohol and cannabis use. MEASUREMENTS The dependent variable was GM volume or WM integrity, with key predictors of alcohol use [Alcohol Use Disorders Identification Test (AUDIT) score] and cannabis use (past 30-day use). FINDINGS Alcohol use showed large clusters of negative associations (ηp2 = 0.028-0.145, P < 0.001) with GM volume among adults and to a lesser extent (one cluster; ηp2 = 0.070, P < 0.05) among adolescents. Large clusters showed significant associations (ηp2 = 0.050-0.124, P < 0.001) of higher alcohol use with poorer WM integrity, whereas adolescents showed no significant associations between alcohol use and WM. No associations were observed between structural measures and past 30-day cannabis use in adults or adolescents. CONCLUSIONS Alcohol use severity is associated with widespread lower gray matter volume and white matter integrity in adults, and with lower gray matter volume in adolescents.
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Affiliation(s)
- Rachel E. Thayer
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Sophie YorkWilliams
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Hollis C. Karoly
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Amithrupa Sabbineni
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | | | - Angela D. Bryan
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Kent E. Hutchison
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO
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42
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Houck JM, Feldstein Ewing SW. Working memory capacity and addiction treatment outcomes in adolescents. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 44:185-192. [PMID: 28726525 DOI: 10.1080/00952990.2017.1344680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Working memory depends upon brain structures and functions that change markedly during neurodevelopment and that can be negatively impacted by substance use. OBJECTIVES In a secondary analysis of data from a clinical trial for adolescent substance use comparing alcohol/marijuana education and MI, we evaluated the relationship between working memory and three-month treatment-outcomes with the hypothesis that the relationship between intervention conditions and outcome would be moderated by working memory. METHODS With a diverse sample of adolescents currently using alcohol and/or marijuana (N = 153, 64.7% male, 70.6% Hispanic), we examined the relationship between baseline measures of working memory and alcohol and cannabis-related problem scores measured at the three-month follow-up. RESULTS The results showed that lower working memory scores were associated with poorer treatment response only for alcohol use, and only within the education group. No relationship was found between working memory and treatment outcomes in the MI group. CONCLUSION The results suggest that issues with working memory capacity may interfere with adolescents' ability to process and implement didactic alcohol and marijuana content in standard education interventions. These results also suggest that MI can be implemented equally effectively across the range of working memory functioning in youth.
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Affiliation(s)
- Jon M Houck
- a Center on Alcoholism, Substance Abuse, and Addictions , University of New Mexico , Albuquerque , NM , USA
| | - Sarah W Feldstein Ewing
- b Department of Child & Adolescent Psychiatry , Oregon Health & Science University , Portland , OR , USA
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43
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Caouette JD, Feldstein Ewing SW. Four Mechanistic Models of Peer Influence on Adolescent Cannabis Use. CURRENT ADDICTION REPORTS 2017; 4:90-99. [PMID: 29104847 DOI: 10.1007/s40429-017-0144-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose of review Most adolescents begin exploring cannabis in peer contexts, but the neural mechanisms that underlie peer influence on adolescent cannabis use are still unknown. This theoretical overview elucidates the intersecting roles of neural function and peer factors in cannabis use in adolescents. Recent findings Novel paradigms using functional magnetic resonance imaging (fMRI) in adolescents have identified distinct neural mechanisms of risk decision-making and incentive processing in peer contexts, centered on reward-motivation and affect regulatory neural networks; these findings inform a theoretical model of peer-driven cannabis use decisions in adolescents. Summary We propose four "mechanistic profiles" of social facilitation of cannabis use in adolescents: (1) peer influence as the primary driver of use; (2) cannabis exploration as the primary driver, which may be enhanced in peer contexts; (3) social anxiety; and (4) negative peer experiences. Identification of "neural targets" involved in motivating cannabis use may inform clinicians about which treatment strategies work best in adolescents with cannabis use problems, and via which social and neurocognitive processes.
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Affiliation(s)
- Justin D Caouette
- Oregon Health & Science University, Department of Psychiatry, 3314 SW US Veteran's Hospital Road, M/C DC7P, Portland, OR 97239, USA
| | - Sarah W Feldstein Ewing
- Oregon Health & Science University, Department of Psychiatry, 3314 SW US Veteran's Hospital Road, M/C DC7P, Portland, OR 97239, USA
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Martz ME, Trucco EM, Cope LM, Hardee JE, Jester JM, Zucker RA, Heitzeg MM. Association of Marijuana Use With Blunted Nucleus Accumbens Response to Reward Anticipation. JAMA Psychiatry 2016; 73:838-44. [PMID: 27384542 PMCID: PMC4972653 DOI: 10.1001/jamapsychiatry.2016.1161] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Marijuana use may alter ventral striatal response to reward, which might heighten susceptibility to substance use disorder. Longitudinal research is needed to determine the effects of marijuana use on neural function involved in reward response. OBJECTIVE To determine whether marijuana use among young adults prospectively affects nucleus accumbens (NAcc) activation during reward anticipation. DESIGN, SETTING, AND PARTICIPANTS One hundred eight young adults were recruited from the Michigan Longitudinal Study, an ongoing study of youth at high risk for substance use disorder and a contrast sample of control families. Participants underwent 3 consecutive functional magnetic resonance imaging scans at approximate ages of 20 (time 1), 22 (time 2), and 24 (time 3) years. Self-report data on marijuana and other drug use occasions were collected annually since age 11 years. MAIN OUTCOMES AND MEASURES Cross-lagged models were used to test the association of marijuana use with neural response in the NAcc to reward anticipation during a monetary incentive delay task controlling for sex, age, other substance use, and family history of substance use disorder. RESULTS Of 108 participants, 39 (36.1%) were female and mean (SD) age at baseline was 20.1 (1.4) years. Greater marijuana use was associated with later blunted activation in the NAcc during reward anticipation (time 1 to time 2: β = -0.26, P = .04; time 2 to time 3: β = -0.25, P = .01). When the cross-lagged model was tested with the inclusion of previous and concurrent cigarette use, the effect of marijuana use from time 2 to time 3 remained significant (β = -0.29; P = .005) and the effect of cigarette use was nonsignificant. CONCLUSIONS AND RELEVANCE The findings of this study indicate that marijuana use is associated with decreased neural response in the NAcc during the anticipation of nondrug rewards. Over time, marijuana use may alter anticipatory reward processing in the NAcc, which may increase the risk for continued drug use and later addiction.
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Affiliation(s)
- Meghan E. Martz
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA,Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48108, USA
| | - Elisa M. Trucco
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA,Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Lora M. Cope
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Jillian E. Hardee
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Jennifer M. Jester
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Robert A. Zucker
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA,Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48108, USA
| | - Mary M. Heitzeg
- Department of Psychiatry and Addiction Research Center, University of Michigan 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
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Silveri MM, Dager AD, Cohen-Gilbert JE, Sneider JT. Neurobiological signatures associated with alcohol and drug use in the human adolescent brain. Neurosci Biobehav Rev 2016; 70:244-259. [PMID: 27377691 DOI: 10.1016/j.neubiorev.2016.06.042] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/17/2016] [Accepted: 06/30/2016] [Indexed: 01/02/2023]
Abstract
Magnetic resonance (MR) techniques provide opportunities to non-invasively characterize neurobiological milestones of adolescent brain development. Juxtaposed to the critical finalization of brain development is initiation of alcohol and substance use, and increased frequency and quantity of use, patterns that can lead to abuse and addiction. This review provides a comprehensive overview of existing MR studies of adolescent alcohol and drug users. The most common alterations reported across substance used and MR modalities are in the frontal lobe (63% of published studies). This is not surprising, given that this is the last region to reach neurobiological adulthood. Comparatively, evidence is less consistent regarding alterations in regions that mature earlier (e.g., amygdala, hippocampus), however newer techniques now permit investigations beyond regional approaches that are uncovering network-level vulnerabilities. Regardless of whether neurobiological signatures exist prior to the initiation of use, this body of work provides important direction for ongoing prospective investigations of adolescent brain development, and the significant impact of alcohol and substance use on the brain during the second decade of life.
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Affiliation(s)
- Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Alecia D Dager
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Julia E Cohen-Gilbert
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer T Sneider
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Subramaniam P, McGlade E, Yurgelun-Todd D. Comorbid Cannabis and Tobacco Use in Adolescents and Adults. CURRENT ADDICTION REPORTS 2016; 3:182-188. [PMID: 27175326 DOI: 10.1007/s40429-016-0101-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of comorbid cannabis and tobacco use has been increasing among adolescents and adults and has been shown to be associated with a range of changes or deficits in physical, psychological and behavioral outcomes. Moreover, comorbid use has been shown to have a differential effect on the structure and function of the brain, especially as it relates to the reward circuitry and learning and memory. This interaction might be mediated by the involvement of the endocannabinoid system and alterations in dopamine signaling in regions associated with reward and cognitive functioning. While current findings demonstrate a differential effect of comorbid use on neurobiological and behavioral correlates compared with single substance use, additional studies are needed controlling for potential psychiatric comorbidities, age of onset of use and use of other substances. Understanding the neurobiological mechanisms associated with comorbid cannabis and tobacco use will be important in developing successful treatment outcomes in the future.
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Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA; Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA
| | - Erin McGlade
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA; Department of Psychiatry, University of Utah, Salt Lake City, UT; George E. Whalen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC), Salt Lake City, UT, USA
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA; Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA; Department of Psychiatry, University of Utah, Salt Lake City, UT; George E. Whalen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC), Salt Lake City, UT, USA
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Conrod PJ, Nikolaou K. Annual Research Review: On the developmental neuropsychology of substance use disorders. J Child Psychol Psychiatry 2016; 57:371-94. [PMID: 26889898 DOI: 10.1111/jcpp.12516] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Adolescence represents a period of development during which critical biological, as well as social and cognitive, changes occur that are necessary for the transition into adulthood. A number of researchers have suggested that the pattern of normative brain changes that occurs during this period not only predisposes adolescents to engage in risk behaviours, such as experimentation with drugs, but that they additionally make the adolescent brain more vulnerable to the direct pharmacological impact of substances of abuse. The neural circuits that we examine in this review involve cortico-basal-ganglia/limbic networks implicated in the processing of rewards, emotion regulation, and the control of behaviour, emotion and cognition. FINDINGS AND CONCLUSIONS We identify certain neurocognitive and personality/comorbidity-based risk factors for the onset of substance misuse during adolescence, and summarise the evidence suggesting that these risk factors may be further impacted by the direct effect of drugs on the underlying neural circuits implicated in substance misuse vulnerability.
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Affiliation(s)
- Patricia J Conrod
- Faculty of Medicine, Department of Psychiatry, Université de Montréal, Montréal, Canada.,Centre de recherche CHU Sainte-Justine, Montréal, Canada.,Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Kyriaki Nikolaou
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Feldstein Ewing SW, Houck JM, Yezhuvath U, Shokri-Kojori E, Truitt D, Filbey FM. The impact of therapists' words on the adolescent brain: In the context of addiction treatment. Behav Brain Res 2015; 297:359-69. [PMID: 26455873 DOI: 10.1016/j.bbr.2015.09.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/09/2015] [Accepted: 09/28/2015] [Indexed: 11/26/2022]
Abstract
At this time, we still do not know how therapist behaviors influence adolescent brain response and related treatment outcomes. Therefore, we examined this question with 17 binge drinking youth (mean age=16.62 years; 64.3% female; 42.9% Hispanic; 28.6% bi-/multi-racial). In this within-subjects design, all youth completed a baseline assessment, two therapy sessions, an fMRI scan, and were re-evaluated for behavior change at one-month post-treatment. During the fMRI session, youth were presented with two types of responses from their treating therapist: higher-skill statements prescribed in an empirically-supported addiction treatment (complex reflections) vs. language standard within addiction treatment more broadly (closed questions). In terms of behavior change, at the one-month follow-up, youth showed significant reductions in number of drinking days and binge drinking days. Further, we found main effects for complex reflections and closed questions across the superior middle temporal gyrus and middle temporal gyrus (FWE-corrected, p<.05). Greater brain response was observed for complex reflections versus closed questions within the bilateral anterior cingulate gyrus. Greater BOLD response in the parietal lobe during closed questions was significantly associated with less post-treatment drinking. Lower BOLD response during complex reflections and closed questions in the precuneus were associated with greater post-treatment ratings of importance of changing. This study represents a first step in understanding how therapist behaviors influence the developing adolescent brain and how that neural response may be associated with youth treatment outcomes.
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Affiliation(s)
- Sarah W Feldstein Ewing
- Oregon Health & Science University, Department of Psychiatry, 3314 SW US Veteran's Hospital Road, M/C DC7P, Portland, OR 97239, USA.
| | - Jon M Houck
- University of New Mexico Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions (UNM CASAA), 2650 Yale Blvd SE, MSC11 6280, Albuquerque, NM 87106, USA.
| | - Uma Yezhuvath
- Advance MRI LLC, 8700 Stonebrook Parkway, #105, Frisco, TX 75034, USA.
| | | | - Dustin Truitt
- University of New Mexico Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions (UNM CASAA), 2650 Yale Blvd SE, MSC11 6280, Albuquerque, NM 87106, USA.
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA.
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