Neurodevelopmental Effects of Cannabis Use in Adolescents and Emerging Adults with ADHD: A Systematic Review.
Neurodevelopmental Effects of Cannabis Use in Adolescents and Emerging Adults with ADHD: A Systematic Review.
复制标题
大麻使用在青少年和有多动症的新兴成年人中使用的神经发育影响：系统评价。
DOI：
10.1097/hrp.0000000000000303
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发表时间：
2021-07-01
影响因子：
3.8
通讯作者：
Leikauf, John E.
中科院分区：
文献类型：
--
作者：
Cawkwell, Philip B.;Hong, David S.;Leikauf, John E.
系统地回顾科学文献，以描述大麻使用对ADHD青少年和年轻人大脑结构，功能和神经发育结果的影响。从开始到2020年1月1日，使用PubMed、Embase、PsycINFO和科克伦中心试验注册，遵循PRISMA指南进行系统性综述。研究大麻使用对ADHD青少年的影响的文章也包括在内。确定了11项研究，比较了使用大麻或合成大麻素的ADHD患者与未使用大麻或合成大麻素的ADHD患者的结果。其中7项研究使用了神经成像技术，包括fMRI、结构MRI和SPECT。不同的激活区域被确定，包括右侧海马和小脑蚓部，以及双侧颞叶。在右侧中央前回和中央后回、左侧脑桥核、右侧上级额回和中央后回中发现了形态学差异。没有研究发现任何添加剂或ADHD ×大麻使用对执行功能的神经心理任务的相互作用。两项研究发现，早发性大麻使用对这一人群产生了不利的不同影响。缺乏证据表明大麻使用对ADHD患者大脑发育和功能的影响，尽管这一人群使用药物的风险升高。有限的，潜在的动力不足的证据不支持大麻使用对患有ADHD的过渡年龄青年的神经心理任务产生有害影响的假设。然而，需要进行更大规模和更长期的研究，以更好地告知临床医生和患者大麻使用对ADHD青少年的影响。
Systematically review the scientific literature to characterize the effects of cannabis use on brain structure, function, and neurodevelopmental outcomes in adolescents and young adults with ADHD. Systematic review following PRISMA guidelines utilizing PubMed, Embase, PsycINFO, and Cochrane CENTRAL trials register from inception until 1 January 2020. Articles that examined the impact of cannabis use on youth with ADHD were included. Eleven studies were identified that compared outcomes for individuals with ADHD who used cannabis or synthetic cannabinoids against those with ADHD who did not. Seven of these studies used neuroimaging techniques, including fMRI, structural MRI, and SPECT. Differential regions of activation were identified, including the right hippocampus and cerebellar vermis, and bilateral temporal lobes. Morphological differences were identified in the right precentral and postcentral gyri, left nucleus accumbens, right superior frontal and postcentral gyri. No study identified any additive or ADHD × cannabis use interaction on neuropsychological tasks of executive function. Two studies found adverse differential impacts of early-onset cannabis use in this population. A dearth of evidence is available on the impact of cannabis use on the developing brain and functioning for individuals with ADHD, despite the elevated risk for substance use in this population. The limited, potentially underpowered evidence does not support the hypothesis that cannabis use has a deleterious impact on neuropsychological tasks in transitional age youth with ADHD. Larger and longer-term studies are needed, however, to better inform clinicians and patients as to the impacts of cannabis use in youth with ADHD.