Cortical Thickness and Neurocognition in Adolescent Marijuana and Alcohol Users Following 28 Days of Monitored Abstinence
Cortical Thickness and Neurocognition in Adolescent Marijuana and Alcohol Users Following 28 Days of Monitored Abstinence
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DOI：
10.15288/jsad.2014.75.729
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发表时间：
2014-09-01
影响因子：
3.4
通讯作者：
Tapert, Susan F.
中科院分区：
文献类型：
--
作者：
Jacobus, Joanna;Squeglia, Lindsay M.;Tapert, Susan F.
目的：随着危害认知的下降，青少年大麻的使用继续增加。更好地了解大麻对神经发育的影响至关重要。这项前瞻性研究旨在调查青少年大麻和酒精使用者在监测戒断前后28天的皮质厚度和神经认知表现。方法：研究对象（N = 54，男性占70%）为青少年大麻使用者（15-18岁），有规律饮酒（MJ + ALC, N = 24）和不饮酒的对照组（CON, N = 30），在4周前后进行顺序尿毒理学检查，以确认是否戒酒。参与者在两个时间点进行了磁共振成像、神经心理评估和物质使用评估。使用协方差重复测量分析来观察组、时间和组x时间相互作用对皮质厚度和神经认知功能的主要影响。双变量相关性估计了皮质厚度、物质使用严重程度和认知表现之间的关联。结果：在监测戒断前后，调整终身酒精使用后，大麻使用者的左内嗅皮层比对照组厚（ps < .03）。终生使用更多的大麻与颞叶和额叶皮层变薄有关，而终生使用更多的酒精和大量的间歇性饮酒与所有四个脑叶皮层变厚有关（p < 0.05）。开始经常使用大麻的年龄与皮质厚度呈正相关（ps < .03）。结论：青少年酒精和大麻的使用可能与长期神经发育轨迹的改变和神经健康的损害有关。在监测戒断前后都观察到皮质厚度的改变和厚度估计的剂量依赖关系，表明神经差异在停止大麻使用后持续28天。神经恢复可能需要更长的随访时间；然而，观察到的与使用严重程度相关的变化可能对未来的社会心理结果有影响。
Objective: Adolescent marijuana use continues to increase in prevalence as harm perception declines. Better understanding of marijuana's impact on neurodevelopment is crucial. This prospective study aimed to investigate cortical thickness and neurocognitive performance before and after 28 days of monitored abstinence in adolescent marijuana and alcohol users. Method: Subjects (N = 54; >70% male) were adolescent marijuana users (ages 15-18 years) with regular alcohol use (MJ + ALC; n = 24) and non-using controls (CON; n = 30) who were compared before and after 4 weeks of sequential urine toxicology to confirm abstinence. Participants underwent magnetic resonance imaging, neuropsychological assessment, and substance use assessment at both time points. Repeated-measures analysis of covariance was used to look at the main effects of group, time, and Group x Time interactions on cortical thickness and neurocognitive functioning. Bivariate correlations estimated associations between cortical thickness, substance use severity, and cognitive performance. Results: Marijuana users showed thicker cortices than controls in the left entorhinal cortex (ps < .03) before and after monitored abstinence, after adjusting for lifetime alcohol use. More lifetime marijuana use was linked to thinner cortices in temporal and frontal regions, whereas more lifetime alcohol use and heavy episodic drinking episodes was linked to thicker cortices in all four lobes (ps < .05). Age of onset of regular marijuana use was positively related to cortical thickness (ps < .03). Conclusions: Adolescent alcohol and marijuana use may be linked to altered longer-term neurodevelopmental trajectories and compromised neural health. Cortical thickness alterations and dose-dependent associations with thickness estimates were observed both before and after monitored abstinence and suggest neural differences continue to persist 28 days after cessation of marijuana use. Neural recovery may be identified with longer follow-up periods; however, observed changes related to use severity could have implications for future psychosocial outcomes.