Induction of Psychosis by {Delta}9-Tetrahydrocannabinol Reflects Modulation of Prefrontal and Striatal Function During Attentional Salience Processing [Original Article]

Source: Archives of General Psychiatry

Context  The aberrant processing of salience is thought to be a fundamental factor underlying psychosis. Cannabis can induce acute psychotic symptoms, and its chronic use may increase the risk of schizophrenia. We investigated whether its psychotic effects are mediated through an influence on attentional salience processing.

Objective  To examine the effects of 9-tetrahydrocannabinol (9-THC) and cannabidiol (CBD) on regional brain function during salience processing.

Design  Volunteers were studied using event-related functional magnetic resonance imaging on 3 occasions after administration of 9-THC, CBD, or placebo while performing a visual oddball detection paradigm that involved allocation of attention to infrequent (oddball) stimuli within a string of frequent (standard) stimuli.

Setting  University center.

Participants  Fifteen healthy men with minimal previous cannabis use.

Main Outcome Measures  Symptom ratings, task performance, and regional brain activation.

Results  During the processing of oddball stimuli, relative to placebo, 9-THC attenuated activation in the right caudate but augmented it in the right prefrontal cortex. 9-Tetrahydrocannabinol also reduced the response latency to standard relative to oddball stimuli. The effect of 9-THC in the right caudate was negatively correlated with the severity of the psychotic symptoms it induced and its effect on response latency. The effects of CBD on task-related activation were in the opposite direction of those of 9-THC; relative to placebo, CBD augmented left caudate and hippocampal activation but attenuated right prefrontal activation.

Conclusions  9-Tetrahydrocannabinol and CBD differentially modulate prefrontal, striatal, and hippocampal function during attentional salience processing. These effects may contribute to the effects of cannabis on psychotic symptoms and on the risk of psychotic disorders.

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