Study register · detailMeta-Analyse · Adolescence & Development · 2013
Is cannabis neurotoxic for the healthy brain? A meta-analytical review of structural brain alterations in non-psychotic users
Rocchetti et al.·Psychiatry and Clinical Neurosciences
MixedGRADEHigh104 citations
Samplek = 14 Studien n = 727 Pat.
ControlNo cannabis use
EndpointHippocampal volume
Blindingunklar
DesignMeta-Analyse
Routeinhalativ
”Key finding
Chronic cannabis use is associated with a significantly smaller hippocampal volume; evidence for further brain structural changes remains inconsistent.
Summary
Meta-analysis k=14 imaging studies (n=362 cannabis users vs. n=365 non-users); consistently smaller hippocampus in cannabis users (effect size significant); limited and contradictory evidence for further gray/white matter changes — suggests neurotoxic effect of chronic cannabis use in cannabinoid receptor-rich brain areas.
P
PopulationNon-psychotic cannabis users and non-users, pooled n=727 (362 users, 365 non-users)
I
InterventionChronic cannabis use (smoking)
C
ControlNo cannabis use
O
OutcomeConsistently smaller hippocampal volume in cannabis users vs. non-users; limited and contradictory evidence at the individual study level for gray and white matter changes
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
<h4>Aims</h4>Despite growing research in the field of cannabis imaging, mostly in those with a psychotic illness, the possible neurotoxic effects of smoked cannabis on the healthy brain have yet to be fully understood. There appears to be a need to evaluate the existing imaging data on the neuroanatomical effects of cannabis use on non-psychotic populations.<h4>Methods</h4>We conducted a meta-analytical review to estimate the putative neurotoxic effect of cannabis in non-psychotic subjects who were using or not using cannabis. We specifically tested the hypothesis that cannabis use can alter grey and white matter in non-psychotic subjects.<h4>Results</h4>Our systematic literature search uncovered 14 studies meeting the inclusion criteria for the meta-analysis. The overall database comprised 362 users and 365 non-users. At the level of the individual studies there is limited and contrasting evidence supporting a cannabis-related alteration on the white and grey matter structures of non-psychotic cannabis users. However, our meta-analysis showed a consistent smaller hippocampus in users as compared to non-users. Heterogeneity across study designs, image acquisition, small sample sizes and limited availability of regions of interest to be included in the meta-analysis may undermine the core findings of this study.<h4>Conclusions</h4>Our results suggest that in the healthy brain, chronic and long-term cannabis exposure may exert significant effects in brain areas enriched with cannabinoid receptors, such as the hippocampus, which could be related to a neurotoxic action.