Sagnik Bhattacharyya, Zerrin Atakan, Rocio Martin-Santos, Jose A. Crippa and Philip K. McGuire Pages 5045 - 5054 ( 10 )
Pharmacological challenge in conjunction with neuroimaging techniques has been employed for over two decades now to understand the neural basis of the cognitive, emotional and symptomatic effects of the main ingredients of cannabis, the most widely used illicit drug in the world. This selective critical review focuses on the human neuroimaging studies investigating the effects of delta-9- tetrahydrocannabinol (THC) and cannabidiol (CBD), the two main cannabinoids of interest present in the extract of the cannabis plant. These studies suggest that consistent with the polymorphic and heterogeneous nature of the effects of cannabis, THC and CBD have distinct and often opposing effects on widely distributed neural networks that include medial temporal and prefrontal cortex and striatum, brain regions that are rich in cannabinoid receptors and implicated in the pathophysiology of psychosis. They help elucidate the neurocognitive mechanisms underlying the acute induction of psychotic symptoms by cannabis and provide mechanistic understanding underlying the potential role of CBD as an anxiolytic and antipsychotic. Although there are ethical and methodological caveats, pharmacological neuroimaging studies such as those reviewed here may not only help model different aspects of the psychopathology of mental disorders such as schizophrenia and offer insights into their underlying mechanisms, but may suggest potentially new therapeutic targets for drug discovery.
Cannabis, THC, CBD, neuroimaging, fMRI, PET, memory, salience, anxiety, psychotic symptoms
Department of Psychosis Studies & Psychosis Clinical Academic Group, King's College London, Institute of Psychiatry, 6th Floor, Main Building, PO Box 067, De Crespigny Park, SE5 8AF, London, UK.