The British Journal of Psychiatry (2007) 190: 230-236. doi: 10.1192/bjp.bp.106.024521
© 2007 The Royal College of Psychiatrists
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Anterior cingulate grey-matter deficits and cannabis use in first-episode schizophrenia

Philip R. Szeszko, PhD, Delbert G. Robinson, MD and Serge Sevy, MD

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks and Albert Einstein College of Medicine, Bronx, and Feinstein Institute for Medical Research, Manhasset, New York, USA

Sanjiv Kumra

Department of Psychiatry, University of Minnesota, Mineapolis, Minnesota, USA

Claudia I. Rupp, PhD

Innsbruck Medical University, Department of Psychiatry, Innsbruck, Austria

Julia D. Betensky, BA

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks, New York, USA

Todd Lencz, PhD

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks, and Albert Einstein College of Medicine, Bronx, and Feinstein Institute for Medical Research, Manhasset, New York, USA

Manzar Ashtari, PhD

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks, New York, USA

John M. Kane, MD and Anil K. Malhotra, MD

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks, and Albert Einstein College of Medicine, Bronx, and Feinstein Institute for Medical Research, Manhasset, New York

Handan Gunduz-Bruce, MD

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

Barbara Napolitano, MA

Zucker Hillside Hospital, Department of Psychiatry Research, Glen Oaks and Feinstein Institute for Medical Research, Manhasset, New York

Robert M. Bilder, PhD

UCLA Neuropsychiatric Institute and Geffen School of Medicine, Los Angeles, California, USA

Correspondence: Dr Philip R. Szeszko, Zucker Hillside Hospital, Psychiatry Research, 75–59 263rd Street, Glen Oaks, NY11004, USA. Tel: +1 718 470 8489; fax: +1 718 343 1659; email: szeszko{at}lij.edu

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Despite the high prevalence of cannabis use in schizophrenia, few studies have examined the potential relationship between cannabis exposure and brain structural abnormalities in schizophrenia.

Aims To investigate prefrontal grey and white matter regions in patients experiencing a first episode of schizophrenia with an additional diagnosis of cannabis use or dependence (n=20) compared with similar patients with no cannabis use (n=31) and healthy volunteers (n=56).

Method Volumes of the superior frontal gyrus, anterior cingulate gyrus and orbital frontal lobe were outlined manually from contiguous magnetic resonance images and automatically segmented into grey and white matter.

Results Patients who used cannabis had less anterior cingulate grey matter compared with both patients who did not use cannabis and healthy volunteers.

Conclusions A defect in the anterior cingulate is associated with a history of cannabis use among patients experiencing a first episode of schizophrenia and could have a role in poor decision-making and in choosing more risky outcomes.


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This may be due to cannabis interference with DHEA
James M. Howard
BJP Online, 9 Mar 2007 [Full text]