Discriminative properties of hippocampal hypoperfusion in marijuana users compared to healthy controls: implications for marijuana administration in Alzheimer's dementia

Daniel G. Amen, Borhan Darmal, Cyrus A. Raji, Weining Bao, Lantie Jorandby, Somayeh Meysami, Cauligi S. Raghavendra

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Few studies have evaluated the impact of marijuana use on regional cerebral blood flow. Objective: To determine whether perfusion in specific brain regions on functional neuroimaging, including those affected by Alzheimer's disease pathology, are abnormal in marijuana users compared to controls. Method: Persons with a diagnosis of cannabis use disorder by DSM-IV and DSM-V criteria (n = 982) were compared to controls (n = 92) with perfusion neuroimaging with SPECT at rest and at a concentration task. Perfusion estimates were quantified using a standard atlas. Cerebral perfusion differences were calculated using one-way ANOVA. Diagnostic separation was determined with discriminant analysis of all subjects. Feature selection with a minimum redundancy maximum relevancy (mRMR) identified predictive regions in a subset of marijuana users (n = 436) with reduced psychiatric co-morbidities. Results: Marijuana users showed lower cerebral perfusion on average (p < 0.05). Discriminant analysis distinguished marijuana users from controls with correct classification of 96% and leave one out cross-validation of 92%. With concentration SPECT regions, there was correct classification of 95% with a leave-one-out cross validation of 90%. AUC analysis for concentration SPECT regions showed 95% accuracy, 90% sensitivity, and 83% specificity. The mRMR analysis showed right hippocampal hypoperfusion on concentration SPECT imaging was the most predictive in separating marijuana subjects from controls. Conclusion: Multiple brain regions show low perfusion on SPECT in marijuana users. The most predictive region distinguishing marijuana users from healthy controls, the hippocampus, is a key target of Alzheimer's disease pathology. This study raises the possibility of deleterious brain effects of marijuana use.

Original languageEnglish
Pages (from-to)261-273
Number of pages13
JournalJournal of Alzheimer's Disease
Volume56
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Hippocampus
  • Imaging
  • Marijuana
  • SPECT

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