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Executive attention impairment in adolescents with schizophrenia who have used cannabis.

Abstract

OBJECTIVE

Repeated exposure to cannabis in nonpsychotic adolescents is associated with impairments in executive control of attention, similar to those observed in young adults with first-episode schizophrenia. To assess the impact of recurrent exposure to cannabis on cognitive function, this study characterized attention performance in both nonpsychotic adolescents and adolescents with early-onset schizophrenia (EOS).

METHOD

The Attention Network Test, a standard procedure that estimates the functional state of neural networks controlling the efficiency of three different attentional behaviors (alerting, orienting, and executive attention), was administered to four groups of participants: (1) adolescents with EOS and comorbid cannabis use disorder (EOS+CUD; n=18), (2) "Pure" schizophrenia (EOS; n=34), (3) "Pure" cannabis use disorder (CUD; n=29), and (4) Healthy controls (HC; n=53). Task performance was examined with a 2×2 design (EOS+ versus EOS- and CUD+ versus CUD-) using multivariate analysis of covariance. Correlative analyses were conducted between executive attention performance and measures of surface area in the right anterior cingulate cortex.

RESULTS

A significant EOS×CUD interaction was observed. In the executive attention network, adolescents with EOS+CUD showed reduced efficiency relative to adolescents with pure EOS, whereas no group differences were found between adolescents with pure CUD and HC. Less efficient executive attention was significantly associated with smaller surface area in the right caudal anterior cingulate cortex in EOS+CUD.

CONCLUSIONS

These preliminary data suggest that the presence of CUD has a moderating effect on attentional performance in adolescents with schizophrenia compared to nonpsychotic adolescents. These deficits could have a role in difficulties with self-regulation and predisposition to substance misuse in this patient group. The anatomic substrate of this cognitive deficit may be related to surface area in the right caudal anterior cingulate cortex.

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  • Authors+Show Affiliations

    ,

    Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, United States. Electronic address: epste069@umn.edu.

    Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, United States.

    Source

    Schizophrenia research 157:1-3 2014 Aug pg 48-54

    MeSH

    Adolescent
    Age of Onset
    Attention
    Brain
    Comorbidity
    Conflict (Psychology)
    Executive Function
    Female
    Humans
    Magnetic Resonance Imaging
    Male
    Marijuana Abuse
    Multivariate Analysis
    Neural Pathways
    Neuropsychological Tests
    Organ Size
    Reaction Time
    Schizophrenia
    Schizophrenic Psychology

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24875171

    Citation

    Epstein, Katherine A., and Sanjiv Kumra. "Executive Attention Impairment in Adolescents With Schizophrenia Who Have Used Cannabis." Schizophrenia Research, vol. 157, no. 1-3, 2014, pp. 48-54.
    Epstein KA, Kumra S. Executive attention impairment in adolescents with schizophrenia who have used cannabis. Schizophr Res. 2014;157(1-3):48-54.
    Epstein, K. A., & Kumra, S. (2014). Executive attention impairment in adolescents with schizophrenia who have used cannabis. Schizophrenia Research, 157(1-3), pp. 48-54. doi:10.1016/j.schres.2014.04.035.
    Epstein KA, Kumra S. Executive Attention Impairment in Adolescents With Schizophrenia Who Have Used Cannabis. Schizophr Res. 2014;157(1-3):48-54. PubMed PMID: 24875171.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Executive attention impairment in adolescents with schizophrenia who have used cannabis. AU - Epstein,Katherine A, AU - Kumra,Sanjiv, Y1 - 2014/05/27/ PY - 2013/12/10/received PY - 2014/04/18/revised PY - 2014/04/23/accepted PY - 2014/5/31/entrez PY - 2014/5/31/pubmed PY - 2015/2/27/medline KW - Adolescent KW - Anterior cingulate KW - Attention Network Test KW - Cannabis KW - Schizophrenia SP - 48 EP - 54 JF - Schizophrenia research JO - Schizophr. Res. VL - 157 IS - 1-3 N2 - OBJECTIVE: Repeated exposure to cannabis in nonpsychotic adolescents is associated with impairments in executive control of attention, similar to those observed in young adults with first-episode schizophrenia. To assess the impact of recurrent exposure to cannabis on cognitive function, this study characterized attention performance in both nonpsychotic adolescents and adolescents with early-onset schizophrenia (EOS). METHOD: The Attention Network Test, a standard procedure that estimates the functional state of neural networks controlling the efficiency of three different attentional behaviors (alerting, orienting, and executive attention), was administered to four groups of participants: (1) adolescents with EOS and comorbid cannabis use disorder (EOS+CUD; n=18), (2) "Pure" schizophrenia (EOS; n=34), (3) "Pure" cannabis use disorder (CUD; n=29), and (4) Healthy controls (HC; n=53). Task performance was examined with a 2×2 design (EOS+ versus EOS- and CUD+ versus CUD-) using multivariate analysis of covariance. Correlative analyses were conducted between executive attention performance and measures of surface area in the right anterior cingulate cortex. RESULTS: A significant EOS×CUD interaction was observed. In the executive attention network, adolescents with EOS+CUD showed reduced efficiency relative to adolescents with pure EOS, whereas no group differences were found between adolescents with pure CUD and HC. Less efficient executive attention was significantly associated with smaller surface area in the right caudal anterior cingulate cortex in EOS+CUD. CONCLUSIONS: These preliminary data suggest that the presence of CUD has a moderating effect on attentional performance in adolescents with schizophrenia compared to nonpsychotic adolescents. These deficits could have a role in difficulties with self-regulation and predisposition to substance misuse in this patient group. The anatomic substrate of this cognitive deficit may be related to surface area in the right caudal anterior cingulate cortex. SN - 1573-2509 UR - https://www.unboundmedicine.com/medline/citation/24875171/Executive_attention_impairment_in_adolescents_with_schizophrenia_who_have_used_cannabis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920-9964(14)00227-8 DB - PRIME DP - Unbound Medicine ER -