Elsevier

NeuroImage: Clinical

Volume 13, 2017, Pages 188-200
NeuroImage: Clinical

Distinct effects of childhood ADHD and cannabis use on brain functional architecture in young adults

https://doi.org/10.1016/j.nicl.2016.09.012Get rights and content
Under a Creative Commons license
open access

Highlights

  • Alterations in functional organization persist in those with childhood ADHD.

  • Network alterations can be linked with specific aspects of the ADHD phenotype.

  • Cannabis use does not appear to exacerbate ADHD-related alterations.

  • Longitudinal studies are required to capture the long-term impact of cannabis use.

Abstract

One of the most salient long-term implications of a childhood diagnosis of ADHD is an increased risk for substance use, abuse, or dependence in adolescence and adulthood. The extent to which cannabis use affects ADHD-related alterations in brain functional organization is unknown, however. To address this research gap, we recruited a sample of 75 individuals aged 21–25 years with and without a childhood diagnosis of ADHD Combined Type, who were either frequent users or non-users of cannabis. These participants have been followed longitudinally since age 7–9.9 years as part of a large multi-site longitudinal study of ADHD, the Multimodal Treatment Study of Children with ADHD (MTA). We examined task-independent intrinsic functional connectivity (iFC) within 9 functional networks using a 2 × 2 design, which compared four groups of participants: (1) individuals with a childhood diagnosis of ADHD who currently use cannabis (n = 23); (2) individuals with ADHD who do not currently use cannabis (n = 22); (3) comparisons who currently use cannabis (n = 15); and (4) comparisons who do not currently use cannabis (n = 15). The main effects of childhood ADHD were primarily weakened iFC in networks supporting executive function and somatomotor control. Contrary to expectations, effects of cannabis use were distinct from those of diagnostic group and no interactions were observed. Exploratory brain-behavior analyses suggested that ADHD-related effects were primarily linked with poorer neurocognitive performance. Deficits in the integrity of functional networks supporting executive function and somatomotor control are consistent with the phenotypic and neurocognitive features of ADHD. Our data suggest that cannabis use does not exacerbate ADHD-related alterations, but this finding awaits replication in a larger sample. Longitudinal neuroimaging studies are urgently required to delineate the neurodevelopmental cascade that culminates in positive and negative outcomes for those diagnosed with ADHD in childhood.

Keywords

ADHD
Cannabis
Marijuana
fMRI
Functional connectivity
Neurocognitive

Cited by (0)

1

The Multimodal Treatment Study of Children with ADHD (MTA) was a National Institute of Mental Health (NIMH) cooperative agreement randomized clinical trial, continued under an NIMH contract as a follow-up study and finally under a National Institute on Drug Abuse (NIDA) contract. Collaborators from NIMH: Benedetto Vitiello, M.D. (Child & Adolescent Treatment and Preventive Interventions Research Branch), Joanne B. Severe, M.S. (Clinical Trials Operations and Biostatistics Unit, Division of Services and Intervention Research), Peter S. Jensen, M.D. (currently at REACH Institute and Mayo Clinic), L. Eugene Arnold, M.D., M.Ed. (currently at Ohio State University), Kimberly Hoagwood, Ph.D. (currently at Columbia); previous contributors from NIMH to the early phases: John Richters, Ph.D. (currently at National Institute of Nursing Research); Donald Vereen, M.D. (currently at NIDA). Principal investigators and co-investigators from the sites are: University of California, Berkeley/San Francisco: Stephen P. Hinshaw, Ph.D. (Berkeley), Glen R. Elliott, Ph.D., M.D. (San Francisco); Duke University Medical Center: Karen C. Wells, Ph.D., Jeffery N. Epstein, Ph.D. (currently at Cincinnati Children's Hospital Medical Center), Desiree W. Murray, Ph.D.; previous Duke contributors to early phases: C. Keith Conners, Ph.D. (former PI); John March, M.D., M.P.H.; University of California, Irvine: James Swanson, Ph.D., Timothy Wigal, Ph.D.; previous contributor from UCLA to the early phases: Dennis P. Cantwell, M.D. (deceased); New York University: Howard B. Abikoff, Ph.D.; Montreal Children's Hospital/ McGill University: Lily Hechtman, M.D.; New York State Psychiatric Institute/Columbia University/Mount Sinai Medical Center: Laurence L. Greenhill, M.D. (Columbia), Jeffrey H. Newcorn, M.D. (Mount Sinai School of Medicine). University of Pittsburgh: Brooke Molina, Ph.D., Betsy Hoza, Ph.D. (currently at University of Vermont), William E. Pelham, Ph.D. (PI for early phases, currently at Florida International University). Follow-up phase statistical collaborators: Robert D. Gibbons, Ph.D. (University of Illinois, Chicago); Sue Marcus, Ph.D. (Mt. Sinai College of Medicine); Kwan Hur, Ph.D. (University of Illinois, Chicago). Original study statistical and design consultant: Helena C. Kraemer, Ph.D. (Stanford University). Collaborator from the Office of Special Education Programs/US Department of Education: Thomas Hanley, Ed.D. Collaborator from Office of Juvenile Justice and Delinquency Prevention/Department of Justice: Karen Stern, Ph.D. Additional investigators for Neuroimaging Substudy: Leanne Tamm, Ph.D., PI (Cincinnati Children's Hospital Medical Center), James Bjork, Ph.D. (Division of Clinical Neuroscience and Behavioral Research, NIDA; currently at Virginia Commonwealth University), Daniel Mathalon, M.D., Ph.D. (UC San Francisco), Allen Song, Ph.D. (Duke), Bradley Peterson, M.D. (Columbia), Steven Potkin, M.D. & Claudia Buss, Ph.D. (UC Irvine), Katerina Velanova, Ph.D. (Pittsburgh), Neuroimaging Consultants: Susan Tapert, Ph.D. & Joshua Kuperman, Ph.D. (UC San Diego), BJ Casey, Ph.D. & Leah Sommerville, Ph.D. (Sackler Institute, Cornell), Krista Lisdahl, Ph.D. (University of Wisconsin-Milwaukee). Neuroimaging Analysis and Interpretation: Terry Jernigan, Ph.D. & Anders Dale, Ph.D. (UC San Diego), F. Xavier Castellanos, M.D. & Clare Kelly, Ph.D. (New York University).