Einflüsse von Cannabiskonsum auf die Gehirnentwicklung und das Erkrankungsrisiko für schizophrene Psychosen

Zusammenfassung

Die Auswirkungen des Cannabiskonsums variieren erheblich über die gesamte Lebensspanne, insbesondere in Bezug auf die Schule, Ausbildung, Arbeitsfähigkeit und Wahrnehmung sozialer Verpflichtungen. Studien zur Remission neurokognitiver Defizite nach chronischem Cannabiskonsum erbrachten widersprüchliche Ergebnisse und reichen von einer vollständigen Gesundung bis hin zu schwersten persistierenden Defiziten und sogar chronischen psychotischen Erkrankungen. In Einklang konnten diese Ergebnisse jedoch größtenteils gebracht werden, nachdem zwischen Konsumenten mit frühem und spätem Konsumbeginn unterschieden wurde. Persistierende neurokognitive Defizite als auch Volumenveränderungen von grauer Substanz und ein erhöhtes Psychoserisiko scheinen in erster Linie bei Menschen mit einem Konsumbeginn vor dem 16./17. Lebensjahr zu bestehen, also einer Zeit, in der bedeutsame Entwicklungsprozesse des jugendlichen Gehirns, insbesondere des Endocannabinoidsystems stattfinden. Gerade in dieser Zeit werden Reifungsprozesse höherer kognitiver Funktionen, sozialer Informationsverarbeitung, planerischen Denkens und der Handlungskontrolle vollzogen. Auch das Endocannabinoidsystem erreicht in dieser Phase seine höchste Rezeptordichte und ist umfangreich an diesen Prozessen beteiligt. Eine langfristige Schädigung dieses Systems (z. B. durch Herabregulierung und Desensitisierung von CB1-Rezeptoren durch Zufuhr von exogenen Cannabinoiden) in dieser kritischen Entwicklungsperiode stellt somit eine Grundlage von zukünftigen neurophysiologischen und neurokognitiven Defiziten als auch einer Erhöhung des Psychoserisikos dar.

Abstract

Cannabis consumption has varying effects over the whole life span, especially on achievements in the areas of schooling, professional life and performance in a social environment. Data from studies on remission from neurocognitive deficits following chronic cannabis consumption are ambiguous. The outcome range included everything from complete remission over considerable lasting deficits up to even chronic psychotic disorders. The data seem to be consistent however, when a differentiation between early begin of consumption (before the age of 16) and late begin of consumption is taken into account. Mainly those cannabis users with an early begin of consumption are prone to developing lasting neurocognitive deficits and even a decrease in grey substance volume, as well as an increase in the risk of psychosis. The correlation of this outcome with cannabis consumption during a phase of brain development that includes the consolidation of higher cognitive functions, awareness of social cues, planning of concepts and motivation as well as tools of functional control, is highly convincing. The endocannabinoid system reaches the point of highest receptor density during this age of 16/17 years, and many of the above-mentioned developmental processes are modulated by this system. A chronic damage to this system (e.g., down-regulation or desensitisation of CB1 receptors by exogenous cannabinoids) therefore holds the potential for permanent neurophysiological as well as neurocognitive deficits, and also for the development of psychotic disorders.

Schlüsselwörter

Cannabis - Gehirnentwicklung - Schizophrenie

Key words

cannabis - brain development - schizophrenia

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