Clinical trial NCT05664763: Understanding Effects of Cannabis Use and Abstinence on Neural Glutamate Homeostasis
Official title: Understanding Effects of Cannabis Use and Abstinence on Neural Glutamate Homeostasis
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: EARLY_PHASE1
Conditions: Cannabis Use Disorder
Keywords: Cannabis
neuroimaging
marijuana
glutamate
tetrahydrocannabinol (THC)
Lead sponsor: Yale University
Sponsor class: OTHER
Collaborators: name: National Institute on Drug Abuse (NIDA)
First posted: 2022-12-27
Enrollment: 6
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: This study will be the first in vivo human multimodal neuroimaging study exploring the relationship between mGluR5 availability (PET), neural oscillations (EEG), and cognitive function in people with CUD. The goal is to test the overall hypothesis that mGluR5 availability is higher in people with CUD compared with HC. In Aim 1, the investigators will determine differences in mGluR5 availability between people with CUD and HC in the fronto-limbic brain circuit. Aim 2 examines the associations between mGluR5 availability, CUD severity, neural oscillations, and cognitive function in CUD subjects. Aim 3 will determine how prolonged abstinence from chronic cannabis use affects mGluR5 availability, neural oscillations, and cognitive function in CUD subjects.

Detailed description: Cannabis use and availability continue to rise significantly in the US. It is critical to expand our knowledge of the negative and positive effects of cannabis to "catch up" to the current reality of widespread and growing use. Cannabis and tetrahydrocannabinol (THC), its primary psychoactive chemical, have widespread effects on neural glutamate homeostasis, and specifically metabotropic glutamate receptor 5 (mGluR5). mGluR5 regulates transmission of glutamate and plays a critical role in neural plasticity (i.e., long-term potentiation; LTP), memory, learning, mood, and addiction. Specifically, it is thought that mGluR5 activation by glutamate initiates production of endocannabinoids (i.e., 2-AG) that bind retrograde to presynaptic cannabinoid receptor 1. This pathway inhibits further glutamate release and modulates synaptic plasticity diffusely in the brain. However, cannabis use disrupts this normal mechanism of glutamate homeostasis. While the relationship between cannabis use and glutamate regulation has been explored in preclinical models, it has not been well-characterized in humans, and particularly in people with cannabis use disorder (CUD).

The goal is to test the overall hypothesis that mGluR5 availability is higher in people with CUD compared with HC. This study will advance our understanding of cannabis effects on the neural glutamate system in humans and may lead to the development of novel therapeutics and biomarkers to treat people with CUD. Aim 1 will determine differences in mGluR5 availability between people with CUD and HC in the fronto-limbic brain circuit. Aim 2 examines the associations between mGluR5 availability, CUD severity, neural oscillations, and cognitive function in CUD subjects. Aim 3 will determine how prolonged abstinence from chronic cannabis use affects mGluR5 availability, neural oscillations, and cognitive function in CUD subjects.

Eligibility criteria: Inclusion Criteria:

HC and CUD Group:

* Voluntary, written, informed consent
* Physically healthy by medical history, physical, neurological, ECG and laboratory exams
* No personal or first-degree relative history of psychiatric disorders (outside of cannabis use for CUD group)
* Full scale and verbal IQs \> 80 (Wechsler Adult Intelligence Scale, Fourth Edition; WAIS-IV).

CUD group:

* Cannabis use disorder as determined by DSM-5 structured interviews
* Urine toxicology evidence of cannabinoid use

HC group:

* lifetime cannabis exposure less than 20 times
* no cannabis use in the past 2 years by self-report
* a negative urine drug screen.

Exclusion Criteria:

* Other substance use disorder within 1 year, except for nicotine
* Another primary DSM-5 Axis I major psychiatric disorder (e.g., schizophrenia, bipolar disorder, major depression, etc.) per SCID-5
* Urine toxicology results positive for other drugs such as opiates / opiate metabolites (e.g., methadone, buprenorphine, etc.)
* A history of significant medical (cardiac, infectious, metabolic) or neurological illness (e.g., cerebrovascular disease, traumatic brain injury)
* A history of seizures/epilepsy
* Current use of psychotropic and/or potentially psychoactive prescription medications
* Medical contraindications to MRI imaging (e.g., ferromagnetic implants/foreign bodies, claustrophobia, etc.)
* Pregnancy or breastfeeding (women).
* Subjects will be excluded for major medical or neurological illness or laboratories consistent with these illnesses or suggesting contraindication to PET or MR imaging

Primary outcomes:
measure: Change in Metabotropic Glutamate Receptor 5 (mGluR5) Availability
timeFrame: Baseline and Day 28
Secondary outcomes:
measure: Change in Neurocognitive Function using CogState Cognitive Battery
timeFrame: Baseline and Day 28
measure: Change in Verbal Memory measured using Electroencephalography (EEG)
timeFrame: Baseline and Day 28
Other outcomes:
Locations:
city: New Haven
country: United States
facility: The Anlyan Center
state: Connecticut
Study officials:
affiliation: Yale University
name: Stephen R Baldassarri, M.D.
role: PRINCIPAL_INVESTIGATOR
References: