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March 29, 2011; 76 (13) Articles

Effects of cannabis on cognitive function in patients with multiple sclerosis

Kimia Honarmand, Mary C. Tierney, Paul O'Connor, Anthony Feinstein
First published March 28, 2011, DOI: https://doi.org/10.1212/WNL.0b013e318212ab0c
Kimia Honarmand
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Citation
Effects of cannabis on cognitive function in patients with multiple sclerosis
Kimia Honarmand, Mary C. Tierney, Paul O'Connor, Anthony Feinstein
Neurology Mar 2011, 76 (13) 1153-1160; DOI: 10.1212/WNL.0b013e318212ab0c

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Abstract

Background: While neuropsychological deficits have been reported in healthy individuals who use street cannabis, data in patients with multiple sclerosis (MS) are lacking. Given that MS is associated with cognitive deterioration, the aim of this study was to determine the neuropsychological effects of cannabis use in this population.

Methods: Two groups, each of 25 patients with MS (cannabis users and nonusers), were administered the Minimal Assessment of Cognitive Function in MS battery of neuropsychological tests, the Hospital Anxiety and Depression Scale (HADS), and the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Group-matching and regression analysis were used to control for the effects of age, sex, education, premorbid intelligence, disability, and disease course and duration on cognitive function.

Results: Cannabis users performed significantly more poorly than nonusers on measures of information processing speed, working memory, executive functions, and visuospatial perception. They were also twice as likely as nonusers to be classified as globally cognitively impaired. There were no between-group differences on the HADS measures of depression and anxiety or lifetime SCID-I psychiatric diagnoses.

Conclusion: This cross-sectional study provides empirical evidence that prolonged use of inhaled or ingested street cannabis in patients with MS is associated with poorer performance on cognitive domains commonly affected in this population. Whatever subjective benefits patients may derive from using street cannabis (e.g., pain and spasticity relief) should be weighed against the associated cognitive side effects.

Footnotes

  • Study funding: Supported by the Multiple Sclerosis Society of Canada.

  • ANART
    American National Adult Reading Test
    BVMT-R
    Brief Visuospatial Memory Test–Revised
    COWAT
    Controlled Oral Word Association Test
    CVLT-II
    California Verbal Learning Test–Revised
    D-KEFS
    Delis-Kaplan Executive Function System
    EDSS
    Expanded Disability Status Scale
    HADS
    Hospital Anxiety and Depression Scale
    JLO
    Judgment of Line Orientation
    MACFIMS
    Minimal Assessment of Cognitive Function in MS
    MFIS
    Modified Fatigue Impact Scale
    MS
    multiple sclerosis
    PASAT
    Paced Auditory Serial Addition Test
    SDMT
    Symbol Digit Modalities Test
    SCID-I
    Structured Clinical Interview for the DSM-IV Axis I Disorders

  • Received August 3, 2010.
  • Accepted December 17, 2010.
  • Copyright © 2011 by AAN Enterprises, Inc.
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