title: Discriminative Properties of Hippocampal Hypoperfusion in Marijuana Users Compared to Healthy Controls: Implications for Marijuana Administration in Alzheimer's Dementia.
abstract: Few studies have evaluated the impact of marijuana use on regional cerebral blood flow.
  
  
  
  To determine whether perfusion in specific brain regions on functional neuroimaging, including those affected by Alzheimer's disease pathology, are abnormal in marijuana users compared to controls.
  
  
  
  Persons with a diagnosis of cannabis use disorder by DSM-IV and DSM-V criteria (n = 982) were compared to controls (n = 92) with perfusion neuroimaging with SPECT at rest and at a concentration task. Perfusion estimates were quantified using a standard atlas. Cerebral perfusion differences were calculated using one-way ANOVA. Diagnostic separation was determined with discriminant analysis of all subjects. Feature selection with a minimum redundancy maximum relevancy (mRMR) identified predictive regions in a subset of marijuana users (n = 436) with reduced psychiatric co-morbidities.
  
  
  
  Marijuana users showed lower cerebral perfusion on average (p < 0.05). Discriminant analysis distinguished marijuana users from controls with correct classification of 96% and leave one out cross-validation of 92%. With concentration SPECT regions, there was correct classification of 95% with a leave-one-out cross validation of 90%. AUC analysis for concentration SPECT regions showed 95% accuracy, 90% sensitivity, and 83% specificity. The mRMR analysis showed right hippocampal hypoperfusion on concentration SPECT imaging was the most predictive in separating marijuana subjects from controls.
  
  
  
  Multiple brain regions show low perfusion on SPECT in marijuana users. The most predictive region distinguishing marijuana users from healthy controls, the hippocampus, is a key target of Alzheimer's disease pathology. This study raises the possibility of deleterious brain effects of marijuana use.
authors.affiliation: Amen Clinics Inc. Costa Mesa, CA, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Amen
authors.affiliation: Amen Clinics Inc. Costa Mesa, CA, USA.
authors.forename: Borhan
authors.initials: B
authors.lastname: Darmal
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Cyrus A
authors.initials: CA
authors.lastname: Raji
authors.affiliation: Department of Electrical Engineering, University of Southern California, Los Angeles, CA, USA.
authors.forename: Weining
authors.initials: W
authors.lastname: Bao
authors.affiliation: Amen Clinics Inc. Costa Mesa, CA, USA.
authors.forename: Lantie
authors.initials: L
authors.lastname: Jorandby
authors.affiliation: UCLA Medical Center, Los Angeles, CA, USA.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Meysami
authors.affiliation: Department of Electrical Engineering, University of Southern California, Los Angeles, CA, USA.
authors.forename: Cauligi S
authors.initials: CS
authors.lastname: Raghavendra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D000074609:Marijuana Use / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D055420:Perfusion Imaging; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
keywords: Hippocampus; SPECT; imaging; marijuana