Left hemisphere lateralization of the limbic system and frontoparietal network (FPN) correlates with positive and negative symptom improvement following cannabidiol (CBD) administration in psychosis and ultra-high risk (UHR) populations: A voxel-wise meta-analysis

Zachary P Pierce; Andrew S Bogatz; Emily R Johnson; Brianna E Lear; Collin C Nelson; Jessica M Black

doi:10.1016/j.jpsychires.2024.05.029

Left hemisphere lateralization of the limbic system and frontoparietal network (FPN) correlates with positive and negative symptom improvement following cannabidiol (CBD) administration in psychosis and ultra-high risk (UHR) populations: A voxel-wise meta-analysis

J Psychiatr Res. 2024 May 9:175:160-169. doi: 10.1016/j.jpsychires.2024.05.029. Online ahead of print.

Authors

Zachary P Pierce¹, Andrew S Bogatz², Emily R Johnson³, Brianna E Lear⁴, Collin C Nelson⁵, Jessica M Black²

Affiliations

¹ Community Behavioral Health Center, Riverside Community Care, Milford, MA, USA; Cell to Society Lab, Boston College School of Social Work, Chestnut Hill, MA, USA. Electronic address: zapierce11@gmail.com.
² Cell to Society Lab, Boston College School of Social Work, Chestnut Hill, MA, USA; Boston College School of Social Work, Chestnut Hill, MA, USA.
³ Cell to Society Lab, Boston College School of Social Work, Chestnut Hill, MA, USA; Primary Care Department, Boston Children's Hospital, Boston, MA, USA.
⁴ Cell to Society Lab, Boston College School of Social Work, Chestnut Hill, MA, USA.
⁵ Community Behavioral Health Center, Riverside Community Care, Milford, MA, USA.

PMID: 38735261
DOI: 10.1016/j.jpsychires.2024.05.029

Abstract

This voxel-wise meta-analysis assesses current findings about the neural correlates of cannabidiol on the positive and negative symptoms among individuals with psychosis or ultra-high risk (UHR) for psychosis. We used PubMed, EMBASE, and ScienceDirect as primary databases and initially retrieved 157 studies. After applying our eligibility criteria, 13 studies remained for inclusion. Ten studies focused on psychosis. Three studies focused on UHR. Quality assessment was performed for included articles using the RoB2 instrument. Statistical analysis implicated a voxel-wise meta-analysis of different task paradigms (emotion recognition, verbal memory recall, and inhibitory control) with a jackknife sensitivity measure, Egger's test of random effects, and a meta-regression with relevant covariates. Article quality was determined to be primarily low risk of bias, with some elements of unclear bias figuring across studies. Our results showed robust, convergent correlations between CBD administration and left hemisphere lateralization of limbic system and frontoparietal network (FPN) subregions across task paradigms in psychosis and UHR populations. Our meta-regression revealed that decreased limbic system activity correlated with positive symptom improvements, and decreased FPN activity correlated with negative symptom improvements. Lastly, sensitivity analyses determined that there was minimal risk bias or risk of confounding variables unduly influencing our meta-analyses (p > 0.05).

Keywords: CBD; Meta-analysis; Psychosis; Schizophrenia; UHR; fMRI.

Publication types

Review