Abstract
Citicoline is an endogenous nucleotide that has historically been used to treat stroke, traumatic brain injury, and cognitive dysfunction. Research has also shown that citicoline treatment is associated with improved cognitive performance in substance-abusing populations. We hypothesized that marijuana (MJ) smokers who received citicoline would demonstrate improvement in cognitive performance as well as increased neural efficiency during tasks of cognitive control relative to those who received placebo. The current study tested this hypothesis by examining the effects of citicoline in treatment-seeking chronic MJ smokers. In an 8-week double-blind, placebo-controlled study, 19 MJ smokers were randomly assigned via a double-blind procedure to the citicoline (8 Males, 2 Females) or placebo group (9 Males, 0 Females). All participants completed fMRI scanning at baseline and after 8 weeks of treatment during two cognitive measures of inhibitory processing, the Multi Source Interference Test (MSIT) and Stroop Color Word Test, and also completed the Barratt Impulsiveness Scale (BIS-11), a self-report measure of impulsivity. Following the 8 week trial, MJ smokers treated with citicoline demonstrated significantly lower levels of behavioral impulsivity, improved task accuracy on both the MSIT and Stroop tasks, and exhibited significantly different patterns of brain activation relative to baseline levels and relative to those who received placebo. Findings suggest that citicoline may facilitate the treatment of MJ use disorders by improving the cognitive skills necessary to fully engage in comprehensive treatment programs.
Highlights
Marijuana (MJ) remains the most widely used illicit drug in the United States
Following the 8 week trial, MJ smokers treated with citicoline demonstrated significantly lower levels of behavioral impulsivity, improved task accuracy on both the Multi Source Interference Test (MSIT) and Stroop tasks, and exhibited significantly different patterns of brain activation relative to baseline levels and relative to those who received placebo
Findings suggest that citicoline may facilitate the treatment of MJ use disorders by improving the cognitive skills necessary to fully engage in comprehensive treatment programs
Summary
Marijuana (MJ) remains the most widely used illicit drug in the United States. An estimated18.9 million Americans aged 12 and older report MJ use in the past month, which is equivalent to 7.3% of the US population [1]. As debates regarding the legalization of MJ top the nation’s headlines, the benefits of medical MJ are often emphasized. This has likely contributed to the decrease in perceived harm of MJ use, which is approaching an alltime low. Perception of risk and harm is inversely correlated with rates of use, and it is not surprising that rates of MJ use increased more than 5% between 2007 and 2012 while use of alcohol, tobacco, and illicit drugs remained stable or declined over the past decade [1]. The decrease in perception of harm and accompanying increase in use are occurring despite reports of the potential adverse effects of marijuana on the brain. Recreational marijuana use has been reported to be associated with a myriad of cognitive impairments [2,3,4] and alterations in brain structure [5,6,7,8,9,10] and function [11,12,13,14]
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