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Analisi dello Studio “Effetti della Cannabis ad alto principio attivo sul Corpo Calloso”

Analisi dello Studio “Effetti della Cannabis ad alto principio attivo sul Corpo Calloso”
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Un piccolo studio, esposto in questi giorni, ha trovato che alcuni consumatori di cannabis con principi attivi elevati (in particolare il THC) hanno avuto cambiamenti delle fibre nervose in una parte specifica del cervello; in questo articolo analizzeremo questa ricerca nel dettaglio, cercando di valutarne obiettivamente il contenuto.

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I ricercatori hanno usato scanner MRI per eseguire la scansione del cervello di 99 adulti – alcuni con psicosi, alcuni senza – alla ricerca di eventuali collegamenti tra piccoli cambiamenti nella loro struttura del cervello e le loro abitudini di utilizzare cannabis.

I ricercatori hanno esaminato in particolare l’effetto sulla struttura fine del corpo calloso. Questo elemento è un gruppo di fibre nervose che collegano i lati sinistro e destro del cervello ed è pensato per aiutare diverse parti del cervello a “comunicare” tra loro.

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Nello studio un gruppo di 56 persone con psicosi ( 37 consumatori di cannabis) e 43 persone senza psicosi (22 consumatori di cannabis) ha avuto una scansione del cervello. Le scansioni sono state usate per cercare possibili collegamenti tra le loro abitudini di cannabis e le eventuali differenze nella struttura della zona del corpo calloso del loro cervello. La maggior parte di quelli con psicosi assumevano farmaci antipsicotici (53 di 56); solo tre non li usavano.

Le scansioni cerebrali hanno utilizzato una tecnica di imaging MRI – tensore di diffusione Imaging tractography – che indica come diverse parti del cervello sono collegate tra loro e quanto facilmente le informazioni vengono trasferite tra le due parti. Questa tecnica misura l’efficienza con la quale si segnala nel viaggio cerebrale (diffusività), dove i punteggi bassi di diffusività indicano un funzionamento del cervello sano e di alta diffusività possono indicare una qualche forma di danno.

Il team ha esaminato quattro misure di imaging del tensore di diffusione comune:

  • anisotropia frazionaria (FA)
  • diffusività media (MD)
  • diffusività assiale (AD)
  • diffusività radiale (RD)

FA è un modo sensibile di raccogliere piccoli cambiamenti strutturali del cervello ed è relativamente generico. MD, AD, e RD danno indicazioni più specifiche in cui i cambiamenti avvengono.

Tutti i partecipanti hanno compilato un questionario che comprendeva la loro abitudine al fumo di cannabis, quando hanno iniziato, la forza della cannabis che hanno usato, e quante volte la hanno usata.

L’analisi statistica ha tenuto conto dei seguenti fattori confondenti:

  • fattori sociodemografici
  • età
  • Genere
  • etnia
  • alcuni fattori di stile di vita, come l’assunzione di alcol

Lo studio ha esposto che i consumatori di cannabis con principio attivo THC elevato – così come coloro che hanno usato alcun tipo di cannabis su base giornaliera – hanno avuto diversi cambiamenti strutturali del corpo calloso, rispetto a coloro che fumavano meno o cannabis con inferiore potenza.

Le scansioni hanno trovato che gli utenti giornalieri di cannabis di potenza elevata avevano una leggermente maggiore – di circa il 2% – “diffusività media” nel corpo calloso.

Ci sono stati anche altri risultati interessanti, ma non tutti sono stati raccolti nei rapporti dei media.

Ad esempio, quelli con diagnosi di psicosi avevano una maggiore probabilità di aver usato cannabis ad un certo punto in passato rispetto a quelli senza psicosi, ma non sono state riportate differenze tra le persone con e senza la psicosi in termini di cannabis in quanto tempo era utilizzata, quanti anni avevano quando hanno usato la sostanza, il tipo di cannabis utilizzata, quanto spesso è stata utilizzata, e la forza dei principi attivi.

Tre delle quattro misure della funzione del corpo calloso non erano diverse in persone affette da psicosi rispetto a quelle senza (MD, RD, DC). FA è risultato essere diverso, ma è un risultato borderline statisticamente significativo, nel senso che c’è una ragionevole probabilità che il risultato sia venuto per caso – specificamente, un 1 su 25 possibilità, p = 0,04.

Poiché la struttura del corpo calloso non era differente fra quelli con e senza psicosi, i ricercatori li hanno riuniti i gruppi per studiare l’effetto della cannabis sul cervello.

Nel complesso, hanno trovato che la struttura del corpo calloso è stata influenzata negativamente nelle persone che usano cannabis di potenza elevata, rispetto a quelli che utilizzano un ceppo di inferiore potenza o non utilizzano cannabis, attraverso MD, AD e misure di diffusione RD, ma non il più generico FA .

Queste alterazioni sono state simili a consumatori con e senza psicosi.

Nessun collegamento è stato trovato tra quelli che hanno avuto il primo utilizzo di cannabis prima dei 15 anni e quelli che iniziano dopo, in termini di cambiamenti nella struttura del corpo calloso.

Ciò che questo studio non ci dice è se questi cambiamenti strutturali fanno del male o causano eventuali effetti negativi sulla salute mentale. Lo studio semplicemente non guarda a questa situazione, ma si limita a riportare un dato statistico che non può divenire certezza ne concatenazione causale.

Gli effetti del consumo di cannabis – sia nel breve e lungo termine – non sono saldamente fissati. 

Lo studio aggiunge nuove conoscenze circa l’effetto potenziale del fumo di cannabis sul cervello, che altri ricercatori possano poi  ricostruire ed analizzare. Ma questa è una ricerca esplorativa e non può fornire alcuna conclusione concreta di causa-effetto.

Lo studio, inoltre, non può dirci se l’uso di cannabis è la causa diretta di queste differenze osservate, o se altri fattori potrebbero essere avere un’influenza.

Studi di coorte seguendo persone nel corso del tempo, esaminando il loro uso di cannabis e svolgendo follow-up di scansioni cerebrali, sarebbero utili per analizzare meglio queste situazioni.

Dunque, come per tutte le ricerche, questo studio ha i suoi limiti.

Ad esempio, 100 persone non sono sufficienti, se vengono poi scisse in molti gruppi, come quelli con e senza psicosi e diversi livelli di consumo di cannabis.

Alcuni dei numeri di gruppo iniziano a diventare molto piccoli, e ciò aumenta le probabilità che non avranno abbastanza persone per trovare differenze statisticamente significative, anche se esistono.

Allo stesso modo, i risultati stessi non erano del tutto coerenti.

C’è un mix di risultati significativi e non significativi per le quattro misure adottate (FA, MD, RD e AD).

Questa mancanza di coerenza intorbida leggermente l’immagine e riduce la nostra fiducia nelle conclusioni.

 

 

Fonte ANALISI: National Healt Service (Servizio Sanitario Britannico)

Rigucci S, Marques TR, Di Forti M, et al. Effetto di cannabis di potenza elevata sul corpo calloso. Psychological Medicine.Pubblicato online il 27 Novembre 2015

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