Assistant Professor University of Vermont University of Vermont Burlington, Vermont, United States
Background: Cannabis is the most commonly used illicit substance during pregnancy. Many studies have demonstrated negative neurocognitive effects in exposed children between infancy and adolescence. These include differences in learning, memory and verbal reasoning. The impact prenatal cannabis (PCE) on attention in adolescents has been less well described.
Objective: The primary objective was to describe association between PCE and attention problems in early adolescents. Secondary objectives included describing the impact of PCE on other behavioral domains, cognition and functional imaging.
Design/Methods: Data was obtained from the Adolescent Brain Cognitive Development (ABCD) study, a national cohort of over 11,500 children. All participants with PCE (N=224) were included in analysis and compared to two control groups (n=224 each); those with matched tobacco and alcohol exposure and those without prenatal drug exposures. The primary outcome was the Attention Problems score on the parent-reported Child Behavior Checklist (CBCL). Secondary behavioral outcomes included remaining CBCL behavioral scales (internalizing, externalizing, thought, social and total problems). Multiple informant data from teacher report forms (TRF) were used when available. Cognitive outcomes were measured with performance on NIH toolbox assessments. Mixed effects modeling was used to assess the association between PCE and outcomes. Brain functioning outcomes included three fMRI tasks: the Stop Signal Task, the MID task and the EN-Back. Permutation Analyses of the Linear Model was used to compare brain activation patterns between those with PCE and the two control groups. Covariates included parental psychopathology, prematurity, and socioeconomic status for all analyses.
Results: Compared to both control groups, PCE was associated with significantly higher attention problems. Other behavioral impacts included increased externalizing behavior and total problems. Results were consistent between the CBCL and TRF. Parental psychopathology was a significant moderator of behavior in all models. No differences were seen on cognitive tests or brain activation mapping. Conclusion(s): There are associations between PCE and attention problems and other behavioral outcomes at age 9/10 years. Assessing for attention problems in adolescents should include a thorough assessment of prenatal exposures. Future investigation of the effect of PCE on adolescent neurocircuitry and among those with known genetic risk factors are warranted to better understand the extent and mechanism of the effect.
Authors/Institutions: Leigh-Anne Cioffredi, University of Vermont, Burlington, Vermont, United States; Hillary Anderson, University of Vermont, Burlington, Vermont, United States; Hannah Loso, University of Vermont, Burlington, Vermont, United States; James East, University of Vermont, Burlington, Vermont, United States; Phillip Nguyen, University of Vermont, Burlington, Vermont, United States; Hugh Garavan, University of Vermont, Burlington, Vermont, United States; Alexandra Potter, University of Vermont, Burlington, Vermont, United States
