The MIND program is Harvard's new research program investigating the relationship between the brain and Cannabis.
Cannabis products are everywhere these days. As a growing number of states relax their medical and recreational cannabis laws, millions of Americans are using the cannabis Sativa plant, commonly known as marijuana, to relax or treat pain, anxiety, insomnia, and other conditions. Still, more data on its impact are needed. "The nation was excited about cannabis use, but politics continues to outpace science," says neuroscientist Staci Gruber, EdM '95, Ph.D., who is working to change that.
Gruber, associate professor of psychiatry at Harvard Medical School, directs both the Cognitive and Clinical Neuroimaging Core and the Marijuana Investigations for Neuroscientific Discovery - the MIND program at McLean Hospital. She and her team are using cognitive and clinical measures, as well as neuroimaging techniques, such as functional MRI, to help elucidate how cannabis affects the human brain.
They found, for example, that individuals who start heavy recreational marijuana use before age 16 - when the brain is still developing - may perform worse on cognitive or behavioural tasks involving the frontal cortex, such as memory, attention, and judgment, than those who do not use cannabis or who started using it later in life.
A recent article that Gruber co-authored highlighted these findings using the results of a simulated driving test. Neuroimaging also revealed changes in the white matter, the neural fibers essential for efficient communication between brain regions, in early-onset cannabis users.
Cannabis products are everywhere these days. As a growing number of states relax their medical and recreational cannabis laws, millions of Americans are using the cannabis Sativa plant, commonly known as marijuana, to relax or treat pain, anxiety, insomnia, and other conditions.
Gruber is especially excited about her team's research on medical cannabis and its effect on cognition, brain structure, function, and quality of life. "There is almost no literature on the long-term impact of medical cannabis," says Gruber, who launched the MIND Program in late 2014 to address this gap.
"Many people are desperate to find something that works to alleviate their symptoms. It would be great to know what really works and what doesn't for patients over time."
Encouraging results emerged from the first MIND program investigation, a longitudinal observational study of individuals using medical cannabis for a variety of conditions and symptoms. The team conducts several assessments before participants - who choose their own products - begin treatment. Other tests take place three, six, 12, 15, 18, and 24 months after starting treatment.
Even after a few months, patients performed better on cognitive tasks that require executive functions; "Instead of getting worse, they're actually getting better," says Gruber. This contrasts with the worse cognitive performance seen among some heavy recreational marijuana users relative to non-users. Patients in this pioneering study also reported improved mood, energy, and sleep, and reduced use of conventional medications.
What explains these improvements? Gruber says patients may be thinking more clearly because their symptoms have eased and/or because they are using less conventional medications such as opioids. Also, medical cannabis patients tend to be older than recreational users, and she says there are some preclinical data suggesting that cannabis may help drive the aging of the body's endocannabinoid system - a natural system that helps to regulate essential functions such as sleep, mood, appetite, and memory.
The MIND program is also conducting medical marijuana research studies involving veterans, women with male and menopausal problems, and those suffering from chronic pain. In addition, Gruber's laboratory launched the country's first clinical trial to compare the effectiveness of two different formulations that include cannabidiol (CBD) - a non-intoxicating component of cannabis - for treating anxiety.
With MIND Program, patients will receive a full spectrum product that is high in CBD and contains other cannabinoids and terpenoids (organic compounds that provide aroma, flavour, and can also have their own effects on the body); a form of CBD composite from a single extraction from the same source; or a placebo. Gruber wants to know if the full spectrum version will work better to reduce anxiety, which affects millions of Americans.$4.5 million HMS gift from Harvard alumnus Charles R. "Bob" Broderick, AM '05, to foster cannabis-related discovery.
Gruber's 20-plus-year quest to understand how cannabis affects the brain began with a summer internship at college that changed his life at McLean, located in Belmont, Massachusetts. "I fell in love with clinical trials and evaluations and neuropsychological tests and I thought, 'I can't imagine doing anything more exciting than this,'" she recalls. She remained at McLean and collaborated with McLean researchers during her college, undergraduate, and graduate years and then joined the faculty. Gruber says she is honored to work with dedicated patient volunteers in her studies. "And if we're doing something that helps improve the quality of life for any group of patients, we change the world."
Cannabis: Used since ancient times, the cannabis Sativa plant contains more than 400 chemical compounds, including more than 100 phytocannabinoids, which can cause drug-like effects in humans. The best known are delta-9-tetrahydrocannabinol (THC), which produces a mental "high" and cannabidiol (CBD), which does not.
Depending on the type of product used, cannabis can be smoked, inhaled, ingested by mouth, rubbed into the skin, or mixed with food and drink. To date, 33 states and Washington, DC, have fully legalized medical marijuana and another 15 allow the use of products with low THC and high levels of CBD for some medical purposes. On the recreational front, 11 states and DC have legalized the recreational use of marijuana by adults.
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