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Cannabis Perturbs Dynamic Brain States

Katharina S Lege, Pablo Mallaroni, Sepehr Mortaheb, Natasha L. Mason, Eef L. Theunissen, Desmond H. Y. Tse, Stefan W. Toennes, Athena Demertzi, Johannes G. Ramaekers

Biological Psychiatry October 21, 2025 DOI: 10.1016/j.biopsych.2025.10.015 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Placebo-controlled neuroimaging trial Peer reviewed
Sample size 43
Population Occasional (n=23) and chronic (n=20) cannabis users
Intervention vaporized cannabis
Topics Cannabis
Keywords Effects of cannabis Relevance law Cognition Neuroimaging Neural activity Cognitive impairment Cognitive psychology Cannabis sativa Biological neural network
Citations 1
Key findings Cannabis intoxication reduces a hyperconnected brain state in both user groups, with chronic users showing persisting neuroadaptations and tolerance to attentional impairment.

Abstract

Background: The impact of acute cannabis exposure on brain function and cognitive performance varies among individuals. Acute effects of cannabis on behavior may be absent or benign in chronic users, while occasional users experience significant impairment in day-to-day operations. It is hypothesized that repeated cannabis use induces neuroadaptations leading to tolerance and desensitization, although the precise mechanisms underlying these adaptations remain unclear.

Methods: In this study, we investigated acute and persistent effects of vaporized cannabis on brain dynamics in a placebo-controlled neuroimaging trial involving occasional ( n = 23) and chronic ( n = 20) cannabis users. Functional resting-state data were collected to assess dynamic functional connectivity changes during intoxication and their association with attentional performance and normative cannabinoid CB 1 receptor density.

Results: Cannabis intoxication induced significant acute alterations in the dynamics of brain network organization, as shown by a reduced occurrence of a hyperconnected brain state in both user groups. Chronic users also displayed decreased segregation of brain networks independent of treatment condition, suggesting persisting neuroadaptations. Dynamic reconfiguration of hyperconnected brain motifs correlated with attentional performance, which was most impaired in occasional users, indicating tolerance in chronic users. Both the acute and persistent effects of cannabis on dynamic brain state organization were significantly associated with spatial CB 1 receptor density.

Conclusions: Acute cannabis-induced cognitive impairment is influenced by (persistent) network reconfigurations and CB 1 receptor density. These findings emphasize the relevance of neural dynamics and individual neuroadaptations to (prolonged) cannabis use when assessing the behavioral effects of cannabis in therapeutic, legal, and societal settings.

Comparable studies

Other randomized controlled trials on cannabis, most cited first.

Study Year Design Participants
Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment Healthy participants 2012 Randomized controlled trial n = 48
Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing Healthy, English-native, right-handed men who had used cannabis 15 times or less in... 2009 Double-blind, randomized, placebo-controlled crossover trial n = 15
Acute Effects of a Single, Oral dose of d9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) Administration in Healthy Volunteers Healthy male subjects 2012 Randomized controlled trial n = 16
Modulation of Mediotemporal and Ventrostriatal Function in Humans by Δ9-Tetrahydrocannabinol Healthy, native English-speaking, right-handed men of white race/ethnicity who had used... 2009 Randomized controlled trial n = 15
Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition Healthy volunteers with a history of light cannabis use 2019 Randomized, double-blind, within-subjects crossover n = 14

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