Same dose, different impact: acute cannabis intoxication impairs visuospatial working memory in both sexes, with disproportionate male vulnerability
Chen Hanna Ryder, Carmit Gal, Einav Levy, Yifaat Tamarkin Leider, Tal Katzenelson, T. Vainshtein, Mohammad E. Naffaa, Samih Badarny, Yazid Badarny
Frontiers in Behavioral Neuroscience April 16, 2026 DOI: 10.3389/fnbeh.2026.1785335 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational case-control study with a 2 x 2 factorial design Peer reviewed |
|---|---|
| Sample size | 154 |
| Population | 77 adults who use cannabis regularly (at least 5 days per week for at least 1 year; 46 males, 31 females) and 77 matched controls (32 males, 45 females) |
| Duration | Testing occurred 45 minutes post-consumption (peak pharmacokinetic window) |
| Measures | Wechsler Memory Scale subtests |
| Topics | Cannabis |
| Key findings | Acute cannabis intoxication selectively impaired visuospatial working memory while leaving auditory-verbal and short-term memory intact. Males showed a larger deficit (Cohen's d = -0.87) than females (d = -0.48), a significant group-by-sex interaction. The authors argue this domain-specific and sex-dependent pattern implicates fronto-parietal CB1-rich networks and supports sex-informed precision medicine and harm reduction. |
Abstract
Introduction: With expanding global cannabis legalization and rising usage rates, elucidating the specific neurocognitive impact of acute cannabis intoxication across biological sexes is critical.
Methods: Using a 2 × 2 factorial design, we examined 154 adults: 77 individuals who use cannabis regularly (≥ 5 days/week for ≥ 1 year; 46 males, 31 females) and 77 matched controls (32 males, 45 females). Participants completed standardized Wechsler Memory Scale subtests assessing four distinct memory domains during the peak pharmacokinetic window (45 min post-consumption of medical-grade cannabis: 16.1% THC, < 1% CBD).
Results: Results demonstrated notable neuropsychological specificity: visuospatial working memory was selectively impaired, whereas auditory-verbal and short-term memory domains remained completely intact—a pattern strongly implicating disruption of fronto-parietal networks rich in CB1 receptors. Crucially, a significant Group × Sex interaction, F(1, 150) = 9.74, p < 0.01, ηp2 = 0.061, revealed differential vulnerability: males exhibited a disproportionately larger deficit relative to male controls (Cohen’s d = −0.87, p < 0.001)—nearly double the impairment magnitude observed in females (d = −0.48, p < 0.05).
Discussion: These findings advance our understanding of cannabis neuropharmacology by demonstrating that cognitive vulnerability is both domain-specific and sex-dependent, with direct implications for precision medicine approaches to cannabis therapeutics and sex-informed harm reduction strategies.