A single dose of CBD reduced activation in the insula, a brain region involved in processing important stimuli, in patients with early psychosis.
Psychiatrists, neuroscientists studying psychosis mechanisms, and researchers investigating CBD therapeutics.
15 early psychosis patientsshowed attenuated insula activation following CBD vs. placebo in crossover fMRI study
What the researchers found
CBD attenuated insula activation during motivational salience processing compared to placebo in early psychosis patients, consistent with the theory that CBD modulates brain regions involved in salience processing.
Why it matters
Understanding how CBD affects the brain could explain its potential antipsychotic properties and lead to targeted treatments for psychosis with fewer side effects than current medications.
The numbers in context
19 healthy controls and 15 participants with early psychosis studied in a within-subject crossover design. Single dose of CBD vs. placebo. Insula activation was attenuated following CBD. Results held after controlling for cannabis use history.
How the study worked
Within-subject, crossover, double-blind, placebo-controlled fMRI study using the monetary incentive delay task to examine brain responses to motivationally salient stimuli (reward and loss anticipation).
Who was studied
19 healthy controls and 15 participants with early psychosis in a within-subject crossover design.
What this study cannot tell us
Small sample size (15 psychosis participants). Single-dose design does not reflect chronic treatment. The monetary incentive delay task captures only one aspect of salience processing. No significant group differences at baseline between patients and controls.
How to read the evidence
Rigorous crossover double-blind placebo-controlled design, but small sample and single-dose limit clinical conclusions.
When this study was published
Recent neuroimaging study contributing to understanding of CBD mechanisms in psychosis.
The bigger picture
Aberrant salience processing is a leading theory of psychosis, and this study provides neuroimaging evidence that CBD may directly modulate this process, offering a mechanistic basis for its potential antipsychotic effects.
Replication
Small sample; larger trials with chronic dosing needed to confirm clinical relevance.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Would chronic CBD treatment show sustained modulation of insular activity?
- Does CBD modulation of the insula correlate with clinical symptom improvement in psychosis?
Read the original research
Cannabidiol attenuates insular activity during motivational salience processing in patients with early psychosis.
Psychological medicine, 53(10), 4732-4741
Citation
Gunasekera, Brandon; Wilson, Robin; O'Neill, Aisling; Blest-Hopley, Grace; O'Daly, Owen; Bhattacharyya, Sagnik. (2023). Cannabidiol attenuates insular activity during motivational salience processing in patients with early psychosis.. Psychological medicine, 53(10), 4732-4741. https://doi.org/10.1017/S0033291722001672