Neuroimaging studies of cannabidiol and potential neurobiological mechanisms relevant for alcohol use disorders: a systematic review

Abstract

The underlying neurobiological mechanisms of cannabidiol's (CBD) management of alcohol use disorder (AUD) remains elusive.Aim We conducted a systematic review of neuroimaging literature investigating the effects of CBD on the brain in healthy participants. We then theorise the potential neurobiological mechanisms by which CBD may ameliorate various symptoms of AUD.Methods This review was conducted according to the PRISMA guidelines. Terms relating to CBD and neuroimaging were used to search original clinical research published in peer-reviewed journals.Results Of 767 studies identified by our search strategy, 16 studies satisfied our eligibility criteria. The results suggest that CBD modulates γ-Aminobutyric acid and glutamate signaling in the basal ganglia and dorso-medial prefrontal cortex. Furthermore, CBD regulates activity in regions associated with mesocorticolimbic reward pathways; salience, limbic and fronto-striatal networks which are implicated in reward anticipation; emotion regulation; salience processing; and executive functioning.Conclusion CBD appears to modulate neurotransmitter systems and functional connections in brain regions implicated in AUD, suggesting CBD may be used to manage AUD symptomatology.

Keywords: Alcohol use disorder; Cannabidiol; Neuroimaging; PET; Pharmacotherapy.

Fig. 1

PRISMA flow chart. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of the study selection process. EM = Embase; Med = Medline; PI = PsycINFO; PM = PubMed; MRI = magnetic resonance imaging; fMRI = functional MRI; rsfMRI = resting state fMRI; MRS = magnetic resonance spectroscopy; PET = positron emission tomography

Fig. 2

Sunburst chart. The proportion of studies using each neuroimaging modality in the inner ring. Each colour in the outer ring indicates a different participant sample