PMC10020206_01
Timeline of important events and examinations in the patient's history and individual treatment.
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Neuropsychological testing and [18F]fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) were performed prior to and post-treatment (Figure 1).
Effects of treatment with 600 mg oral cannabidiol per day in a 19-year-old male with clinically high mental risk before (pre) and on day 30 (post). (A) Positive and Negative Symptoms Scale (PANSS; P: Positive, N: Negative, G: General subscore segments marked by respective letters), the Schizophrenia Proneness Instrument - Adult (SPI-A) and the Structured Interview for Prodromal Syndromes (SIPS) before (red bars) and after (green bars) treatment. Significant clinical improvement was observed, reflected by the substantial reduction in scale scores. (B) FDG positron emission tomography scans of the brain before (pre) and after treatment (post) and the difference between post- and pre-treatment. (C) Increase in local cerebral glucose utilization after treatment in specific brain regions (in %). Brain regions (striatum, medial temporal cortex and midbrain) previously reported to be functionally modulated in CHR individuals by a single oral dose of 600 mg cannabidiol in a functional MRI study are highlighted by red arrows.
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Medication adherence was notable during the treatment period, and no adverse events or side effects (in particular no extrapyramidal symptoms, no weight gain, no changes in blood pathology, and no sexual dysfunction), but a substantial clinical improvement were observed (Scores on day 0/day 30: PANSS Total 70/51 [PANSS Positive 23/16; PANSS Negative 14/11; PANSS General 33/24]; SPI-A 71/30; SIPS 35/18; Figure 2A), clinically notable already at day seven. The average FDG uptake (standardized uptake value (SUV)) was substantially increased after cannabidiol treatment (Figures 2B,C). The absolute differences ranged from -0.48 (negative difference solely in the right cuneus) to up to +7.43 (left gyrus precentralis; Figures 2B,C).