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Δ9-Tetrahydrocannabinol (THC) impairs visual working memory performance: a randomized crossover trial


With the increasing prevalence of legal cannabis use and availability, there is an urgent need to identify cognitive impairments related to its use. It is widely believed that cannabis, or its main psychoactive component Δ9-tetrahydrocannabinol (THC), impairs working memory, i.e., the ability to temporarily hold information in mind. However, our review of the literature yielded surprisingly little empirical support for an effect of THC or cannabis on working memory. We thus conducted a study with three main goals: (1) quantify the effect of THC on visual working memory in a well-powered sample, (2) test the potential role of cognitive effects (mind wandering and metacognition) in disrupting working memory, and (3) demonstrate how insufficient sample size and task duration reduce the likelihood of detecting a drug effect. We conducted two double-blind, randomized crossover experiments in which healthy adults (N = 23, 23) performed a reliable and validated visual working memory task (the “Discrete Whole Report task”, 90 trials) after administration of THC (7.5 and/or 15 mg oral) or placebo. We also assessed self-reported “mind wandering” (Exp 1) and metacognitive accuracy about ongoing task performance (Exp 2). THC impaired working memory performance (d = 0.65), increased mind wandering (Exp 1), and decreased metacognitive accuracy about task performance (Exp 2). Thus, our findings indicate that THC does impair visual working memory, and that this impairment may be related to both increased mind wandering and decreased monitoring of task performance. Finally, we used a down-sampling procedure to illustrate the effects of task length and sample size on power to detect the acute effect of THC on working memory.

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Fig. 1: Stimuli used in the whole report task.
Fig. 2: Mean working memory performance.
Fig. 3: Illustrations of the effects of THC (15 mg) vs. placebo on working memory performance (N = 46, Exp 1 and Exp 2 combined).
Fig. 4: Changes to mind wandering and metacognitive accuracy after THC or placebo.
Fig. 5: Power analysis predicts the distribution of p-values for published studies.


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MD and EP collected data. KA performed analyses and drafted the manuscript. KA, MD, EP, EV, and HdW planned the experiments and revised the manuscript.

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Correspondence to Kirsten C. S. Adam.

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Adam, K.C.S., Doss, M.K., Pabon, E. et al. Δ9-Tetrahydrocannabinol (THC) impairs visual working memory performance: a randomized crossover trial. Neuropsychopharmacol. 45, 1807–1816 (2020).

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