Gray and white matter morphology in substance use disorders: a neuroimaging systematic review and meta-analysis

Abstract

Substance use disorders (SUDs) are characterized by a compulsion to seek and consume one or more substances of abuse, with a perceived loss of control and a negative emotional state. Prolonged substance use seems to be associated with morphological changes of multiple neural circuits, in particular the frontal–striatal and limbic pathways. Such neuroadaptations are evident across several substance disorders, but may vary depending on the type of substance, consumption severity and/or other unknown factors. We therefore identified studies investigating the effects of SUDs using volumetric whole-brain voxel-based morphometry (VBM) in gray (GM) and white matter (WM). We performed a systematic review and meta-analysis of VBM studies using the anatomic likelihood estimation (ALE) method implemented in GingerALE (PROSPERO pre-registration CRD42017071222). Sixty studies met inclusion criteria and were included in the final quantitative meta-analysis, with a total of 614 foci, 94 experiments and 4938 participants. We found convergence and divergence in brain regions and volume effects (higher vs. lower volume) in GM and WM depending on the severity of the consumption pattern and type of substance used. Convergent pathology was evident across substances in GM of the insula, anterior cingulate cortex, putamen, and thalamus, and in WM of the thalamic radiation and internal capsule bundle. Divergent pathology between occasional use (cortical pathology) and addiction (cortical-subcortical pathology) provides evidence of a possible top-down neuroadaptation. Our findings indicate particular brain morphometry alterations in SUDs, which may inform our understanding of disease progression and ultimately therapeutic approaches.

A coordinate-based meta-analysis of white matter alterations in patients with alcohol use disorder

“…This important work showed small to moderate effect sizes ( g = 0.304, SD = 0.134) but did not test for convergence of imaging results in order to draw conclusions about the location of altered WM in AUD. A recent large-scale meta-analysis focused on gray and white matter morphology across all substance use disorders and indicates general and substance-specific structural brain changes in patients compared with healthy controls [ 26 ]. Sub-analysis regarding AUD in specific revealed convergent WM alterations in regions of the corticospinal tract and anterior thalamic radiation.…”

Age- and Sex-Related Cortical Gray Matter Volume Differences in Adolescent Cannabis Users: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies

“…Other adult sMRI studies have shown no neuroanatomical differences between CU adults and age-matched controls ( 11 , 22 ). Notably absent from this literature are GMV studies in adults that show increased cortical thickness or GMV in relation to cannabis use ( 21 ), although one or two studies have reported increased volumes in non-cortical regions including the striatum ( 23 ) and cerebellum ( 15 ). In contrast, based upon systematic examination of the adolescent sMRI literature [see ( 24 ) for review], more variability in morphologic findings is seen, and the opposite pattern of cannabis-related GMV abnormalities is observed, with a number of studies showing larger GMV volumes in CU compared to typically-developing (TD) youth ( 12 , 25 , 26 ).…”

Differential age-associated brain atrophy and white matter changes among homeless and precariously housed individuals compared to the general population

“…Previous studies report mixed findings and that the direction of the association between substance use and structural MRI measures depends on the specific substance and the region of interest. 45,46…”