Magnetic resonance imaging evidence of “silent” cerebrovascular toxicity in cocaine dependence

Bartzokis, George; Beckson, Mace; Hance, Darwood B.; Lu, Po H.; Foster, Jennifer A.; Mintz, Jim; Ling, Walter; Bridge, Peter

doi:10.1016/s0006-3223(98)00228-5

Cited by 77 publications

(41 citation statements)

References 58 publications

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“…In the earliest study of this kind, Volkow et al (1988b) observed a greater number of MRI focal signal hyperintensities in WM in drug abusers (cocaine or heroin), suggestive of demyelination. Bartzokis et al (1999a) found a greater frequency of WMHI in cocaine users vs. controls in the cerebral WM and subinsular WM. Although WMHI occur in the course of normal aging, Bartzokis et al (1999b) reported levels of WMHI in cocaine users that were similar to controls who were 20 year older.…”

Section: Introductionmentioning

confidence: 72%

Brain macrostructural and microstructural abnormalities in cocaine dependence

Lim

Wozniak

Mueller

et al. 2008

Drug and Alcohol Dependence

144

115

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Rationale-Two previous studies have utilized Diffusion Tensor Imaging (DTI) to examine microstructural integrity in cocaine abuse and found evidence of brain abnormalities in white matter.Objective-Using anatomical magnetic resonance imaging (MRI), DTI, and clinical evaluation, the macrostructural and microstructural correlates of cocaine abuse were investigated.Methods-21 men and women (mean age 42.5, mean 18.9 years of cocaine use) and 21 age/gendermatched controls were included. Fractional anisotropy (FA) was measured in frontal white matter ROIs. Gray and white matter volumes in superior and inferior frontal regions were compared.Results-DTI data revealed that cocaine users had lower FA than controls, specifically in inferior frontal white matter. FA differences were not seen in other areas. Significant volumetric differences were not seen, but both grey and white matter inferior frontal volumes trended toward smaller in the cocaine group. The data suggested that duration of use was associated with decreased grey and white matter volumes. FA and grey matter volume were correlated in cocaine users.Conclusions-Both macrostructural and microstructural abnormalities were seen in a group of cocaine abusers. Length of cocaine use was associated with severity of the brain abnormalities. Future studies of white matter tissue integrity are warranted including examination of the relationship between DTI measures and traditional volumetric measures.

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Section: Introductionmentioning

confidence: 72%

Brain macrostructural and microstructural abnormalities in cocaine dependence

Lim

Wozniak

Mueller

et al. 2008

Drug and Alcohol Dependence

144

115

View full text Add to dashboard Cite

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“…Drug use, or the lifestyle associated with it, may accelerate the process of age-related brain atrophy (Liu et al 1998;Pfefferbaum et al 1998;Bartzokis et al 1999b). In our sample, the CD group did not differ from the normal control group in any of the CSF volume variables.…”

Section: Discussionmentioning

confidence: 99%

“…Since cocaine dependence has been associated with increased rates of white matter lesions (Bartzokis et al 1999b), we obtained the same volume measurements for a matched group of eleven normal control subjects.…”

Section: We Evaluated the Hypothesis That Ventricular And Cortical Csmentioning

confidence: 99%

“…As with the ventricular volumes, we hypothesized that the volume of CSF in this cortical region will also correlate negatively to the cocaine infusion-associated experience of euphoria. Again, in order to assess whether this structure/function association was region-specific or due to a generalized atrophy of the cortex, we also measured the volume of the remaining (posterior) portion of cortical CSF.Since cocaine dependence has been associated with increased rates of white matter lesions (Bartzokis et al 1999b), we obtained the same volume measurements for a matched group of eleven normal control subjects. …”

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confidence: 99%

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Increased CSF Volumes Are Associated with Diminished Subjective Responses to Cocaine Infusion

Bartzokis

Beckson

et al. 2000

Neuropsychopharmacology

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We evaluated the hypothesis that ventricular and cortical CSF volume increases are associated with reductions in the magnitude of euphoric effects produced by intravenous IV cocaine infusion in cocaine dependent (CD) individuals. Eleven CD patients participating in a cocaine-infusion study and eleven control subjects underwent magnetic resonance imaging (MRI). Two CSF regions of interest (lateral ventricles and frontal cortex CSF) and two comparison regions (third ventricle and posterior cortex CSF) were measured. Self-reported ratings of the intensity of euphoric response ("high") were obtained from the CD subjects at 3, 10, and 30 minutes after IV administration of cocaine. A significant negative correlation was observed between the volume of the lateral ventricles and subjective ratings of the "high" experienced at 3 minutes, but not at 10 The relationship between brain variables and subjective effects of cocaine has not been extensively studied. Morgan et al. (1993), using non-contrast computerized tomography (CT), examined the association between ventricular brain ratio (VBR) and intensity of response to the effects of 40 mg of intravenous cocaine. They obtained subjective ratings of drug effect every minute for 30 minutes after the cocaine injection and observed a significant negative correlation (r ϭ Ϫ .53, p ϭ .02) between VBR and the average rating of drug response over the first 10 minute interval but no relationship over the last two 10 minute intervals (r ϭ Ϫ .22 and r ϭ (Morgan et al. 1993). This suggested that subjects with larger ventricles had reduced sensitivity to cocaine's immediate euphoric effects.As part of a recent study investigating the possible attenuating effects of selegiline on cocaine-induced euphoria and brain metabolism (Bartzokis et al. 1999a), non-treatment seeking "crack" cocaine smokers were evaluated with magnetic resonance imaging (MRI) of the brain in order to identify patients with enlarged ventricles who may be less responsive to IV cocaine's euphoric effects. The total volume of the lateral ventricles was measured in order to evaluate the magnitude of the negative association between this volume measure and the experience of euphoria ("high") associated with cocaine infusion. The volume of the third ventricle was also measured in order to assess whether this structure/function association was specific to the lateral ventricles or a phenomenon associated with generalized ventriculomegaly.In addition, the volume of the supracortical cerebrospinal fluid (CSF) in the frontal region of the cerebral cortex was measured in order to indirectly assess whether reduced frontal cortex gray matter observed in the polysubstance dependent (Liu et al. 1998) and alcohol dependent (Pfefferbaum et al. 1998) populations is also associated with a diminished intensity of cocaine infusion-induced euphoria. As with the ventricular volumes, we hypothesized that the volume of CSF in this cortical region will also correlate negatively to the cocaine infusion-associated experience of euphoria...

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“…Indeed, white matter hyperintensities have been observed in cocaine abusers, suggesting that white matter involvement may be an important sequelae of cocaine use. 49 There is some evidence of white matter abnormalities in OCD. Rosenberg et al found that all of the corpus callosum regions they measured (except the isthmus) were significantly larger in pediatric OCD patients than in matched controls.…”

Section: Future Directionsmentioning

confidence: 99%

Neuropsychiatric applications of DTI – a review

2002

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Psychiatric disorders are common throughout the world and are a leading cause of disability. There is a growing appreciation of the importance of connectivity to brain function. Disruption of this connectivity can result in brain dysfunction manifested in impaired cognitive functioning and the development of clinical symptoms. White matter forms the basis of anatomical connectivity. Diffusion tensor imaging (DTI) is a useful tool for examining and quantifying white matter microstructure. Clinical research studies in alcoholism, HIV-1 infection, geriatric depression and schizophrenia using DTI have revealed abnormalities in white matter microstructure. The use of complementary imaging methods may be helpful in further characterizing these abnormalities. Other psychiatric disorders may also have white matter involvement amenable to study with DTI. Advances in acquisition and analysis methods will be necessary to further advance work in this field. The study of animal models and postmortem tissue may be helpful in elucidating the neurobiological underpinnings of abnormalities observed with DTI.

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Magnetic resonance imaging evidence of “silent” cerebrovascular toxicity in cocaine dependence

Cited by 77 publications

References 58 publications

Brain macrostructural and microstructural abnormalities in cocaine dependence

Brain macrostructural and microstructural abnormalities in cocaine dependence

Increased CSF Volumes Are Associated with Diminished Subjective Responses to Cocaine Infusion

Neuropsychiatric applications of DTI – a review

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