Abnormal cerebral blood flow in methamphetamine abusers assessed by brain perfusion single emission computed tomography

Document Type: Original Article

Authors

1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Medical Toxicology Research Center, Mashhad University of Medical Sciences. Mashhad, Iran

4 Addiction Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction:Amphetamines are central nervous system (CNS) stimulant substances and amphetamine abuse is considered a growing problem in our country. Previous studies revealed destructive effects of amphetamines on metabolism, perfusion and structure of brain. The aim of current study was evaluating regional cerebral blood flow (rCBF) disturbances in methamphetamine (MA) abusers using brain perfusion SPECT.
Methods: This case control study was carried out on 15 MA abusers and 10 healthy volunteers. All 15 MA abusers had a history of MA abuse for at least one year, positive qualitative urinary test for amphetamine. All cases were substance dependent based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria. Patients with opioid and other substance abuse except nicotine and caffeine, positive history of head trauma, loss of consciousness more than 30 minutes and also pregnant women were excluded. All subjects underwent brain perfusion Single-photon emission computed tomography (SPECT).
Results: Of 15 MA users 11 and 4 cases were males and females respectively. Mean age was 42/46±12.08 (range: 22-65) years old. Mean age of control group was 39.56±10.10 (range: 25-63) years old. All MA abusers were currently on using MA. Mean dose of MA use was 0.7 gram per day and mean duration of consumption was 4.86 (1-12) years. Significant differences were observed in scan results (normal or abnormal scan) between two groups (p˂0.05). Of all 15 MA abusers, global decreased tracer uptake was observed in 4 patients (26.7%), global decrease uptake except for the cerebellum was detected in 6 cases (40%), and decreased tracer uptake in fronto-temporal lobes was observed in 2 cases (13.3%), decreased uptake was detected only in the temporal lobe in 2 patients (13.3%) and in temporo-occipital lobes in one case (6.7%). In patients group, decrease in perfusion was more prominent in right frontal, superior frontal and parietal lobes compared with left hemisphere. SPM (Statistical Parametric Mapping) analysis showed significant difference in rCBF between MA abusers and normal volunteers throughout the cerebral cortex with nonhomogeneous decreased tracer uptake.

Conclusion: In this study, we showed that amphetamine abuse can induce diffuse and nonhomogeneous disorders of brain perfusion which was more prominent in the right hemisphere.

Keywords

Main Subjects


  1. Volkow ND, Chang L, Wang GJ, Fowler JS, Ding YS, Sedler M, Logan J, Franceschi D, Gatley J, Hitzemann R, Gifford A, Wong C, Pappas N. Low level of brain dopamine D2 receptors in methamphetamine abusers: association with metabolism in the orbitofrontal cortex. Am J Psychiatry. 2001 Dec;158(12):2015-21.
  2. De-Carolis C, Boyd GA, Mancinelli L, Pagano S, Eramo S. Methamphetamine abuse and "meth mouth" in Europe. Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20(2):e205-10.
  3. Paulus MP1, Hozack NE, Zauscher BE, Frank L, Brown GG, Braff DL, Schuckit MA. Behavioral and functional neuroimaging evidence for prefrontal dysfunction in methamphetamine-dependent subjects. Neuropsychopharmacology. 2002 Jan;26(1):53-63.
  4. Cuzen NL, Koopowitz SM, Ferrett HL, Stein DJ, Yurgelun-Todd D. Methamphetamine and cannabis abuse in adolescence: a quasi-experimental study on specific and long-term neurocognitive effects. BMJ Open. 2015 Jan 30;5(1):e005833.
  5. Chung YA, Peterson BS, Yoon SJ, Cho SN, Chai S, Jeong J, Kim DJ. In vivo evidence for long-term CNS toxicity, associated with chronic binge use of methamphetamine. Drug Alcohol Depend. 2010 Sep 1;111(1-2):155-60.
  6. Volkow ND, Chang L, Wang GJ, Fowler JS, Leonido-Yee M, Franceschi D, Sedler MJ, Gatley SJ, Hitzemann R, Ding YS, Logan J, Wong C, Miller EN. Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers. Am J Psychiatry. 2001 Mar;158(3):377-82.
  7. Thompson PM, Hayashi KM, Simon SL, Geaga JA, Hong MS, Sui Y, Lee JY, Toga AW, Ling W, London ED. Structural abnormalities in the brains of human subjects who use methamphetamine. J Neurosci. 2004 Jun 30;24(26):6028-36.
  8. Iyo M, Namba H, Yanagisawa M, Hirai S, Yui N, Fukui S. Abnormal cerebral perfusion in chronic methamphetamine abusers: a study using 99mTc-HMPAO and SPECT. Prog Neuropsychopharmacol Biol Psychiatry. 1997 Jul;21(5):789-96.
  9. Kao CH, Wang SJ, Yeh SH. Presentation of regional cerebral blood flow in amphetamine abusers by 99Tcm-HMPAO brain SPECT. Nucl Med Commun. 1994 Feb;15(2):94-8.
  10. Hwang J, Lyoo IK, Kim SJ, Sung YH, Bae S, Cho SN, Lee HY, Lee DS, Renshaw PF. Decreased cerebral blood flow of the right anterior cingulate cortex in long-term and short-term abstinent methamphetamine users. Drug Alcohol Depend. 2006 Apr 28;82(2):177-81.
  11. Chang L, Ernst T, Speck O, Patel H, DeSilva M, Leonido-Yee M, Miller EN. Perfusion MRI and computerized cognitive test abnormalities in abstinent methamphetamine users. Psychiatry Res. 2002 Jun 15;114(2):65-79.
  12. Mathew RJ1, Wilson WH. Substance abuse and cerebral blood flow. Am J Psychiatry. 1991 Mar;148(3):292-305.