Background: Amphetamines constitute a group of central nervous system stimulators with an increasing frequency of usage and destructive outcomes on the metabolism, perfusion, and structure of the brain. This study aimed at evaluating the structural brain changes following amphetamines abuse, using Magnetic Resonance Imaging (MRI).
Methods: This cross sectional study was conducted on the individuals, who were admitted to the toxicology Emergency Room (ER) with continuous amphetamines abuse for at least six months and a positive methamphetamine urine test. Positive Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dependency and addiction to methamphetamine were also considered as the inclusion criteria. Following informed consent, the demographic information, and data on methamphetamine use were collected. An MRI was performed for all participants as soon as relative recovery. A matched control group also underwent MRI simultaneously.
Results: Forty male (20 cases of methamphetamine addicts and 20 healthy individuals) with a mean±SD age of 28.1±5.11 years were investigated. The mean±SD age of starting methamphetamine abuse was 25.6±10 years. About (75%), (n=15) of the patients abused methamphetamine 6-9 months, while others had abused it for more than 10 months. All cases used to abuse methamphetamine at least once a week, with (85%) of them inhaling it. The results showed that the only change in the brain MRI of methamphetamine abusers was hyperintensities increase in deep and periventricular white matter (only positive MRI in 3 cases, P=0.231). Oral consumption and higher doses had induced greater changes in the brain structure.
Conclusion: Methamphetamine dependency may increase deep and periventricular white matter hyperintensities.
Laurence L. Brunton O, Randa Hilal-Dandan, Björn C. Knollmann. Neuropharmacology. In: Laurence L. Brunton, Randa Hilal-Dandan, Björn C, editores. Goodman & Gilman's: The pharmacological basis of therapeutics, 13e. New York: McGraw-Hill; 2018.
Larisch R, Sitte W, Antke C, Nikolaus S, Franz M, Tress W, et al. Striatal dopamine transporter density in drug naive patients with attention-deficit/hyperactivity disorder. Nuclear medicine Communications. 2006; 27(3):267-70. [DOI:10.1097/00006231-200603000-00010] [PMID]
Elliott JM, Beveridge TJ. Psychostimulants and monoamine transporters: Upsetting the balance. Current Opinion in pharmacology. 2005; 5(1):94-100. [DOI:10.1016/j.coph.2004.09.005] [PMID]
United nations office on drugs and crime. World Drug Report 2010. Vienna: United Nations Office on Drugs and Crime; 2010.
United Nations Office on Drugs and Crime. UNODC: Amphetamine-type stimulants ranked world’s second most used drug after cannabis [Internet]. 2011 [updated 2019 july 30]. Availble from: https://www.unodc.org/unodc.
ShamshiriMilani H, Abadi AR, Helmzadeh Z, Abachizadeh K. Prevalence of Ecstasy use and predisposing factors among Iranian female high school students. Journal of the Pakistan Medical Association. 2011; 61(6):566-71. [PMID]
Paulus MP, Hozack NE, Zauscher BE, Frank L, Brown GG, Braff DL, et al. Behavioral and functional neuroimaging evidence for prefrontal dysfunction in methamphetamine-dependent subjects. Neuropsychopharmacology. 2002; 26(1):53-63. [DOI:10.1016/S0893-133X(01)00334-7]
Kao CH, Wang SJ, Yeh SH. Presentation of regional cerebral blood flow in amphetamine abusers by 99Tcm-HMPAO brain SPECT. Nuclear Medicine Communications. 1994; 15(2):94-8. [DOI:10.1097/00006231-199402000-00005] [PMID]
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. Neuro-psychopharmacology & Biological Psychiatry. 1997; 21(5):789-96. [DOI:10.1016/S0278-5846(97)00079-1]
Chang L, Ernst T, Speck O, Patel H, DeSilva M, Leonido-Yee M, et al. Perfusion MRI and computerized cognitive test abnormalities in abstinent methamphetamine users. Psychiatry Research. 2002; 114(2):65-79. [DOI:10.1016/S0925-4927(02)00004-5]
Alicata D, Chang L, Cloak C, Abe K, Ernst T. Higher diffusion in striatum and lower fractional anisotropy in white matter of methamphetamine users. Psychiatry Research. 2009; 174(1):1-8. [DOI:10.1016/j.pscychresns.2009.03.011] [PMID] [PMCID]
Berman S, O’Neill J, Fears S, Bartzokis G, London ED. Abuse of amphetamines and structural abnormalities in the brain. Annals of the New York Academy of Sciences. 2008; 1141:195-220. [DOI:10.1196/annals.1441.031] [PMID] [PMCID]
Bartzokis G, Beckson M, Lu PH, Edwards N, Rapoport R, Wiseman E, et al. Age-related brain volume reductions in amphetamine and cocaine addicts and normal controls: Implications for addiction research. Psychiatry Research. 2000; 98(2):93-102. [DOI:10.1016/S0925-4927(99)00052-9]
Kim SJ, Lyoo IK, Hwang J, Chung A, Hoon Sung Y, Kim J, et al. Prefrontal grey-matter changes in short-term and long-term abstinent methamphetamine abusers. International Journal of Neuropsychopharmacology. 2006; 9(2):221-8. [DOI:10.1017/S1461145705005699] [PMID]
Thompson PM, Hayashi KM, Simon SL, Geaga JA, Hong MS, Sui Y, et al. Structural abnormalities in the brains of human subjects who use methamphetamine. Journal of Neuroscience. 2004; 24(26):6028-36. [DOI:10.1523/JNEUROSCI.0713-04.2004] [PMID]
Lawyer G, Bjerkan PS, Hammarberg A, Jayaram-Lindstrom N, Franck J, Agartz I. Amphetamine dependence and co-morbid alcohol abuse: Associations to brain cortical thickness. BMC Pharmacology. 2010; 10(5):1-10. [DOI:10.1186/1471-2210-10-5] [PMID] [PMCID]
McMurtray A, Nakamoto B, Shikuma C, Valcour V. Cortical atrophy and white matter hyperintensities in HIV: The Hawaii Aging with HIV Cohort Study. Journal of Stroke and Cerebrovascular Diseases. 2008; 17(4):212-7. [DOI:10.1016/j.jstrokecerebrovasdis.2008.02.005] [PMID] [PMCID]
Awad IA, Johnson PC, Spetzler RF, Hodak JA. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly, II, Postmortem pathological correlations. Stroke. 1986; 17(6):1090-7.[DOI:10.1161/01.STR.17.6.1090] [PMID]
Ernst T, Chang L, Oropilla G, Gustavson A, Speck O. Cerebral perfusion abnormalities in abstinent cocaine abusers: A perfusion MRI and SPECT study. Psychiatry Research. 2000; 99(2):63-74. [DOI:10.1016/S0925-4927(00)00056-1]
Ince PG, Fernando M, MRC Cognitive Function and Ageing Neuropathology Study. Evidence for an ischaemic origin of deep white matter lesions in the ageing brain. Neuropathology and Applied Neurobiology. 2002; 28(2):150-1. [DOI:10.1046/j.1365-2990.2002.39286_8.x]
Kruit MC, Thijs RD, Ferrari MD, Launer LJ, van Buchem MA, van Dijk JG. Syncope and orthostatic intolerance increase risk of brain lesions in migraineurs and controls. Neurology. 2013; 80(21):1958-65. [DOI:10.1212/WNL.0b013e318293e1c7] [PMID] [PMCID]
London ED, Berman SM, Voytek B, Simon SL, Mandelkern MA, Monterosso J, et al. Cerebral metabolic dysfunction and impaired vigilance in recently abstinent methamphetamine abusers. Biological Psychiatry. 2005; 58(10):770-8. [DOI:10.1016/j.biopsych.2005.04.039] [PMID]
Bae SC, Lyoo IK, Sung YH, Yoo J, Chung A, Yoon SJ, et al. Increased white matter hyperintensities in male methamphetamine abusers. Drug and Alcohol Dependence. 2006; 81(1):83-8. [DOI:10.1016/j.drugalcdep.2005.05.016] [PMID]
Kim SJ, Lyoo IK, Hwang J, Sung YH, Lee HY, Lee DS, et al. Frontal glucose hypometabolism in abstinent methamphetamine users. Neuropsychopharmacology. 2005; 30(7):1383-91. [DOI:10.1038/sj.npp.1300699] [PMID]
Paganini-Hill A, Ross RK, Henderson BE. Postmenopausal oestrogen treatment and stroke: A prospective study. British Medical Journal. 1988; 297(6647):519-22. [DOI:10.1136/bmj.297.6647.519] [PMID] [PMCID]
Dluzen DE, McDermott JL. Estrogen, anti-estrogen, and gender: Differences in methamphetamine neurotoxicity. Annals of the New York Academy of Sciences. 2002; 965(1):136-56. [DOI:10.1111/j.1749-6632.2002.tb04157.x]
Beyer JL, Young R, Kuchibhatla M, Krishnan KR. Hyperintense MRI lesions in bipolar disorder: A meta-analysis and review. International Review of Psychiatry. 2009; 21(4):394-09. [DOI:10.1080/09540260902962198] [PMID] [PMCID]
Bae S, Kim JE, Hwang J, Lee YS, Lee HH, Lee J, et al. Increased prevalence of white matter hyperintensities in patients with panic disorder. Psychopharmacol. 2010; 24(5):717-23. [DOI:10.1177/0269881108098476] [PMID]
Herrmann LL, Le Masurier M, Ebmeier KP. White matter hyperintensities in late life depression: A systematic review. Journal of Neurology, Neurosurgery, and Psychiatry. 2008; 79(6):619-24. [DOI:10.1136/jnnp.2007.124651] [PMID]
Jan RK, Kydd RR, Russell BR. Functional and structural brain changes associated with methamphetamine Abuse. Brain Sciences. 2012; 2(4):434-82. [DOI:10.3390/brainsci2040434] [PMID] [PMCID]
Chang L, Cloak C, Patterson K, Grob C, Miller EN, Ernst T. Enlarged striatum in abstinent methamphetamine abusers: A possible compensatory response. Biological Psychiatry. 2005; 57(9):967-74. [DOI:10.1016/j.biopsych.2005.01.039] [PMID] [PMCID]
Oh JS, Lyoo IK, Sung YH, Hwang J, Kim J, Chung A, et al. Shape changes of the corpus callosum in abstinent methamphetamine users. Neuroscience Letters. 2005; 384(1-2):76-81. [DOI:10.1016/j.neulet.2005.04.082] [PMID]
Bartzokis G, Beckson M, Lu PH, Nuechterlein KH, Edwards N, Mintz J. Age-related changes in frontal and temporal lobe volumes in men: A magnetic resonance imaging study. Archives of General Psychiatry. 2001; 58(5):461-5. [DOI:10.1001/archpsyc.58.5.461] [PMID]
Jernigan TL, Gamst AC, Archibald SL, Fennema-Notestine C, Mindt MR, Marcotte TD, et al. Effects of methamphetamine dependence and HIV infection on cerebral morphology. The American Journal of Psychiatry. 2005; 162(8):1461-72. [DOI:10.1176/appi.ajp.162.8.1461] [PMID]
Schwartz DL, Mitchell AD, Lahna DL, Luber HS, Huckans MS, Mitchell SH, et al. Global and local morphometric differences in recently abstinent methamphetamine-dependent individuals. NeuroImage. 2010; 50(4):1392-401. [DOI:10.1016/j.neuroimage.2010.01.056] [PMID] [PMCID]
Nakama H, Chang L, Fein G, Shimotsu R, Jiang CS, Ernst T. Methamphetamine users show greater than normal age-related cortical gray matter loss. Addiction. 2011; 106(8):1474-83. [DOI:10.1111/j.1360-0443.2011.03433.x] [PMID] [PMCID]
Croft RJ, Mackay AJ, Mills AT, Gruzelier JG. The relative contributions of ecstasy and cannabis to cognitive impairment. Psychopharmacology. 2001; 153(3):373-9. [DOI:10.1007/s002130000591] [PMID]
Rogers RD, Everitt BJ, Baldacchino A, Blackshaw AJ, Swainson R, Wynne K, et al. Dissociable deficits in the decision-making cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophan-depleted normal volunteers: Evidence for monoaminergic mechanisms. Neuropsychopharmacology. 1999; 20(4):322-39. [DOI:10.1016/S0893-133X(98)00091-8]