Abuse of amphetamines and structural abnormalities in the brain.

TitleAbuse of amphetamines and structural abnormalities in the brain.
Publication TypeJournal Article
Year of Publication2008
AuthorsBerman, S, O'Neill J, Fears S, Bartzokis G, London ED
JournalAnnals of the New York Academy of Sciences
Volume1141
Pagination195-220
Date Published2008 Oct
ISSN1749-6632
KeywordsAbnormalities, Drug-Induced, Adult, Amphetamine-Related Disorders, Amphetamines, Animals, Attention Deficit Disorder with Hyperactivity, Brain, Cats, Female, Humans, Magnetic Resonance Imaging, Male, Methamphetamine, Myelin Sheath, N-Methyl-3,4-methylenedioxyamphetamine, Neurons, Neurotransmitter Agents, Pregnancy, Prenatal Exposure Delayed Effects, Primates, Rats, Species Specificity
Abstract

We review evidence that structural brain abnormalities are associated with abuse of amphetamines. A brief history of amphetamine use/abuse and evidence for toxicity is followed by a summary of findings from structural magnetic resonance imaging (MRI) studies of human subjects who had abused amphetamines and children who were exposed to amphetamines in utero. Evidence comes from studies that used a variety of techniques including manual tracing, pattern matching, voxel-based, tensor-based, or cortical thickness mapping, quantification of white matter signal hyperintensities, and diffusion tensor imaging. Ten studies compared controls to individuals who were exposed to methamphetamine. Three studies assessed individuals exposed to 3-4-methylenedioxymethamphetamine (MDMA). Brain structural abnormalities were consistently reported in amphetamine abusers, as compared to control subjects. These included lower cortical gray matter volume and higher striatal volume than control subjects. These differences might reflect brain features that could predispose to substance dependence. High striatal volumes might also reflect compensation for toxicity in the dopamine-rich basal ganglia. Prenatal exposure was associated with striatal volume that was below control values, suggesting that such compensation might not occur in utero. Several forms of white matter abnormality are also common and may involve gliosis. Many of the limitations and inconsistencies in the literature relate to techniques and cross-sectional designs, which cannot infer causality. Potential confounding influences include effects of pre existing risk/protective factors, development, gender, severity of amphetamine abuse, abuse of other drugs, abstinence, and differences in lifestyle. Longitudinal designs in which multimodal datasets are acquired and are subjected to multivariate analyses would enhance our ability to provide general conclusions regarding the associations between amphetamine abuse and brain structure.

DOI10.1111/j.1541-0420.2011.01736.x
Alternate JournalAnn. N. Y. Acad. Sci.