Abstract

BackgroundCocaine use has been consistently associated with decreased gray matter volumes in the prefrontal cortex. However, it is unclear if such neuroanatomical abnormalities depict either pre-existing vulnerability markers or drug-induced consequences. Thus, this longitudinal MRI study investigated neuroplasticity and cognitive changes in relation to altered cocaine intake.MethodsSurface-based morphometry, cocaine hair concentration, and cognitive performance were measured in 29 cocaine users (CU) and 38 matched controls at baseline and follow-up. Based on changes in hair cocaine concentration, CU were classified either as Decreasers (n = 15) or Sustained Users (n = 14). Surface-based morphometry measures did not include regional tissue volumes.ResultsAt baseline, CU displayed reduced cortical thickness (CT) in lateral frontal regions, and smaller cortical surface area (CSA) in the anterior cingulate cortex, compared to controls. In Decreasers, CT of the lateral frontal cortex increased whereas CT within the same regions tended to further decrease in Sustained Users. In contrast, no changes were found for CSA and subcortical structures. Changes in CT were linked to cognitive performance changes and amount of cocaine consumed over the study period.ConclusionsThese results suggest that frontal abnormalities in CU are partially drug-induced and can recover with decreased substance use. Moreover, recovery of frontal CT is accompanied by improved cognitive performance confirming that cognitive decline associated with cocaine use is potentially reversible.

Highlights

  • Results from recent wastewater analyses from 2017 have revealed a worrying picture about cocaine consumption in Europe as they emphasize a strong upward trend for detected benzoylecgonine levels across many European cities (EMCDDA, 2018)

  • Similar to former studies including cocaine users (CU) and controls, Decreasers and Sustained Users differed from the control group in the subjective rating of ADHD symptoms, and Beck Depression Inventory (BDI) score (Vonmoos et al, 2013, 2014)

  • We found lower cortical thickness (CT) in the superior frontal gyrus (SFG), inferior frontal gyrus (IFG), and lateral orbitofrontal cortex (OFC) in CU compared to controls

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Summary

Introduction

Results from recent wastewater analyses from 2017 have revealed a worrying picture about cocaine consumption in Europe as they emphasize a strong upward trend for detected benzoylecgonine (main metabolite of cocaine) levels across many European cities (EMCDDA, 2018). Cocaine use has been consistently associated with decreased gray matter volumes in the prefrontal cortex. It is unclear if such neuroanatomical abnormalities depict either pre-existing vulnerability markers or drug-induced consequences. This longitudinal MRI study investigated neuroplasticity and cognitive changes in relation to altered cocaine intake. Methods: Surface-based morphometry, cocaine hair concentration, and cognitive performance were measured in 29 cocaine users (CU) and 38 matched controls at baseline and follow-up. Results: At baseline, CU displayed reduced cortical thickness (CT) in lateral frontal regions, and smaller cortical surface area (CSA) in the anterior cingulate cortex, compared to controls. Recovery of frontal CT is accompanied by improved cognitive performance confirming that cognitive decline associated with cocaine use is potentially reversible

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