GENDER DIFFERENCES IN CEREBRAL PERFUSION IN COCAINE ABUSE - TECHNETIUM-99M-HMPAO SPECT STUDY OF DRUG-ABUSING WOMEN

Cocaine abuse continues to be a major public health concern, with a va riety of medical and neurologic sequelae. Previous studies have demons trated abnormalities in cerebral perfusion in chronic cocaine abusers and after acute administration of cocaine. Although women are becoming increasingly represented among drug abusers, few studies have include d women. To the authors' knowledge, none has compared cerebral perfusi on in asymptomatic women with that in men. Methods: The cerebral perfu sion of 13 cocaine-dependent women, 4 of whom were also heroin depende nt, was studied with (TC)-T-99m hexamethylpropyleneamine oxime (HMPAO) SPECT. These women were compared with 13 cocaine-dependent men and 26 healthy control subjects. Structural brain lesions and neurologic abn ormalities were excluded by MRI and neurologic evaluation. Perfusion s tudies were interpreted in a standardized fashion by reviewers blinded to clinical information. Results: It was found that cocaine-dependent women were much less likely to have abnormal study findings than coca ine-dependent men (p = 0.003) and were indistinguishable from normal w omen (p = 1.0). However, the results in both women and men who concurr ently used heroin plus cocaine were all abnormal. Perfusion abnormalit ies tended to be located in anterior brain structures, such as the fro ntal and temporal cortex and the basal ganglia. Conclusion: These data suggest that cocaine-dependent women have fewer abnormalities in cere bral perfusion than cocaine-dependent men, but that concurrent abuse o f heroin and cocaine is associated with more perfusion abnormalities i n both sexes.