WHITE-MATTER CHANGES CAUSED BY CHRONIC SOLVENT ABUSE

PURPOSE: To examine the brain damage of solvent abusers in Japan, wher e pure industrial toluene is frequently abused, METHODS: Twenty solven t abusers 17 to 33 years of age with 7.2 +/- 4.0 years of abuse were e xamined with a 1.5-T MR imaging system. RESULTS: White matter hyperint ensities in cerebrum, brain stem, and cerebellum on T2-weighted images were found in seven cases, The extent of white matter change was most clearly shown on proton density-weighted images. The patients with re stricted white matter change and intermediate white matter change show ed white matter hyperintensities in the brain stem and cerebellum on T 2-weighted images, in some cases, with additional hypointensities in t he corresponding T1-weighted images. These patients had mainly abused pure toluene. The patients with diffuse white matter change showed obv ious brain atrophy, including hippocampal atrophy and thinning of the corpus callosum, These patients had mainly abused lacquer thinner. CON CLUSION: There are some patients with restricted but severe enough cha nge to cause the neurologic symptoms in specific regions, such as the brain stem and/or cerebellum, before the brain atrophy becomes apparen t. This suggests that the restricted white matter change represents no t only an early change of diffuse white matter change, but at least in some cases also represents a qualitatively different change than that of diffuse white matter change. We suggest that pure toluene has a po ssible relation to this qualitative difference.