CEREBRAL PERFUSION AND NEUROPSYCHOLOGICAL CONSEQUENCES OF CHRONIC COCAINE USE

Research indicates that cocaine significantly constricts the cerebral vasculature and can lead to ischemic brain infarction. Long-term effec ts of intermittent or casual cocaine use in patients without symptoms of stroke or transient ischemic attack were investigated. Single-photo n emission computed tomography with xenon-133 and [Tc-99m]hexamethylpr opyleneamine oxime, magnetic resonance imaging, and selected neuropsyc hological measures were used to study cerebral perfusion, brain morpho logy, and cognitive functioning. Patients were drug free for at least 6 months before evaluation. All showed regions of significant cerebral hypoperfusion in the frontal, periventricular, and/or temporal-pariet al areas. Deficits in attention, concentration, new learning, visual a nd verbal memory, word production, and visuomotor integration were obs erved. This study indicates that long-term cocaine use may produce sus tained brain perfusion deficits and persistent neuropsychological comp romise in some subgroups of cocaine-abusing patients.