Cerebral perfusion abnormalities in abstinent cocaine abusers: a perfusionMRI and SPECT study

Nuclear medicine studies found decreased regional cerebral blood flow (rCBF ) in the cortex and deep gray matter of cocaine users. Perfusion magnetic r esonance imaging (MRI), a non-radioactive technique, has not been applied t o evaluate persistent rCBF abnormalities. Twenty-five abstinent cocaine use rs and 15 healthy subjects without a history of drug use were examined with perfusion MRI, using dynamic bolus-tracking, and single photon emission co mputed tomography (SPECT), using Xe-133-calibrated Tc-99m-HMPAO. After core gistration of SPECT with MRI, the relative rCBF (from perfusion MRI and SPE CT) and absolute rCBF (from SPECT) were determined in 10 brain regions in e ach hemisphere. There was a statistically significant interaction between d rug use and brain region on SPECT alone (relative and absolute rCBF), and o n SPECT and perfusion MRI combined, but not on perfusion MRI alone. There a lso was a significant interaction among gender, drug use, and brain region. Compared to the control subjects, cocaine users showed increased rCBF in t he frontal white matter (+8.6%, P = 0.02) and in the globus pallidus (+6.3% , P = 0.05), and decreased rCBF in the putamen (-3.9%, P = 0.04) and the te mporal cortex (-2.4%, P= 0.02). SPECT and perfusion MRI detect a regional p attern of rCBF abnormalities in cocaine users that is consistent across the two methods. The hypoperfusion in the cortex and deep gray matter of the c ocaine users is consistent with previous results. The increased rCBF in the white matter of cocaine users may be due to the presence of reactive glia. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.