Quantitative medial temporal lobe brain morphology and hypothalamic-pituitary-adrenal axis function in cocaine dependence: a preliminary report

Preclinical and clinical studies have shown that cocaine increases plasma a drenocorticotropin hormone (ACTH) and cortisol. Chronic elevation of plasma cortisol exerts direct toxic effects upon hippocampal neurons and exacerba tes hippocampal damage resulting from ischemia and seizures. The authors te sted for evidence of hippocampal damage in patients with chronic cocaine de pendence. Medial temporal lobe and total brain volumes were quantified usin g magnetic resonance imaging (MRI) in 27 patients with cocaine dependence a nd 16 healthy subjects. Basal and ovine corticotropin releasing hormone (oC RH) stimulated ACTH and cortisol levels were also examined in a subset of 8 healthy and 9 cocaine dependent subjects after 21 days of abstinence. No e vidence for decreased hippocampal or total brain volume in cocaine dependen ce was observed. Similarly, basal and oCRH stimulated ACTH and cortisol lev els in cocaine dependent patients did not differ from those in healthy subj ects. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.