Article

Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse

Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024-1759, USA.
Molecular Psychiatry (Impact Factor: 14.5). 11/2007; 13(9):897-908. DOI: 10.1038/sj.mp.4002107
Source: PubMed

ABSTRACT

Changes in brain function during the initial weeks of abstinence from chronic methamphetamine abuse may substantially affect clinical outcome, but are not well understood. We used positron emission tomography with [F-18]fluorodeoxyglucose (FDG) to quantify regional cerebral glucose metabolism, an index of brain function, during performance of a vigilance task. A total of 10 methamphetamine-dependent subjects were tested after 5-9 days of abstinence, and after 4 additional weeks of supervised abstinence. A total of 12 healthy control subjects were tested at corresponding times. Global glucose metabolism increased between tests (P=0.01), more in methamphetamine-dependent (10.9%, P=0.02) than control subjects (1.9%, NS). Glucose metabolism did not change in subcortical regions of methamphetamine-dependent subjects, but increased in neocortex, with maximal increase (>20%) in parietal regions. Changes in reaction time and self-reports of negative affect varied more in methamphetamine-dependent than in control subjects, and correlated both with the increase in parietal glucose metabolism, and decrease in relative activity (after scaling to the global mean) in some regions. A robust relationship between change in self-reports of depressive symptoms and relative activity in the ventral striatum may have great relevance to treatment success because of the role of this region in drug abuse-related behaviors. Shifts in cortical-subcortical metabolic balance either reflect new processes that occur during early abstinence, or the unmasking of effects of chronic methamphetamine abuse that are obscured by suppression of cortical glucose metabolism that continues for at least 5-9 days after cessation of methamphetamine self-administration.

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Available from: Edythe D London, Aug 19, 2014
    • "In chronic methamphetamine users, mood disorders and anxiety disorders are fairly frequent (Conway, Compton, Stinson, & Grant, 2006), and a smaller proportion of these have been attributed directly to the use of the drug (Salo et al., 2011). Changes in selfreported depressive symptoms were in strong correlation with relative deoxyglucose uptake in ventral striatum, in a study with two measurements 4 weeks of supervised abstinence apart (Berman, Voytek, et al., 2008). Striatal dopamine D 2 receptor availability in striatum, at baseline or after amphetamine administration, was however not associated with depression (Parsey et al., 2001), but this remains to be investigated in drug users. "
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    ABSTRACT: Administration of amphetamine and methamphetamine can elicit psychiatric adverse effects at acute administration, binge use, withdrawal, and chronic use. Most troublesome of these are psychotic states and aggressive behavior, but a large variety of undesirable changes in cognition and affect can be induced. Adverse effects occur more frequently with higher dosages and long-term use. They can subside over time but some persist long-term. Multiple alterations in the gray and white matter of the brain assessed as changes in tissue volume or metabolism, or at molecular level, have been associated with amphetamine and methamphetamine use and the psychiatric adverse effects, but further studies are required to clarify their causal role, specificity, and relationship with preceding states and traits and comorbidities. The latter include other substance use disorders, mood and anxiety disorders, attention deficit hyperactivity disorder, and antisocial personality disorder. Amphetamine- and methamphetamine-related psychosis is similar to schizophrenia in terms of symptomatology and pathogenesis, and these two disorders share predisposing genetic factors. © 2015 Elsevier Inc. All rights reserved.
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    • "While few other studies have examined relationships between denial and the brain in addiction, the cortical and limbic regions identified in the current study have been variously associated with other abnormalities in methamphetamine users. Compared to healthy control subjects, methamphetamine-dependent participants have exhibited hypoactivity of the ACC associated with inhibitory control deficits (Nestor et al., 2011), increase in cerebral glucose metabolism in the precuneus during early abstinence (Berman et al., 2007), gray matter deficits in the ACC, OFC, precuneus, amygdala and hippocampus (Morales et al., 2012; Thompson et al., 2004), and aberrant relative glucose metabolism in the ACC, OFC and amygdala associated with inattention and mood disturbances (London et al., 2004, 2005). Future studies are needed to investigate mechanisms by which these abnormalities may, in isolation or combination, contribute to reduced insight/denial. "
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    • "FDG-PET previously demonstrated elevated glucose metabolism in methamphetamine-abusing subjects following up to14 days (London et al. 2004) or 14 days to 2 years (Volkow et al. 2001; Berman et al. 2008) abstinence from drug. In combination with these findings, the present results reinforce the view that methamphetamine abuse is associated with dysfunction in brain areas, such as medial parietal cortex, with sparse dopaminergic innervation (Descarries et al. 1987). "
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