Brain abnormalities detected on magnetic resonance imaging of amphetamine users presenting to an emergency department: a pilot study

Abstract

Objectives: To determine the prevalence of occult brain abnormalities in magnetic resonance imaging of active amphetamine users. Design, setting and participants: Prospective convenience study in a tertiary hospital emergency department (ED). Patients presenting to the ED for an amphetamine‐related reason were eligible for inclusion. We collected demographic data, drug use data, and performed a mini‐mental state examination (MMSE). Main outcome measures: The proportion of patients with an abnormality on their MRI scan. Results: Of 38 patients enrolled, 30 had MRI scans. Nineteen were male and their mean age was 26.7 ± 5.4 years (range 19–41 years). The mean age of first amphetamine use was 18 years (range 13–26 years). Sixteen patients used crystal methamphetamine (mean amount 2.5 g/week), nine used amphetamine (“speed”) (mean amount 2.9 g/week), and 23 used ecstasy (mean amount 2.3 tablets/week). Marijuana was smoked by 26 (mean amount 5.9 g/week), and 28 drank alcohol (mean amount 207 g/week). The median MMSE score was 27/30 (interquartile range, 26–29). Abnormalities on brain MRI scans were identified in six patients, most commonly an unidentified bright object (n = 4). Conclusion: In this pilot study of brain MRI of young people attending the ED with an amphetamine‐related presentation, one in five had an occult brain lesion. While the significance of this is uncertain, it is congruent with evidence that amphetamines cause brain injury.

Methamphetamine Enhances the Development of Schizophrenia in First-Degree Relatives of Patients with Schizophrenia

“…In addition, the neurological basis of MA-induced schizophrenia has rarely been reported, although in vivo imaging has been widely employed to find the structural and functional abnormalities in the brain of MA users. 12,13 There is an accumulation of evidence showing damage in frontostriatal regions subserving selective attention and memory, such as the striatum, frontal cortex, hippocampus, and amygdala. [13][14][15][16] For example, MRI demonstrated an increase in cortical grey matter loss with age in MA users.…”

“…12,13 There is an accumulation of evidence showing damage in frontostriatal regions subserving selective attention and memory, such as the striatum, frontal cortex, hippocampus, and amygdala. [13][14][15][16] For example, MRI demonstrated an increase in cortical grey matter loss with age in MA users. 17 In contrast, an increase in regional striatal volume was observed in adolescent MA and cannabis abusers.…”

Spontaneously regressing brain lesions in Smith–Lemli–Opitz syndrome

“…Whether dysregulation of these small GTPases and their downstream pathways results in the lesions seen on brain imaging remains undetermined. Interestingly, UBOs on brain MRI have also been reported in 4 of 30 individuals actively using amphetamine (Fatovich et al, ). In addition, Wheeler et al, () showed that amphetamine activated Rho and Rac GTPases, leading to downstream effect on extracellular dopamine availability.…”

“…Whether dysregulation of these small GTPases and their downstream pathways results in the lesions seen on brain imaging remains undetermined. Interestingly, UBOs on brain MRI have also been reported in 4 of 30 individuals actively using amphetamine [Fatovich et al . 2010].…”