Brain perfusion in polysubstance users: Relationship to substance and tobacco use, cognition, and self-regulation

Abstract

Background Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity or decision making are not well known. Methods Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol dependent individuals with comorbid stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers. Results ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity. Conclusion Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.

Neurocognition and inhibitory control in polysubstance use disorders: Comparison with alcohol use disorders and changes with abstinence

“…Some of the cross-sectional neurocognitive and inhibitory control deficits described in this PSU cohort are associated with previously described morphometric abnormalities in primarily prefrontal brain regions of a subsample of this PSU cohort with neuroimaging data (Mon et al, 2014; Pennington et al, 2015). Our neurocognitive findings also further complement studies in subsamples of this PSU cohort that exhibit prefrontal cortical deficits measured by magnetic resonance spectroscopy (Abe et al, 2013) and cortical blood flow (Murray et al, 2015). …”

“…Identifying the specific neurocognitive and inhibitory control deficits that differentiate PSU and AUD may provide helpful insights into the specific clinical needs of this understudied (Connor et al, 2014), albeit highly prevalent population of PSU in substance use treatment centers today; such deficits potentially differ from those in the more extensively studied AUD population and therefore may require more tailored treatment approaches to increase treatment effectiveness. Our recent reports of different neurobiological abnormalities in AUD and a subset of the PSU cohort presented here (Abe et al, 2013; Murray et al, 2015) further supports the view that neurocognition may also differ between AUD and PSU populations. Accordingly, the main goals of this study were to determine the degree to which one-month-abstinent PSU and AUD differ on neurocognitive functioning and inhibitory control, and if cigarette smoking affects neurocognition in PSU, similar to what has been reported in AUD.…”

“…), with 1.3 million people in the United States alone in 2013 (Kedia et al, 2007; Substance Abuse and Mental Health Services Administration, 2013); therefore, this group is better described as “polysubstance users” (PSU), a term used in the literature to describe AUD who meet dependence criteria for additional substances (Abe et al, 2013; Murray et al, 2015; Pennington et al, 2015; Moreno-Lopez et al, 2012). Given the cognitive and inhibitory control deficits observed in AUD studies, it is not surprising that recently detoxified individuals with a substance use dependence diagnosis on any combination of heroin, alcohol, methamphetamine, and/or cannabis also performed worse than controls on several measures of executive function, including working memory, response inhibition, cognitive flexibility, and on inhibitory control measures of decision making (Moreno-Lopez et al, 2012).…”

Relación entre autoconcepto, consumo de sustancias y uso problemático de videojuegos en universitarios: un modelo de ecuaciones estructurales

“…Diversos trabajos de investigación revelan como los jóvenes que realizan las ingestas de alcohol más elevadas son los que más fuman, ya que ambas drogas pueden actuar como sustancias puente Murray et al, 2015). Del mismo modo, puede ocurrir una situación similar sobre el consumo de alcohol y el uso problemático de videojuegos, especialmente por motivos adictivo-patológicos, de evitación y escape, socialización o baja autoestima (McKay et al, 2012;Palmer et al, 2013;Van Rooij et al, 2010).…”

The Relationship Between Regional Cerebral Blood Flow Estimates and Alcohol Problems at 5‐Year Follow‐Up: The Role of Level of Response

“…The study of cerebral blood flow (CBF) could provide additional neurobiological information regarding the heightened risk for heavier drinking, alcohol problems, and AUDs associated with the low LR profile. CBF is tightly coupled with glucose metabolism (Jueptner and Weiller, 1995) and brain function (Raichle et al, 1976), and reductions in regional CBF and glucose metabolism in the sober state, particularly in frontal brain regions, have been observed with the misuse of multiple substances (Murray et al, 2015), including alcohol (Hamdi et al, 2003;Moselhy et al, 2001). These regional CBF reductions have been associated with severity of AUD (Hamdi et al, 2003) and important functional outcomes, such as relapse to drinking after treatment (Durazzo et al, 2010) and neurocognitive functioning (Goldstein et al, 2004).…”