DTI-MRI findings in synthetic cannabinoid users

Abstract

Background/aim: Synthetic cannabinoids (SCs) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter (WM) changes of SC users using DTI. Materials and methods: The study included 22 patients with a history of using SC for 5-37 months, and 22 healthy, age and sexmatched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) values were obtained. ROIs were placed on WM areas of normal appearance. Results: In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2 ± 58.9 vs. 263 ± 27.4; P = 0.002) and right hippocampus (224.5 ± 61.5 vs. 255 ± 24.3; P = 0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides. Conclusion: The SC use causes WM microstructural changes, especially in the hippocampus and temporal lobes. DTI is a useful tool to reveal WM changes in SC addicts and can be used earlier than conventional MRI.

Measuring white matter microstructure in 1,457 cannabis users and 1,441 controls: A systematic review of diffusion-weighted MRI studies

“…Finally, the review did not include samples who consumed synthetic cannabinoids, due to their different psychopharmacological profile of synthetic cannabinoids vs. cannabinoids (van Amsterdam et al, 2015 ). Synthetic cannabinoids can also affect white matter integrity (Zorlu et al, 2016 ; Gokharman et al, 2020 ) and are becoming increasingly diversified and available. Therefore, further research is required to examine how synthetic cannabinoids affect white matter microstructure.…”