Solvent-Induced Leukoencephalopathy: A Disorder of Adolescence?

Abstract

Volatile substance misuse is common during early adolescence; however, limited work has been conducted investigating the neurobiological effects of such use on the developing brain. While both animal and human studies report cognitive and neurobiological harm associated with volatile substance misuse during adolescence (particularly involving white matter structures), the complex psychosocial characteristics of volatile substance misusers confound the specificity of reported volatile substance-related pathology in human subjects. In addition, few studies have examined whether cognitive and neurobiological recovery occurs with abstinence, although there is some literature indicating that neurological and cognitive improvement is possible, but relates to the frequency and duration of previous use. Longitudinal studies utilizing well-matched control samples are required to fully delineate the short- and long-term impact of volatile substance misuse on adolescent brain development.

Eating Disorders, Addictions and Substance Use Disorders

“…The most recent version of the Diagnostic and Statistical Manual of Mental Illness considers what was formerly indicated as substance abuse and dependence as a continuum of disorders involving the use of substances from mild to severe, according to the number of endorsed symptoms (American Psychiatric Association, 2013). Some substances of abuse have been shown to be directly neurotoxic such as ecstasy, inhalants, hallucinogens, and methamphetamine (Ares- Santos, Granado, & Moratalla, 2013;Cairney et al, 2013;Capela et al, 2013;Cowan, Roberts, & Joers, 2008;Marona-Lewicka, Nichols, & Nichols, 2011;Takagi, Lubman, & Yucel, 2011). Craving is a symptom not present in the previous version of the Manual (i.e., a strong desire to use a substance).…”

Toxic Leukoencephalopathy in the Intensive Care Unit

“…Recovery is variable, however, despite the cessation of solvent abuse and the absence of clinical progression, changes are still noted at autopsy 21 . Abstinence from petrol sniffing can result in significant clinical improvement, however, this is not seen after chronic glue sniffing 23 .…”

“…Either occupational or recreational exposure to solvents, particularly toluene, is known to cause multifocal demyelination at autopsy, perhaps due to a direct toxic effect on myelin, although the onset of neurological signs is slow and progressive 2 . The cerebellum seems to be primarily affected 21 and effects appear to be dose-and duration-dependent 22,23 . Recovery is variable, however, despite the cessation of solvent abuse and the absence of clinical progression, changes are still noted at autopsy 21 .…”

Neurotoxicant effects on white matter

“…The toxicity of organic solvents has been investigated in the framework of occupational exposure. Short-term exposures in adults have been reported as relatively harmless, however, binge usage and chronic abuse of solvents in the pediatric population have the potential for significant lifelong medical, neurological and psychiatric comorbidities, as neurodevelopment, particularly late myelination proceeds into the third decade [43]. Organic solvent inhalation, due to its widespread access in the home, local retail establishments, ease of access and relatively low cost, is a common form of substance abuse in children, adolescents and young adults [39,44].…”