Holman B L, Carvalho P A, Mendelson J, Teoh S K, Nardin R, Hallgring E, Hebben N, Johnson K A
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
J Nucl Med. 1991 Jun;32(6):1206-10.
Cocaine abuse is widespread and has been associated with serious neurovascular complications. We studied a group of cocaine-dependent polydrug users with 99mTc-HMPAO and high-resolution SPECT and compared their perfusion pattern to cerebral perfusion in a group of older control subjects. Sixteen of 18 cocaine-dependent polydrug users had abnormal perfusion characterized primarily as small focal defects involving inferoparietal, temporal, and anterofrontal cortex and basal ganglia. Psychometric testing was abnormal in all 18 cocaine-dependent subjects. No relation was found between the severity of SPECT abnormalities and mode of administration or frequency or length of cocaine use. All 15 older normal subjects had normal cerebral perfusion. While the focal perfusion abnormalities to the cortex and basal ganglia could be explained by the profound vasoconstrictor effects of cocaine, the combinational use of multiple substances including cannabis and alcohol may play a contributory role. This study documents the high incidence of functional brain abnormalities in cocaine-dependent chronic polydrug users without corresponding abnormalities on imaging studies of cerebral anatomy and morphology.
可卡因滥用现象普遍，且与严重的神经血管并发症有关。我们对一组可卡因依赖的多药滥用者进行了99mTc-HMPAO和高分辨率单光子发射计算机断层扫描（SPECT）研究，并将他们的灌注模式与一组老年对照受试者的脑灌注情况进行比较。18名可卡因依赖的多药滥用者中有16人存在灌注异常，主要表现为涉及下顶叶、颞叶、前额叶皮质和基底神经节的小灶性缺损。所有18名可卡因依赖受试者的心理测试均异常。未发现SPECT异常的严重程度与给药方式、可卡因使用频率或时长之间存在关联。所有15名老年正常受试者的脑灌注均正常。虽然皮质和基底神经节的局灶性灌注异常可以用可卡因的强烈血管收缩作用来解释，但包括大麻和酒精在内的多种物质的联合使用可能也起到了一定作用。这项研究证明，在可卡因依赖的慢性多药滥用者中，功能性脑异常的发生率很高，而在脑解剖结构和形态的影像学研究中却没有相应异常。
