Alaee Abdulrasool, Zarghami Mehran, Farnia Samaneh, Khademloo Mohammad, Khoddad Talayeh
Department of Radiology, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Psychiatry, Mazandaran University of Medical Sciences, Sari, Iran.
Iran J Radiol. 2014 May;11(2):e14275. doi: 10.5812/iranjradiol.14275. Epub 2014 May 15.
Previous studies have proven the development of white matter hyperintensities (WMH) in methamphetamine and opioid users. Opiates and methamphetamines (MA) are the most common addictive agents in Iran. The adverse effects of drugs on the CNS is of concern to specialists and researchers, and given that the neurotoxicity associated with methamphetamine is greater than opioids, it is hypothesized that the severity of WMH in patients with methamphetamine dependence is more than opioid drug-dependent individuals.
To our knowledge, this is the first research comparing the effect of methamphetamine and methadone (M) on the brain.
In a historical cohort study, we compared WMH in the brain MRI of 50 methamphetamine-dependent patients, 50 methadone-dependent patients and 50 healthy volunteers who were matched for age, sex and dominant hand.
WMH was detected in 18 methamphetamine users, in 12 methadone users and in seven controls (P = 0.038). The site of brain lesions in MA users was mostly in the frontal lobe in 17 cases, in M users in the frontal lobe in 12 cases and in the control group, it was in the parietal lobe in four cases (P=0.001). The frontal lobes were the predominant locations of WMH in MA and M groups (P = 0.001). The frequency of brain lesions was mostly in the deep WM in 18 cases in MA users, in 12 cases in M users and in two cases in the control group (P=0.007). Hyper-signal foci of deep WM in the MA group were grade I (punctuate) in 12 cases, grade II (beginning confluence) in five cases and grade III (large confluent) in four cases. In the M group, there were six cases in grade I, three cases in grade II and one case in grade III. In the control group, there were three grade I cases, two grade II cases, and no grade III cases. Except for periventricular WMH (P = 0.13), there were statistical significant differences in the deep WMH (P = 0.007) and subcortex WMH (P = 0.01) between the three groups. The history of using other drugs and the duration of MA and M consumption were similar. The prevalence of brain lesions was generally higher in both drug user groups compared with the healthy controls. Increased WMH in the MA group was higher than the M group.
A greater number of blood flow defects and ischemic lesions in the brain of MA users compared to opiate users may explain the prevalence of psychiatric disorders in these patients.
先前的研究已证实甲基苯丙胺和阿片类药物使用者会出现脑白质高信号（WMH）。阿片类药物和甲基苯丙胺是伊朗最常见的成瘾剂。药物对中枢神经系统的不良影响受到专家和研究人员的关注，鉴于与甲基苯丙胺相关的神经毒性大于阿片类药物，因此推测甲基苯丙胺依赖患者的WMH严重程度高于阿片类药物依赖个体。
据我们所知，这是第一项比较甲基苯丙胺和美沙酮对大脑影响的研究。
在一项历史性队列研究中，我们比较了50名甲基苯丙胺依赖患者、50名美沙酮依赖患者和50名年龄、性别和利手相匹配的健康志愿者的脑部MRI中的WMH。
在18名甲基苯丙胺使用者、12名美沙酮使用者和7名对照者中检测到WMH（P = 0.038）。甲基苯丙胺使用者的脑损伤部位大多在额叶，有17例；美沙酮使用者的脑损伤部位大多在额叶，有12例；对照组的脑损伤部位在顶叶，有4例（P = 0.001）。额叶是甲基苯丙胺组和美沙酮组WMH的主要部位（P = 0.001）。甲基苯丙胺使用者的脑损伤频率大多在深部白质，有18例；美沙酮使用者有12例；对照组有2例（P = 0.007）。甲基苯丙胺组深部白质的高信号灶12例为I级（点状），5例为II级（开始融合），4例为III级（大融合）。美沙酮组I级有6例，II级有3例，III级有1例。对照组I级有3例，II级有2例，无III级病例。除脑室周围WMH外（P = 0.13），三组之间深部WMH（P = 0.007）和皮质下WMH（P = 0.01）存在统计学显著差异。使用其他药物的历史以及甲基苯丙胺和美沙酮的使用时间相似。与健康对照组相比，两个药物使用者组的脑损伤患病率普遍较高。甲基苯丙胺组WMH增加高于美沙酮组。
与阿片类药物使用者相比，甲基苯丙胺使用者大脑中更多的血流缺陷和缺血性病变可能解释了这些患者精神障碍的患病率。
