Department of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 3. Floor, Copenhagen Ø, Denmark.
J Anal Toxicol. 2019 Jun 1;43(5):378-384. doi: 10.1093/jat/bky110.
Brain tissue may serve as a useful supplement to blood in postmortem investigations. However, reference concentrations for central stimulant drugs are scarce in brain tissue. This study involves some frequently used stimulants: amphetamine, cocaine, ephedrine, MDMA and methylphenidate. We present concentrations from brain and blood and brain-blood ratios of the analytes from autopsies. The cases were grouped according to the cause of death: A: The compound solely caused a fatal intoxication. B: The compound contributed to a fatal outcome in combination with other drugs, alcohol or disease. C: The compound was not related to the cause of death. Analyses were carried out using solid-phase extraction and ultra high-performance liquid chromatography. Paired brain and femoral blood concentrations from 133 cases were analysed. Positive correlations were observed for all analytes with correlation coefficients ranging from 0.58 to 0.95. The following median brain-blood ratios were obtained: cocaine 2.0 (range 0.20-7.0), amphetamine 3.2 (range 1.5-4.5), ephedrine 2.3 (range 1.1-6.2), MDMA 3.9 (range 0.92-5.1) and methylphenidate 2.4 (0.92-4.6). The concentrations in femoral blood generally agreed with the literature for all compounds. The metabolite of cocaine, benzoylecgonine, was also quantified in brain and blood from 60 cases, and the median brain-blood ratio was 0.66 with 10-90 percentiles of 0.39-1.27. The results of this study can aid the toxicological investigation in determining the cause of death.
脑组织可能是死后调查中血液的有用补充。然而，中枢兴奋剂在脑组织中的参考浓度却很少。本研究涉及一些常用的兴奋剂：苯丙胺、可卡因、麻黄碱、MDMA 和哌甲酯。我们提供了来自尸检的脑和血液中的浓度以及分析物的脑-血比值。这些病例根据死因进行了分组：A：该化合物仅导致致命中毒。B：该化合物与其他药物、酒精或疾病一起导致致命后果。C：该化合物与死因无关。分析采用固相萃取和超高效液相色谱法进行。对 133 例病例的配对脑和股动脉血进行了分析。所有分析物均观察到正相关，相关系数范围为 0.58 至 0.95。得到的以下中位数脑-血比值为：可卡因 2.0（范围 0.20-7.0），苯丙胺 3.2（范围 1.5-4.5），麻黄碱 2.3（范围 1.1-6.2），MDMA 3.9（范围 0.92-5.1）和哌甲酯 2.4（0.92-4.6）。对于所有化合物，股动脉血中的浓度与文献中的浓度基本一致。可卡因的代谢物苯甲酰古柯碱也在 60 例脑和血液中进行了定量，脑-血比值中位数为 0.66，10-90 百分位数为 0.39-1.27。本研究结果可有助于毒理学调查确定死因。
