Instituto de Neurobiología, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, Mexico.
Symbiosis Center for Medical Image Analysis, Symbiosis Institute of Technology, Symbiosis International University, Pune, Maharashtra, India.
Prog Neuropsychopharmacol Biol Psychiatry. 2022 Mar 8;113:110474. doi: 10.1016/j.pnpbp.2021.110474. Epub 2021 Nov 7.
Cocaine use disorder (CUD) is characterized by a compulsive search for cocaine. Several studies have shown that cocaine users exhibit cognitive deficits, including lack of inhibition and decision-making as well as brain volume and diffusion-based white-matter alterations in a wide variety of brain regions. However, the non-specificity of standard volumetric and diffusion-tensor methods to detect structural micropathology may lead to wrong conclusions. To better understand microstructural pathology in CUD, we analyzed 60 CUD participants (3 female) and 43 non-CUD controls (HC; 2 female) retrospectively from our cross-sectional Mexican SUD neuroimaging dataset (SUDMEX-CONN), using multi-shell diffusion-weighted imaging and the neurite orientation dispersion and density imaging (NODDI) analysis, which aims to more accurately model microstructural pathology. We used Viso values of NODDI that employ a three-compartment model in white (WM) and gray-matter (GM). These values were also correlated with clinical measures, including psychiatric severity status, impulsive behavior and pattern of cocaine and tobacco use in the CUD group. We found higher whole-brain microstructural pathology in WM and GM in CUD patients than controls. ROI analysis revealed higher Viso-NODDI values in superior longitudinal fasciculus, cingulum, hippocampus cingulum, forceps minor and Uncinate fasciculus, as well as in frontal and parieto-temporal GM structures. We also found correlations between significant ROI and impulsivity, onset age of cocaine use and weekly dosage with Viso-NODDI. However, we did not find correlations with psychopathology measures. Overall, although their clinical relevance remains questionable, microstructural pathology seems to be present in CUD both in gray and white matter.
可卡因使用障碍（CUD）的特征是对可卡因的强制性搜索。几项研究表明，可卡因使用者表现出认知缺陷，包括缺乏抑制和决策，以及大脑体积和扩散为基础的白质改变在广泛的大脑区域。然而，标准体积和扩散张量方法对检测结构微观病理学的非特异性可能导致错误的结论。为了更好地了解 CUD 的微观结构病理学，我们从我们的墨西哥 SUD 神经影像学数据集（SUDMEX-CONN）中回顾性地分析了 60 名 CUD 参与者（3 名女性）和 43 名非 CUD 对照组（HC；2 名女性），使用多壳扩散加权成像和神经丝取向分散和密度成像（NODDI）分析，旨在更准确地模拟微观结构病理学。我们使用 NODDI 的 Viso 值，该值在白质（WM）和灰质（GM）中采用三腔室模型。这些值还与临床测量值相关，包括 CUD 组的精神病严重程度、冲动行为和可卡因及烟草使用模式。我们发现 CUD 患者的全脑 WM 和 GM 的微观结构病理学更高。ROI 分析显示，在胼胝体上束、扣带、海马扣带、小内囊和钩束以及额颞 GM 结构中，Viso-NODDI 值更高。我们还发现显著的 ROI 与冲动性、可卡因使用的发病年龄和每周剂量之间存在相关性，与 Viso-NODDI 呈正相关。然而，我们没有发现与精神病理学测量值的相关性。总的来说，尽管其临床相关性仍存在疑问，但 CUD 患者的灰质和白质中似乎都存在微观结构病理学。
