Elsevier

Biological Psychiatry

Volume 58, Issue 10, 15 November 2005, Pages 770-778
Biological Psychiatry

Original article
Cerebral Metabolic Dysfunction and Impaired Vigilance in Recently Abstinent Methamphetamine Abusers

https://doi.org/10.1016/j.biopsych.2005.04.039Get rights and content

Background

Methamphetamine (MA) abusers have cognitive deficits, abnormal metabolic activity and structural deficits in limbic and paralimbic cortices, and reduced hippocampal volume. The links between cognitive impairment and these cerebral abnormalities are not established.

Methods

We assessed cerebral glucose metabolism with [F-18]fluorodeoxyglucose positron emission tomography in 17 abstinent (4 to 7 days) methamphetamine users and 16 control subjects performing an auditory vigilance task and obtained structural magnetic resonance brain scans. Regional brain radioactivity served as a marker for relative glucose metabolism. Error rates on the task were related to regional radioactivity and hippocampal morphology.

Results

Methamphetamine users had higher error rates than control subjects on the vigilance task. The groups showed different relationships between error rates and relative activity in the anterior and middle cingulate gyrus and the insula. Whereas the MA user group showed negative correlations involving these regions, the control group showed positive correlations involving the cingulate cortex. Across groups, hippocampal metabolic and structural measures were negatively correlated with error rates.

Conclusions

Dysfunction in the cingulate and insular cortices of recently abstinent MA abusers contribute to impaired vigilance and other cognitive functions requiring sustained attention. Hippocampal integrity predicts task performance in methamphetamine users as well as control subjects.

Section snippets

Subjects

Written informed consent was obtained from all participants after a detailed description of the study, which was approved by the institutional review boards of University of California Los Angeles (UCLA) and the Long Beach Veterans Administration Medical Center. They were generally healthy by physical examination, medical history, and laboratory tests. Exclusion criteria included use of medications that affect the central nervous system; cardiovascular, pulmonary or systemic disease;

General Experimental Design

Methamphetamine-abusing subjects were inpatients (at the UCLA General Clinical Research Center or the UCLA Neuropsychiatric Institute and Hospital) during their participation. Cerebral glucose metabolism was assayed by the FDG PET method (Reivich et al 1979, Phelps et al 1979) when the MA abusers were abstinent for 4 to 7 days. About 90% of MA administered orally is excreted within 4 days (Caldwell et al 1972). Control subjects participated on a nonresidential basis. Urine drug screens on the

Description of Subjects

The groups did not differ significantly in gender, handedness, race, age, or mother’s education (Table 1). The MA abusers, however, had fewer years of education than the control subjects [t(31) = 2.61, p = .014]. One of the control participants had a history of a manic episode and two each had a past depressive episode. In addition, one MA abuser had a current diagnosis of social phobia and three met criteria for marijuana abuse but not dependence; three participants in the MA abuse group but

Discussion

Methamphetamine abusers differed from control subjects in the relationships between auditory CPT performance (normalized errors, i.e., log [1 + % errors]) and relative rCMRglc of the infragenual, perigenual, and midcingulate cortices and the insula. These cortical regions, as well as the lateral orbitofrontal gyrus, previously showed abnormalities in rCMRglc (London et al 2004). Although MA abusers also had a deficit in hippocampal structure (Thompson et al 2004a), both groups showed a negative

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