The Incidence of T2-Weighted MR Imaging Signal Abnormalities in the Brain of Cocaine-Dependent Patients Is Age-Related and Region-Specific
George Bartzokis
,a,
Iris B. Goldsteina,
Darwood B. Hancea,
Mace Becksona,
David Shapiroa,
Po H. Lua,
Nancy Edwardsa,
Jim Mintza and
Peter Bridgea
a From the Mental Health Service Line (G.B.), Central Arkansas Veterans Healthcare System, Little Rock, AR; the Department of Psychiatry (G.B., P.H.L.), University of Arkansas for Medical Sciences, Little Rock, AR; VA Greater Los Angeles Healthcare System (G.B., M.B., P.H.L., N.E., J.M.), West Los Angeles, CA; the Department of Psychiatry (G.B., I.B.G., M.B., D.S., J.M.), University of California, Los Angeles, CA; the Department of Radiology (D.B.H.), University of California, Los Angeles, CA; and the Medication Development Division (P.B.), National Institute on Drug Abuse, Rockville, MD.
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FIG 1. Representative images of the three grades of lesions in cerebral and insular subcortex white matter regions. Grade 0 is not included and contains no hyperintensities. Grade 1 has minimal changes, Grade 2 involves mild changes, and Grade 3 indicates moderate-to-severe changes, thought to be significant indicators of a possible pathologic process. Arrowheads point to rated T2-weighted hyperintensities.
Top panel, Cerebral white matter hyperintensities (Grade 3 image has too many large hyperintensities to be defined by arrowheads).
Lower panel, hyperintensities in the insular subcortex white matter region.
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FIG 2. Axial T2-weighted spin-echo images (2500/90/2) of four cocaine-dependent participants. These are examples of severe cerebral white matter lesions (arrows), graded as 3 on an increasing severity scale of 0 to 3. These participants were randomly selected from those with cerebral white matter ratings of 3
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FIG 3. Axial T2-weighted spin-echo images (2500/90/2) of four cocaine-dependent participants. These are examples of severe insular subcortex white matter lesions (arrows), graded as 3 on an increasing severity scale of 0 to 3. These participants were randomly selected from those with cerebral white matter ratings of 3
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FIG 4. Percent of participants with severe lesions in the insular subcortex white matter versus age. Cocaine-dependent participants had a significantly increased incidence of severe insular subcortex white matter lesions compared with normal control participants. The age dependence of the lesion incidence was significantly different in the two groups (eg, the shapes of the two lines differ). The lines are derived from logistic regression analysis of 62 cocaine addicts and 116 normal control participants. The raw data from each group were divided into age quartiles and are displayed at the median age of the quartile. The sample sizes of the age quartiles (in order of ascending age) were 10, 22, 14, and 16 for the cocaine group and 28, 29, 28, and 31 for the normal group. Severe lesions graded as grade 3 based on a 0 to 3 severity scale
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FIG 5. Percent of participants with severe lesions in the cerebral white matter versus age. Cocaine-dependent participants have a significantly increased incidence of severe cerebral white matter lesions compared with normal control participants. The lines are derived from logistic regression analysis of 62 cocaine addicts and 116 normal control participants. The raw data from each group were divided into age quartiles and are displayed at the median age of the quartile. The sample sizes of the age quartiles (in order of ascending age) were 10, 22, 14, and 16 for the cocaine group and 28, 29, 28, and 31 for the normal group. Severe lesions graded as grade 3 based on a 0 to 3 severity scale
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FIG 6. Percent of participants with severe lesions in the insular subcortex or cerebral white matter versus age. When the combined incidence of white matter lesions (cerebral or insular subcortex white matter) is used in the analysis, cocaine-dependent participants have a markedly significantly increased incidence of severe white matter lesions compared with normal control participants. The lines are derived from logistic regression analysis of 62 cocaine addicts and 116 normal control participants. The raw data from each group were divided into age quartiles and are displayed at the median age of the quartile. The sample sizes of the age quartiles (in order of ascending age) were 10, 22, 14, and 16 for the cocaine group and 28, 29, 28, and 31 for the normal group. Severe lesions graded as grade 3 based on a 0 to 3 severity scale
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