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J Neuropsychiatry Clin Neurosci 1993; 5:419-427
Copyright © 1993 by American Neuropsychiatric Association
Cerebral perfusion and neuropsychological consequences of chronic cocaine use
TL Strickland, I Mena, J Villanueva-Meyer, BL Miller, J Cummings, CM Mehringer, P Satz and H Myers
Department of Psychiatry, Drew University of Medicine and Science, Los Angeles, CA 90059.
Research indicates that cocaine significantly constricts the cerebral
vasculature and can lead to ischemic brain infarction. Long-term effects of
intermittent or casual cocaine use in patients without symptoms of stroke
or transient ischemic attack were investigated. Single-photon emission
computed tomography with xenon-133 and [99mTc]hexamethylpropyleneamine
oxime, magnetic resonance imaging, and selected neuropsychological measures
were used to study cerebral perfusion, brain morphology, and cognitive
functioning. Patients were drug free for at least 6 months before
evaluation. All showed regions of significant cerebral hypoperfusion in the
frontal, periventricular, and/or temporal-parietal areas. Deficits in
attention, concentration, new learning, visual and verbal memory, word
production, and visuomotor integration were observed. This study indicates
that long-term cocaine use may produce sustained brain perfusion deficits
and persistent neuropsychological compromise in some subgroups of
cocaine-abusing patients.
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