Cerebral measurements and their correlation with the onset age and the duration of opioid abuse

Authors

  • Reetta Kivisaari, MD, PhD
  • Pekka Rapeli, Psyc. Lic.
  • Koen Van Leemput, PhD
  • Seppo Kähkönen, MD, PhD
  • Varpu Puuskari, MD
  • Olga Jokela, MD
  • Taina Autti, MD, PhD

DOI:

https://doi.org/10.5055/jom.2010.0040

Keywords:

MRI, Sylvian fissure ratio, brain, opioid dependence, imaging, neuropsychological tests

Abstract

Background: Opioid-dependent patients have been shown to have structural brain alterations. This study focuses on magnetic resonance imaging (MRI) measurements of brain and their correlation with the onset age and the duration of opioid abuse.
Methods: Brain MRI was obtained from 17 opioid-dependent patients (mean age 34 years, SD 7 years) and 17 controls. Compulsive opioid use had begun between ages 15 and 31 (mean 20) and had continued from 5 to 26 years. All patients were tobacco smokers, six had also abused amphetamines and 11 benzodiazepines. Relative volumes of cerebral white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) spaces were measured. In addition, Sylvian fissure ratio (SFR), bifrontal ratio, and midsagittal cerebellar vermian area were correlated with the onset age and the duration of opioid abuse.
Results: The total volume (GM + WM + CSF) of the cerebrum was significantly smaller in patients than in controls (Mann-Whitney U-test, p = 0.026) as well as the absolute volumes of GM and WM (p = 0.014 and p = 0.007, respectively). There was no significant difference in GM and WM volumes normalized with total cerebral volume. In contrast, the absolute volume of CSF did not significantly differ between the groups, but the relative volume of CSF was significantly higher in opioid dependents (p = 0.029). SFR and bifrontal ratio were larger in opioid dependents than in controls (p = 0.005 and p = 0.013). The SFR correlated negatively (p = 0.017, r = −0.569) and the area of vermis cerebelli correlated positively (p = 0.043, r = 0.496) with the onset age of opioid abuse. The length of opioid abuse and the area of vermis cerebellum had a negative correlation (p = 0.038, r = −0.523) even though the areas of cerebellar vermis did not significantly differ between opioid dependents and controls. The authors speculate that the onset of substance abuse in adolescence or early adulthood may have in part disturbed the late brain maturation process, as in normal development, the dorsolateral frontal cortex and superior parts of the temporal lobes are the last to maturate. Also, the cerebellar vermis may be affected by early onset substance abuse. It is possible that the brain is more vulnerable to substance abuse at a young age than later in life.

Author Biographies

Reetta Kivisaari, MD, PhD

Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; BioMag Laboratory, Helsinki University Central Hospital, Helsinki, Finland.

Pekka Rapeli, Psyc. Lic.

Department of Psychology, University of Helsinki, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.

Koen Van Leemput, PhD

Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts; Department of Information and Computer Science, Helsinki University of Technology, Helsinki, Finland.

Seppo Kähkönen, MD, PhD

BioMag Laboratory, Helsinki University Central Hospital, Helsinki, Finland; Pain Clinic, Helsinki University Central Hospital, Helsinki, Finland.

Varpu Puuskari, MD

Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.

Olga Jokela, MD

Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.

Taina Autti, MD, PhD

Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.

References

Andersen SN, Skullerud K: Hypoxic/ischaemic brain damage, especially pallidal lesions, in heroin addicts. Forensic Sci Int. 1999; 102: 51-59.

Gatley SJ, Volkow ND: Addiction and imaging of the living human brain. Drug Alcohol Depend. 1998; 51: 97-108.

Pau CW, Lee TM, Chan SF: The impact of heroin on frontal executive functions. Arch Clin Neuropsychol. 2002; 17: 663-670.

Verdejo-Garcia A, Lopez-Torrecillas F, Gimenez CO, et al.: Clinical implications and methodological challenges in the study of the neuropsychological correlates of cannabis, stimulant, and opioid abuse. Neuropsychol Rev. 2004; 14: 1-41.

Mintzer MZ, Copersino ML, Stitzer ML: Opioid abuse and cognitive performance. Drug Alcohol Depend. 2005; 78: 225-230.

Rapeli P, Kivisaari R, Autti T, et al.: Cognitive function during early abstinence from opioid dependence: A comparison to age, gender, and verbal intelligence matched controls. BMC Psychiatry [computer file]. 2006; 6: 9.

Liu X, Matochik JA, Cadet JL, et al.: Smaller volume of prefrontal lobe in polysubstance abusers: A magnetic resonance imaging study. Neuropsychopharmacology. 1998; 18: 243-252.

Lyoo IK, Pollack MH, Silveri MM, et al.: Prefrontal and temporal gray matter density decreases in opiate dependence. Psychopharmacology. 2006; 184: 139-144.

Schlaepfer TE, Lancaster E, Heidbreder R, et al.: Decreased frontal white-matter volume in chronic substance abuse. Int J Neuropsychopharmacol. 2006; 9: 147-153.

Kivisaari R, Kähkönen S, Puuskari V, et al.: Magnetic resonance imaging of severe, long-term, opiate-abuse patients without neurologic symptoms may show enlarged cerebrospinal spaces but no signs of brain pathology of vascular origin. Arch Med Res. 2004; 35: 395-400.

Pezawas LM, Fischer G, Diamant K, et al.: Cerebral CT findings in male opioid-dependent patients: Stereological, planimetric and linear measurements. Psychiatry Res. 1998; 83: 139-147.

Strang J, Gurling H: Computerized tomography and neuropsychological assessment in long-term high-dose heroin addicts. Br J Addict. 1989; 84: 1011-1019.

De Bellis MD, Narasimhan A, Thatcher DL, et al.: Prefrontal cortex, thalamus, and cerebellar volumes in adolescent and young adults with adolescent-onset alcohol use disorders and comorbid mental disorders. Alcohol Clin Exp Res. 2005; 29(9): 1590-1600.

De Bellis MD, Clark DB, Beers SR, et al.: Hippocampal volume in adolescent-onset alcohol use disorders. Am J Psychiatry. 2000; 157(5): 737-744.

Bartzokis G, Beckson M, Lu PH, et al.: Brain maturation may be arrested in chronic cocaine addicts. Biol Psychiatry. 2002; 51(8): 605-611.

Gogtay N, Giedd JN, Lusk L, et al.: Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci USA. 2004; 101: 8174-8179.

Giorgio A, Watkins KE, Chadwick M, et al.: Longitudinal changes in grey and white matter during adolescence. Neuroimage. 2010; 49(1): 94-103.

First MB, Spitzer RL, Gibbon M, et al.: Structured Clinical Interview for DSM-IV Axis I Disorders. Version 2.0. New York: New York State Psychiatric Institute, 1994.

First MB, Spitzer RL, Gibbon M, et al.: Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Version 2.0. New York: New York State Psychiatric Institute, 1994.

Evans AC, Collins DL, Mills SR, et al.: 3D statistical neuroanatomical models from 305 MRI volumes. Proceedings of the IEEE Nuclear Science Symposium and Medical Imaging Conference. San Diego, CA: Institute of Electrical and Electronics Engineers (IEEE), 1993: 1813-1817.

Ashburner J, Friston KJ: Voxel-based morphometry—The methods. Neuroimage. 2000; 11: 805-821.

van Leemput K, Maes F, Vandermeulen D, et al.: Automated model-based tissue classification of MR images of the brain. IEEE Trans Med Imaging. 1999; 18(10): 897-908.

van Zagten M, Kessels F, Boiten J, et al.: Interobserver agreement in the assessment of cerebral atrophy on CT using bicaudate and sylvian-fissure ratios. Neuroradiology. 1999; 41: 261-264.

Tapert SF, Brown SA: Neuropsychological correlates of adolescent substance abuse: Four-year outcomes. J Int Neuropsychol Soc. 1999; 5: 481-493.

LeMay M: Radiologic changes of the aging brain and skull. AJR Am J Roentgenol. 1984; 143: 383-389.

Guo X, Steen B, Matousek M, et al.: A population-based study on brain atrophy and motor performance in elderly women. J Gerontol A Biol Sci Med Sci. 2001; 56: M633-M637.

Haselhorst R, Dursteler-MacFarland KM, Scheffler K, et al.: Frontocortical N-acetylaspartate reduction associated with long-term IV heroin use. Neurology. 2002; 58: 305-307.

Schadrack J, Willoch F, Platzer S, et al.: Opioid receptors in the human cerebellum: Evidence from [11C]diprenorphine PET, mRNA expression and autoradiography. Neuroreport. 1999; 10(3): 619-624.

Lader MH, Ron M, Petursson H: Computed axial brain tomography in long-term benzodiazepine users. Psych Med. 1984; 14: 203-206.

Moodley P, Golombok S, Shine P, et al.: Computed axial brain tomograms in long-term benzodiazepine users. Psychiatry Res. 1993; 48: 135-144.

Berman S, O’Neill J, Fears S, et al.: Abuse of amphetamines and structural abnormalities in brain. Ann N Y Acad Sci. 2008; 1141: 195-220.

Gallinant J, Meisenzahl E, Jacobsen LK, et al.: Smoking and structural brain deficits: A volumetric MR investigation. Eur J Neurosci. 2006; 24: 1744-1750.

Yücel M, Solowij N, Respondek C, et al.: Regional brain abnormalities associated with long-term heavy cannabis use. Arch Gen Psychiatry. 2008; 65(6): 694-701.

Jarvis K, DelBello MP, Mill N, et al.: Neuroanatomic comparison of bipolar adolescents with and without cannabis use disorders. J Child Adolesc Psychopharmacol. 2008; 18(6): 557-563.

Rais M, Cahn W, Van Haren N, et al.: Excessive brain volume loss over time in cannabis-using first-episode schizophrenia patients. Am J Psychiatry. 2008; 165: 490-496.

Dolan MC, Deakin JF, Roberts N, et al.: Quantitative frontal and temporal structural MRI studies in personality-disordered offenders and control subjects. Psychiatry Res. 2002; 116: 133-149.

Woods BT, Brennan S, Yurgelun-Todd D, et al.: MRI abnormalities in major psychiatric disorders: An exploratory comparative study. J Neuropsychiatry Clin Neurosci. 1995; 7(1): 49-53.

Published

01/29/2018

How to Cite

Kivisaari, MD, PhD, R., P. Rapeli, Psyc. Lic., K. Van Leemput, PhD, S. Kähkönen, MD, PhD, V. Puuskari, MD, O. Jokela, MD, and T. Autti, MD, PhD. “Cerebral Measurements and Their Correlation With the Onset Age and the Duration of Opioid Abuse”. Journal of Opioid Management, vol. 6, no. 6, Jan. 2018, pp. 423-9, doi:10.5055/jom.2010.0040.