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Tuesday, May 1, 2012

Does Cocaine Shrink the Brain?

Chronic Cocaine Abuse may accelerate Brain Atrophy

Of the estimated 21 million cocaine users worldwide, about 1.9 million lived in the U.S. as of 2008. 
 And the largest segment of U.S. users were people ages 18 to 25—some 1.5 percent of whom said they had used cocaine in the past month, according to the National Institutes of Health.

According to the United Nations Office on Drugs and Crime of the 21 million users worldwide about one percent of these people become dependent on the drug. 

Cocaine makes people feel more alert and confident while they are using the drug. In the long run, cocaine eats holes in  nose and sinus tissues, can cause heart attacks and the latest research reports that cocaine abuse may also shrink the brain.  Chronic cocaine use may speed up brain aging suggests a new study published online April 24 in Molecular Psychiatry.

Dr Karen D. Ersche and colleagues at Cambridge University report that cocaine abuse accelerates the process of normal aging, which is associated, among other things, with a gradual loss of brain volume in later years in parallel with cognitive decline.

The British researchers using brain imaging compared the gray matter volume of 120 individuals 18-50 years of age, half of whom were dependent on cocaine and found that those with cocaine dependence had greater levels of age-related loss of brain gray matter.

Both groups showed the expected decline in gray matter as a direct function of age, however, in cocaine dependent individuals the brain atrophied at twice the normal rate as in normal aging. 

The loss of gray matter was most severe in the prefrontal cortex and temporal lobes, areas critical for executive functions - memory, attention, decision-making, and self-regulation the investigators noted in a news release.

Deeper regions of the brain, the striatum, were less affected by cocaine dependency. 

"As we age, we all lose gray matter. However, what we have seen is that chronic cocaine users lose gray matter at a significantly faster rate, which could be a sign of premature aging. Our findings therefore provide new insight into why the [mental] deficits typically seen in old age have frequently been observed in middle-aged chronic users of cocaine," Dr. Karen Ersche, of the Behavioral and Clinical Neuroscience Institute at University of Cambridge, said in the news release.

While the study doesn't conclusively prove cocaine causes brain atrophy and other symptoms of aging, the association is cause for concern, the researchers said.

"Our findings clearly highlight the need for preventative strategies to address the risk of premature aging associated with cocaine abuse. Young people taking cocaine today need to be educated about the long-term risk of aging prematurely," Ersche said.

 They warn accelerated aging also affects older adults who have abused cocaine and other drugs since early adulthood so no group is spared the additional risk of brain atrophy caused by abusing this drug.

The reporting in the journal of Molecular Psychiatry is Introduced below:

Journal of Molecular Psychiatry:
Cocaine dependence: a fast-track for brain ageing?
K D Ersche, P S Jones, G B Williams, T W Robbins and E T Bullmore
Cocaine-dependent individuals anecdotally appear aged and their mortality rates are estimated up to eight times higher than in the healthy population.1 

Psychological and physiological changes typically associated with old age such as cognitive decline, brain atrophy, or immunodeficiency are also seen in middle-aged cocaine-dependent individuals.2, 3 
These observations raise the question of whether cocaine abuse might accelerate the process of normal ageing. 

Although this is a little-studied area, there are several reasons for assuming that chronic cocaine exposure interferes with the processes of brain aging.

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The U.S. National Institute on Drug Abuse has more about cocaine.

More information:

Why do the brains of cocaine-users shrink faster than the brains of non-cocaine users?

Cocaine-dependent individuals showed a significantly greater-than-normal age-related decline in gray matter in prefrontal and temporal regions compared with healthy controls. By contrast, parts of the striatum appeared resistant to age-related volume decline in the cocaine-using group. Enlarged striatal volume has frequently been reported in stimulant-dependent individuals,5, 6 possibly reflecting a marker of reduced dopamine neurotransmission in this dopamine-rich brain region where drugs like cocaine work. Decline in striatal dopamine receptor density has been associated with normal age-related cognitive decline.7 The relative absence of age-related changes in the striatum of cocaine-dependent people may thus reflect another feature of an abnormal brain ageing process.
Could it be related to possible neurotoxicity, or to the long-term effects of dopamine receptor down regulation?
 Could the effects also be generalizable to those who take dopamine-based ADD medications?

A link to the Letter to the Editor appeared in Molecular Psychiatry to which the ScienceNow article refers:
Cocaine dependence: a fast-track for brain ageing?


Similar Reporting From Huffington Post:

Regular cocaine users often experience early cognitive decline and brain atrophy, and the new findings show how these users are, indeed, actually losing gray matter in their brain much faster than people who don’t take the drug.

“As we age we all lose gray matter,” Karen Ersche of the Behavioral and Clinical Neuroscience Institute at the University of Cambridge and co-author of the new study, said in a prepared statement. But, she noted, “chronic cocaine users lose grey matter at a significantly faster rate, which could be a sign of premature aging.”

Cocaine users lost much more gray matter in the prefrontal and temporal regions—which help control memory, decision-making and attention—than non-users did.

The findings bring new insight into “why the cognitive deficits typically seen in old age have frequently been observed in middle aged chronic users of cocaine,” Ersche said. 

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