Grey matter abnormalities in methcathinone abusers with a Parkinsonian syndrome

Julius Juurmaa, Ricarda A.L. Menke, Pierre Vila, Andreas Müürsepp, Tiiu Tomberg, Pilvi Ilves, Mait Nigul, Heidi Johansen-Berg, Michael Donaghy, Charlotte J. Stagg, Ainārs Stepens, Pille Taba

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Abstract

Background: A permanent Parkinsonian syndrome occurs in intravenous abusers of the designer psychostimulant methcathinone (ephedrone). It is attributed to deposition of contaminant manganese, as reflected by characteristic globus pallidus hyperintensity on T1-weighted MRI. Methods: We have investigated brain structure and function in methcathinone abusers (n = 12) compared to matched control subjects (n = 12) using T1-weighted structural and resting-state functional MRI. Results: Segmentation analysis revealed significant (p <.05) subcortical grey matter atrophy in methcathinone abusers within putamen and thalamus bilaterally, and the left caudate nucleus. The volume of the caudate nuclei correlated inversely with duration of methcathinone abuse. Voxel-based morphometry showed patients to have significant grey matter loss (p <.05) bilaterally in the putamina and caudate nucleus. Surface-based analysis demonstrated nine clusters of cerebral cortical thinning in methcathinone abusers, with relative sparing of prefrontal, parieto-occipital, and temporal regions. Resting-state functional MRI analysis showed increased functional connectivity within the motor network of patients (p <.05), particularly within the right primary motor cortex. Conclusion: Taken together, these results suggest that the manganese exposure associated with prolonged methcathinone abuse results in widespread structural and functional changes affecting both subcortical and cortical grey matter and their connections. Underlying the distinctive movement disorder caused by methcathinone abuse, there is a more widespread pattern of brain involvement than is evident from the hyperintensity restricted to the basal ganglia as shown by T1-weighted structural MRI.

Original languageEnglish
Article numbere00539
JournalBrain and Behavior
Volume6
Issue number11
DOIs
Publication statusPublished - 1 Nov 2016

Keywords*

  • ephedrone
  • manganese toxicity
  • methcathinone
  • MRI
  • Parkinsonism

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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