Grey matter abnormalities in methcathinone abusers with a Parkinsonian syndrome

Funding Information: The study was supported by Grants GARNR9199 and GARLA0148P of the Estonian Science Foundation, and Grant No. 5.8.2 of the National Research Program of Latvia. Ricarda A L Menke is employed by the University of Oxford and her salary is funded by the Medical Research Council of the UK. Heidi Johansen-Berg is employed by the Universities of Oxford and Oslo, holds grants from the Wellcome Trust, National Institutes of Health Research, Education Endowment Foundation, Stroke Association, and Royalties from Elsevier. Charlotte J Stagg holds a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society. Ain?rs Stepens holds Grant No. 5.8.2 of the National Research Program of Latvia, which supported this study. Pille Taba holds Grant 9199 of the Estonian Science Foundation, which supported this study, is principal investigator of Grant 3.2.1001.11-0017 of the EU European Regional Development Fund, and participates in Grant IUT2-4 of the Estonian Research Council. Publisher Copyright: © 2016 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.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.Peer reviewe

Dissociation of reward and effort sensitivity in methcathinone-induced Parkinsonism

Methcathinone-induced Parkinsonism is a recently described extrapyramidal syndrome characterized by globus pallidus and substantia nigra lesions, which provides a unique model of basal ganglia dysfunction. We assessed motivated behaviour in this condition using a novel cost-benefit decision-making task, in which participants decided whether it was worth investing effort for reward. Patients showed a dissociation between reward and effort sensitivity, such that pallidonigral complex dysfunction caused them to become less sensitive to rewards, while normal sensitivity to effort costs was maintained

Grey matter abnormalities in methcathinone abusers with a parkinsonian syndrome

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<0.05) 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<0.05) 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<0.05), 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

Methcathinone (ephedrone) and manganese both reduce D2-receptor function: An animal SPECT study

Poster presentation

Grey matter abnormalities in methcathinone abusers with a parkinsonian syndrome

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&lt;0.05) 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&lt;0.05) 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&lt;0.05), 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