Increased frontal lobe phosphocreatine levels observed in heavy cocaine users after treatment for cocaine dependence - An 1 H MRS T 2 relaxometry study

Abstract. We have recently reported that relative concentrations of phosphocreatine (PCr) and creatine (Cr) may be estimated from brain 1H MR spectra based upon T2 relaxation times. Emission tomography studies have consistently associated cocaine dependence and abstinence with decreased cerebral metabolism. We hypothesized that increased frontal lobe PCr levels would accompany treatment for cocaine dependence. Twenty-four cocaine dependent (CD) subjects were studied before and after 8 weeks of cocaine dependence treatment. Nine comparison subjects were studied at the same time points. At baseline, left frontal lobe ratios of PCr/tCr were 0.406 ± 0.081 in CD subjects and 0.411 ± 0.016 in comparison subjects. After treatment, these ratios increased 14.3% (0.464 vs. 0.406; p = 0.006) in CD subjects, remaining unchanged in comparison subjects (2.9%, 0.399 vs. 0.411; p = 0.480). At baseline, PCr levels of non-responders were 17.8% lower (0.375 vs. 0.442; p = 0.042) than those of responders, defined as 25% decrease in urine cocaine metabolites. After treatment, CD subjects had increased PCr levels: 18.4% (0.444 vs. 0.375; p = 0.035) for non-responders and 10.4% (0.488 vs. 0.442; p = 0.092) for responders. These results are consistent with decreased cerebral metabolism during treatment, measured as increased PCr. This is the first report using 1 H MRS T2 relaxometry to measure a change in human brain energetics

Coping strategies, satisfaction with life, and quality of life in Crohn’s disease: A gender perspective using structural equation modeling analysis

<div><p>Objective</p><p>To identify coping strategies and socio-demographics impacting satisfaction with life and quality of life in Crohn’s disease (CD).</p><p>Methods</p><p>402 patients completed the Patient Harvey-Bradshaw Index, Brief COPE Inventory, Satisfaction with Life Scale (SWLS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ). We performed structural equation modeling (SEM) of mediators of quality of life and satisfaction with life.</p><p>Results</p><p>The cohort comprised: men 39.3%, women 60.1%; P-HBI 4.75 and 5.74 (p = 0.01). In inactive CD (P-HBI≤4), both genders had SWLS score 23.8; men had SIBDQ score 57.4, women 52.6 (p = 0.001); women reported more use of emotion-focused, problem-focused and dysfunctional coping than men. In active CD, SWLS and SIBDQ scores were reduced, without gender differences; men and women used coping strategies equally. A SEM model (all patients) had a very good fit (X²₍₆₎ = 6.68, p = 0.351, X²/df = 1.114, SRMR = 0.045, RMSEA = 0.023, CFI = 0.965). In direct paths, economic status impacted SWLS (β = 0.39) and SIBDQ (β = 0.12), number of children impacted SWLS (β = 0.10), emotion-focused coping impacted SWLS (β = 0.11), dysfunctional coping impacted SWLS (β = –0.25). In an indirect path, economic status impacted dysfunctional coping (β = –0.26), dysfunctional coping impacted SIBDQ (β = –0.36). A model split by gender and disease activity showed that in active CD economic status impacted SIBDQ in men (β = 0.43) more than women (β = 0.26); emotional coping impacted SWLS in women (β = 0.36) more than men (β = 0.14).</p><p>Conclusions</p><p>Gender differences in coping and the impacts of economic status and emotion-focused coping vary with activity of CD. Psychological treatment in the clinic setting might improve satisfaction with life and quality of life in CD patients.</p></div

General model with path analysis showing the direct and indirect effects of economic status and number of children on SIBDQ and SWLS, with emotion-focused and dysfunctional coping strategies as mediators.

<p>Each of the coefficients in the model exceeds p≤0.05 significance.</p

Four groups model path analysis, with the cohort split by gender (women, men) and disease activity (inactive disease, active disease).

<p>All β coefficients ≥ 0.15 reached p≤0.05 significance.</p

Cohort characteristics (N = 402).

<p>Cohort characteristics (N = 402).</p

Comparison of structural alternative model and path magnitudes between four groups.

<p>Comparison of structural alternative model and path magnitudes between four groups.</p

Descriptive values of psychological measures by disease activity and gender.

<p>Descriptive values of psychological measures by disease activity and gender.</p