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Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study
Published on: August 18, 2020
Brain abnormalities detected on magnetic resonance imaging of amphetamine users presenting to an emergency
Daniel M Fatovich1, David L McCoubrie, Swithin J Song
1Royal Perth Hospital, Perth, WA, Australia. daniel.fatovich@health.wa.gov.au
Objectives:
To determine the prevalence of occult brain abnormalities in magnetic resonance imaging of active amphetamine users.
Design, Setting And Participants:
Prospective convenience study in a tertiary hospital emergency department (ED). Patients presenting to the ED for an amphetamine-related reason were eligible for inclusion. We collected demographic data, drug use data, and performed a mini-mental state examination (MMSE).
Main Outcome Measures:
The proportion of patients with an abnormality on their MRI scan.
Results:
Of 38 patients enrolled, 30 had MRI scans. Nineteen were male and their mean age was 26.7 +/- 5.4 years (range 19-41 years). The mean age of first amphetamine use was 18 years (range 13-26 years). Sixteen patients used crystal methamphetamine (mean amount 2.5 g/week), nine used amphetamine ("speed") (mean amount 2.9 g/week), and 23 used ecstasy (mean amount 2.3 tablets/week). Marijuana was smoked by 26 (mean amount 5.9 g/week), and 28 drank alcohol (mean amount 207 g/week). The median MMSE score was 27/30 (interquartile range, 26-29). Abnormalities on brain MRI scans were identified in six patients, most commonly an unidentified bright object (n = 4).
Conclusion:
In this pilot study of brain MRI of young people attending the ED with an amphetamine-related presentation, one in five had an occult brain lesion. While the significance of this is uncertain, it is congruent with evidence that amphetamines cause brain injury.
