Abnormal white matter integrity in chronic users of codeine-containing cough syrups: a tract-based spatial statistics...

Area of Science:

• Neuroimaging
• Addiction Medicine
• Cognitive Neuroscience

Background:

• Codeine-containing cough syrups are widely abused by young people globally.
• Chronic abuse is associated with cognitive impairments, but white matter (WM) effects remain understudied.

Purpose of the Study:

• To investigate brain white matter (WM) microstructure abnormalities in chronic codeine-containing cough syrup users.
• To determine the relationship between WM abnormalities, duration of use, and clinical impulsivity.

Main Methods:

• Diffusion tensor imaging (DTI) and voxelwise fractional anisotropy (FA) analysis using tract-based spatial statistics.
• Barratt Impulsiveness Scale (BIS-11) surveyed for impulsivity assessment.
• Volume-of-interest analysis to correlate FA with impulsivity and duration of use.

Main Results:

• Chronic users showed significantly lower FA in the inferior fronto-occipital fasciculus and corona radiata compared to controls.
• Lower FA in specific frontal regions correlated negatively with overall impulsivity and non-planning impulsivity scores.
• Reduced FA in the right frontal inferior fronto-occipital fasciculus also correlated negatively with the duration of syrup use.

Conclusions:

• Chronic codeine-containing cough syrup abuse is associated with impaired white matter (WM) integrity.
• These microstructural brain deficits may underlie the heightened impulsivity observed in chronic users.