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Published on: January 22, 2016
White matter microstructure and impulsivity in methamphetamine dependence with and without a history of psychosis
Anne Uhlmann1, Jean-Paul Fouche1,2, Katharina Lederer1
1Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
Background:
Methamphetamine (MA) use may lead to white matter injury and to a range of behavioral problems and psychiatric disorders, including psychosis. The present study sought to assess white matter microstructural impairment as well as impulsive behavior in MA dependence and MA-associated psychosis (MAP).
Methods:
Thirty patients with a history of MAP, 39 participants with MA dependence and 40 healthy controls underwent diffusion tensor imaging (DTI). Participants also completed the UPPS-P impulsive behavior questionnaire. We applied tract-based spatial statistics (TBSS) to investigate group differences in mean diffusivity (MD), fractional anisotropy (FA), axial (λ‖ ) and radial diffusivity (λ⊥ ), and their association with impulsivity scores and psychotic symptoms.
Results:
The MAP group displayed widespread higher MD, λ‖ and λ⊥ levels compared to both controls and the MA group, and lower FA in extensive white matter areas relative to controls. MD levels correlated positively with negative psychotic symptoms in MAP. No significant DTI group differences were found between the MA group and controls. Both clinical groups showed high levels of impulsivity, and this dysfunction was associated with DTI measures in frontal white matter tracts.
Conclusions:
MAP patients show distinct patterns of impaired white matter integrity of global nature relative to controls and the MA group. Future work to investigate the precise nature and timing of alterations in MAP is needed. The results are further suggestive of frontal white matter pathology playing a role in impulsivity in MA dependence and MAP. Hum Brain Mapp 37:2055-2067, 2016. © 2016 Wiley Periodicals, Inc.
Insights
Methamphetamine-associated psychosis (MAP) patients exhibit widespread white matter damage, unlike those with only methamphetamine dependence. This brain injury is linked to impulsivity and psychotic symptoms, suggesting frontal white matter pathology.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Methamphetamine (MA) use is associated with white matter injury, behavioral issues, and psychiatric disorders like psychosis.
- Understanding the specific white matter microstructural changes and impulsivity in MA dependence and MA-associated psychosis (MAP) is crucial.
Purpose of the Study:
- To assess white matter microstructural integrity using diffusion tensor imaging (DTI) in patients with MAP, MA dependence, and healthy controls.
- To evaluate impulsive behavior using the UPPS-P questionnaire in these groups.
- To investigate the association between white matter changes, impulsivity, and psychotic symptoms.
Main Methods:
- Diffusion tensor imaging (DTI) was performed on 30 MAP patients, 39 MA-dependent individuals, and 40 healthy controls.
- Tract-based spatial statistics (TBSS) analyzed mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (λ‖), and radial diffusivity (λ⊥).
- Participants completed the UPPS-P impulsive behavior questionnaire.
Main Results:
- MAP patients showed significantly higher MD and λ levels and lower FA across widespread white matter areas compared to controls and the MA group.
- No significant DTI differences were observed between the MA group and controls.
- Higher MD in MAP correlated with negative psychotic symptoms. Both clinical groups exhibited high impulsivity, linked to frontal white matter measures.
Conclusions:
- MAP is characterized by distinct, global white matter integrity impairments compared to MA dependence and healthy controls.
- Frontal white matter alterations may contribute to impulsivity in MA dependence and MAP.
- Further research is needed to clarify the precise nature and timeline of these white matter alterations in MAP.
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