Brain imaging in substance abuse : research, clinical, and forensic applications

Contents xi Foreword ........................................................................................................................ v Preface ......................................................................................................................... vii Acknowledgments ..................................................................................................... viii List of Figures .............................................................................................................xix List of Tables........................................................................................................... xxiii List of Contributors ...................................................................................................xxv Chapter 1: Electroencephalography, Topographic Mapping, and Event-Related Potentials in Substance Abuse Research .........1 Elena M. Kouri, PhD and Scott E. Lukas, PhD History of the Electroencephalogram ........................................................... 1 Recording the Electroencephalogram .......................................................... 2 EEG Amplifiers ..................................................................................... 4 EEG Filters ............................................................................................. 5 EEG Montages ....................................................................................... 5 Analysis of the EEG ...................................................................................... 7 Topographic Mapping ................................................................................. 10 Artifact Avoidance....................................................................................... 10 Utility of Electroencephalographic Techniques in Substance Abuse Research ................................................................................................... 11 Measures of Acute Drug Effects ......................................................... 11 Measures of Tolerance and Dependence ............................................ 15 Correlates of Vulnerabilities to Drug Abuse ...................................... 16 Event-Related Potentials ............................................................................. 16 Utility of Event-Related Potentials in Substance Abuse Research ........... 19 Measures of Acute Drug Effects ......................................................... 19 Measures of Tolerance and Dependence ............................................ 20 Correlates of Vulnerabilities to Drug Abuse ...................................... 20 Caveats in Interpreting Electrophysiologic Data in Substance Abuse Research .................................................................. 21 Future Directions ......................................................................................... 22 Acknowledgments ....................................................................................... 22 References .................................................................................................... 22 xii Contents Chapter 2: Positron Emission Tomography and Single-Photon Emission Computed Tomography: Methods and Applications in Substance Abuse Research .................................................... 29 Robert T. Malison, MD Introduction .................................................................................................. 29 Principles Underlying Positron Emission Tomography and Single-Photon Emission Computed Tomography ........................... 30 Positron and Single-Photon Generation .............................................. 30 PET and SPECT Cameras ................................................................... 31 Computed Tomography ....................................................................... 33 Basic Limitations of Positron Emission Tomography and Single-Photon Emission Computed Tomography ........................... 33 Radioactive Decay ............................................................................... 33 Photon Attenuation .............................................................................. 34 Photon Scatter ...................................................................................... 34 Limited Spatial Resolution .................................................................. 36 Tracer Modeling .................................................................................. 36 Applications in Substance Abuse Research................................................ 39 In Vivo Pharmacology ......................................................................... 39 Neuronal Activity/Metabolism ............................................................ 40 Brain Chemistry ................................................................................... 41 Neurotransmitter Synthesis ............................................................. 41 Receptors and Transporters ............................................................. 41 Neurotransmitter Release ................................................................ 42 Conclusions .................................................................................................. 42 References .................................................................................................... 43 Chapter 3: Fundamentals of Magnetic Resonance ..................... 47 Perry F. Renshaw, MD, PhD, Blaise deB. Frederick, PhD, and Luis C. Maas III, MD, PhD Introduction .................................................................................................. 47 General Principles ........................................................................................ 48 Magnetic Resonance Spectroscopy ............................................................. 50 Evolution of Methods .......................................................................... 50 Current Status of Research .................................................................. 54 Magnetic Resonance Imaging ..................................................................... 59 Methods ................................................................................................ 59 Image Contrast ..................................................................................... 60 Contrast Agents .................................................................................... 61 Contraindications ................................................................................. 61 Claustrophobia ..................................................................................... 62 Contents xiii Functional Magnetic Resonance Imaging .................................................. 62 BOLD fMRI ......................................................................................... 63 Principles .......................................................................................... 63 Data Processing Methods ................................................................ 65 Advantages and Limitations ............................................................ 65 Dynamic Susceptibility Contrast MRI ................................................ 66 Principles .......................................................................................... 66 Limitations ....................................................................................... 68 Other Magnetic Resonance Methods .......................................................... 68 Diffusion Weighted Imaging ............................................................... 68 Magnetic Resonance Angiography ..................................................... 69 Relaxometry ......................................................................................... 69 Magnetization Transfer ....................................................................... 69 Summary ...................................................................................................... 70 Acknowledgments ....................................................................................... 70 References .................................................................................................... 70 Chapter 4: Electroencephalographic Studies of Substance Use and Abuse....................................................... 77 Lance O. Bauer, PhD Introduction .................................................................................................. 77 Electroencephalographic Studies of Acute Effects of Psychoactive Drugs ........................................................................................................ 77 Spontaneous EEG Activity .................................................................. 77 Alcohol ............................................................................................. 78 Benzodiazepines .............................................................................. 80 Marijuana/THC ................................................................................ 81 Opioids ............................................................................................. 82 Cocaine ............................................................................................. 82 Evoked Potentials (EP) and Event-Related Potentials (ERP)............ 83 Alcohol ............................................................................................. 84 Benzodiazepines .............................................................................. 85 Marijuana/THC ................................................................................ 86 Opioids ............................................................................................. 87 Cocaine ............................................................................................. 87 Electroencephalographic Studies of Chronic Substance Abusers ............. 88 Alcohol ................................................................................................. 89 Benzodiazepines .................................................................................. 90 Marijuana/THC .................................................................................... 91 Opioids ................................................................................................. 91 Cocaine ................................................................................................. 94 xiv Contents Discussion .................................................................................................... 97 Neuroimaging Research in Context .................................................... 97 Future Directions ............................................................................... 100 Acknowledgments ..................................................................................... 100 References .................................................................................................. 101 Chapter 5: Emission Tomographic Studies in Substance Abuse ....................................................................113 Jonathan M. Levin, MD, MPH Introduction ................................................................................................ 113 Alcohol and Alcoholism ............................................................................ 114 Acute Alcohol Administration .......................................................... 114 Cerebral Blood Flow ..................................................................... 114 Cerebral Metabolism ..................................................................... 115 Chronic Alcohol Effects and Alcoholism ......................................... 115 Cerebral Blood Flow ..................................................................... 115 Cerebral Metabolism ..................................................................... 116 Receptor Studies ............................................................................ 117 Effects of Withdrawal and Abstinence ......................................... 117 Neurological Disorders Associated with Alcoholism ...................... 118 Wernicke-Korsakoff Syndrome .................................................... 118 Marchiafava-Bignami Syndrome .................................................. 119 Cerebellar Degeneration ................................................................ 119 Hepatic Encephalopathy ................................................................ 119 Drug Challenge and Receptor Level Studies .................................... 120 Effects of Treatment for Alcohol Abuse ...................................... 120 Benzodiazepine Studies ................................................................. 120 Dopamine Studies .......................................................................... 120 Serotonin Studies ........................................................................... 121 Summary ............................................................................................ 121 Marijuana ................................................................................................... 121 Acute Intoxication ............................................................................. 121 Chronic Use and Abuse ..................................................................... 122 Hallucinogens ............................................................................................ 122 Ketamine ............................................................................................ 122 MDMA (“Ecstasy”) ........................................................................... 122 Psilocybin and Mescaline .................................................................. 123 Summary ............................................................................................ 123 Benzodiazepines ........................................................................................ 123 Effects of Acute Administration ....................................................... 123 Cerebral Blood Flow ..................................................................... 123 Cerebral Metabolism ..................................................................... 124 Effects of Chronic Administration .................................................... 124 Contents xv Heroin and Opiates .................................................................................... 124 Acute Administration ........................................................................ 124 Cerebral Blood Flow and Receptor Studies ................................. 124 Cerebral Metabolism ..................................................................... 125 Chronic Administration ..................................................................... 125 Withdrawal and Abstinence .............................................................. 126 Cocaine ....................................................................................................... 128 Acute Cocaine Administration .......................................................... 128 Cerebral Blood Flow ..................................................................... 128 Cerebral Metabolism ..................................................................... 129 Cocaine Binding and Receptor Studies ........................................ 130 Chronic Cocaine Abuse and Dependence ......................................... 131 Cerebral Blood Flow ..................................................................... 131 Cerebral Metabolism ..................................................................... 132 Withdrawal ..................................................................................... 133 Cocaine Craving ............................................................................ 133 Abstinence ...................................................................................... 135 Receptor/Transporter Effects ........................................................ 135 Treatment for Cocaine Abuse and Dependence ........................... 136 Summary ............................................................................................ 137 Amphetamine and Methamphetamine ...................................................... 137 Amphetamine ..................................................................................... 137 Cerebral Blood Flow ..................................................................... 137 Cerebral Metabolism ..................................................................... 138 Receptor Studies ............................................................................ 138 Chronic Effects .................................................................................. 138 Methamphetamine ............................................................................. 139 Methylphenidate ........................................................................................ 139 Cerebral Blood Flow and Metabolism .............................................. 139 Receptor Studies ................................................................................ 139 Solvents (“Thinners”) and Toluene .......................................................... 140 Conclusions ................................................................................................ 141 Acknowledgment ....................................................................................... 142 References .................................................................................................. 142 Chapter 6: Magnetic Resonance Findings in Substance Abuse ................................................................... 155 Marc J. Kaufman, PhD and Jonathan M. Levin, MD, MPH Introduction ................................................................................................ 155 Alcohol and Alcoholism ............................................................................ 156 Acute Effects ...................................................................................... 156 MR Imaging ................................................................................... 156 MR Spectroscopy ........................................................................... 156 Functional MRI .............................................................................. 158 xvi Contents Chronic Effects .................................................................................. 159 MR Imaging ................................................................................... 159 Tissue Relaxation Abnormalities .............................................. 159 Ventricular Enlargement ........................................................... 160 Cortical Atrophy ........................................................................ 161 Corpus Callosum Atrophy ......................................................... 161 Cerebellar Degeneration ............................................................ 161 White Matter Lesions ................................................................ 164 Effects of Aging ......................................................................... 164 Abstinence and Relapse ................................................................. 165 MR Imaging ............................................................................... 165 MR Spectroscopy ....................................................................... 165 Special Syndromes Associated with Alcohol Abuse ....................... 166 Hepatic Cirrhosis and Encephalopathy ......................................... 166 MR Imaging ............................................................................... 166 MR Spectroscopy ....................................................................... 166 Wernicke and Korsakoff’s Syndromes ......................................... 167 Central Pontine Myelinolysis ........................................................ 168 Marchiafava-Bignami Disease ...................................................... 169 Fetal Alcohol Exposure ................................................................. 169 Methanol ........................................................................................ 170 Marijuana and Hallucinogens.................................................................... 170 Benzodiazepines ........................................................................................ 171 Heroin and Opiates .................................................................................... 171 Acute Effects ...................................................................................... 171 Cerebrovascular Effects..................................................................... 172 Leukoencephalopathy .................................................................... 172 Chronic Effects .................................................................................. 174 Cocaine ....................................................................................................... 174 Acute Effects ...................................................................................... 174 Research Studies ................................................................................ 175 MR Spectroscopy ........................................................................... 175 Functional MRI .............................................................................. 176 Cocaine Craving ............................................................................ 178 MR Angiography ........................................................................... 179 Chronic Effects .................................................................................. 179 Prenatal Effects .................................................................................. 181 Amphetamine and Other Stimulants ......................................................... 181 Amphetamine ..................................................................................... 181 Methamphetamine ............................................................................. 182 Methylphenidate ................................................................................ 182 Solvent Abuse and Occupational Exposure .............................................. 183 Acute Effects ...................................................................................... 183 Chronic Effects .................................................................................. 183 Contents xvii Polydrug Abuse.......................................................................................... 184 MR Imaging ....................................................................................... 184 MR Spectroscopy ............................................................................... 184 Concluding Remarks ................................................................................. 185 Acknowledgments ..................................................................................... 185 References .................................................................................................. 186 Chapter 7: Neuropsychological Correlates of Drug Abuse...... 199 Staci A. Gruber, EdM and Deborah A. Yurgelun-Todd, PhD Introduction ................................................................................................ 199 Alcohol ....................................................................................................... 201 Acute Effects ...................................................................................... 201 Chronic Effects .................................................................................. 203 Marijuana ................................................................................................... 205 Acute Effects ...................................................................................... 205 Chronic Effects .................................................................................. 205 Summary ............................................................................................ 207 Hallucinogens ............................................................................................ 208 Acute Effects ...................................................................................... 208 Chronic Effects .................................................................................. 209 Phencyclidine ..................................................................................... 210 Acute Effects .................................................................................. 210 Chronic Effects .............................................................................. 211 Benzodiazepines ........................................................................................ 211 Acute Effects ...................................................................................... 211 Chronic Effects .................................................................................. 212 Opiates........................................................................................................ 212 Acute Effects ...................................................................................... 213 Chronic Effects .................................................................................. 213 Cocaine ....................................................................................................... 214 Acute Effects ...................................................................................... 215 Chronic Effects .................................................................................. 215 Summary ............................................................................................ 217 Amphetamine and Other Stimulants ......................................................... 217 Acute Effects ...................................................................................... 217 Chronic Effects .................................................................................. 218 Solvents ...................................................................................................... 218 Acute Effects ...................................................................................... 219 Chronic Effects .................................................................................. 219 Conclusion ................................................................................................. 220 Acknowledgments ..................................................................................... 221 References .................................................................................................. 221 Chapter 8: Neuroimages as Legal Evidence ............................ 231 Jennifer J. Kulynych, JD, PhD and Douglas W. Jones, PhD Introduction ................................................................................................ 231 Science and the Law .................................................................................. 232 The Meaning of “Evidence” .............................................................. 232 From the Laboratory to the Courtroom............................................. 233 Neuroimages as Psychiatric Evidence ...................................................... 237 Evidentiary Tests for the Admissibility of Expert Scientific Testimony....................................................................................... 238 Scientific Uncertainty and the Interpretation of Neuroimaging Data ................................................................... 240 Substance Abuse, Neuroimaging, and Crime ........................................... 241 Substance Abuse as a Defense to Crime ........................................... 243 Legal Applications of Substance Abuse Imaging Data.................... 244 Conclusion ................................................................................................. 245 References .................................................................................................. 245 Glossary .................................................................................... 249 Bibliography of Research Studies in Substance Abuse ............. 261 Marc J. Kaufman, PhD Introduction to the Bibliography ............................................................... 261 Bibliography Table of Contents ................................................................ 263 EEG and Evoked Potentials ...................................................................... 269 Emission Tomography ............................................................................... 306 Magnetic Resonance .................................................................................. 335 Neuropsychology ....................................................................................... 360 Index ............................................................................................................... 399