Shabbir Hashimbhai Ezuddin MD, Presenter: Nothing to Disclose

Mike F Georgiou PhD, Abstract Co-Author: Nothing to Disclose

Reshma Mathen BS, Abstract Co-Author: Nothing to Disclose

Drenna Waldrop-Valverde PhD, Abstract Co-Author: Nothing to Disclose

George N. Sfakianakis MD, Abstract Co-Author: Nothing to Disclose

Mahendra Kumar PhD, Abstract Co-Author: Nothing to Disclose

Substance abusers have drug-brain-behavior interactions which are reflected both clinically and on functional/metabolic imaging. The purpose of this study is to determine the reversal process in the brain using PET-FDG after prolonged withdrawal of drugs in the absence of any permanent neurological damage caused by brain infarcts.

The study included 18 patients with previous DU, 13 males and 5 females, 2 whites (W), 6 Hispanics (H) and 10 blacks (B), ages 20-46 years (mean 34). DU included 1 Ecstasy, 8 Marijuana, 1 Cocaine, 2 Crack and 6 multiple drugs. Last reported DU was 1 year to 5 years. Controls included 8 patients with no previous DU, 3 males and 5 females, 2 H, 2 W, and 4 B, ages 18 to 36 years (mean 24). All brains were imaged on dedicated PET scanner (Philips C-PET Plus), 40 minutes after IV FDG (0.05mCi/kg). All studies were read by a NM Physician and a radiologist using strict semi quantitative analysis of standardized rainbow color settings which enabled appreciation of up to 5% color change. Maximum, minimum and average values were noted in each lobe bilaterally.

The average values in 8 control patients with no DU were plotted and the highest activity was found in the occipital lobes (as patients were imaged with eyes open) followed by parietal lobes, frontal lobes, putamen, thalamus, caudate, temporal lobes and cerebellum in the ratios of 100, 99, 98, 96, 91, 86, 75 and 72% respectively. Eighteen patients with previous DU were similarly evaluated and were found to have very similar findings (± 4%) in different parts of the brain. Also the variations between right and left lobes were also very similar between the two groups (± 3%).

Prolonged withdrawal of DU before permanent neurological deficits due to brain infarcts results in metabolic uptake and distribution of F-18 FDG in the Brain very similar to that seen in the normal control population, hence indicating that the process is significantly reversible. These findings matched with clinical manifestations as none of these patients had any significant clinical sequelae. Both the right and left sides of the brain had almost similar metabolism but varied widely in different lobes.

M.F.G.,D.W.,M.K.: NIH grant number R01 DA 13550-S1

Ezuddin, S, Georgiou, M, Mathen, R, Waldrop-Valverde, D, Sfakianakis, G, Kumar, M, Metabolic Pattern of Uptake and Distribution of F-18 FDG in Normal Control Brains versus Patients Who Were Users of Drugs (DU) Who Met DSM-IV Diagnostic Criteria for Substance Dependence Who Have Completely Withdrawn for a Prolonged Period of Time.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410408.html