Buzz Juice: Neurological sequelae of synthetic cannabinoids

DTI-MRI findings in synthetic cannabinoid users

Background/aim

Synthetic cannabinoids (SCs) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter (WM) changes of SC users using DTI.

Materials and methods

The study included 22 patients with a history of using SC for 5–37 months, and 22 healthy, age and sex-matched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) values were obtained. ROIs were placed on WM areas of normal appearance.

Results

In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2 ± 58.9 vs. 263 ± 27.4; P = 0.002) and right hippocampus (224.5 ± 61.5 vs. 255 ± 24.3; P = 0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides.

Conclusion

The SC use causes WM microstructural changes, especially in the hippocampus and temporal lobes. DTI is a useful tool to reveal WM changes in SC addicts and can be used earlier than conventional MRI.

Toxic leukoencephalopathy with extrapyramidal dysfunction due to synthetic cannabinoids

Neurologic sequelae of synthetic cannabinoids are not well understood. We report a case of a woman who developed hyperreflexia, paratonia and cogwheel rigidity after consumption of synthetic cannabinoids. MR imaging demonstrated T2/FLAIR signal enhancement in the supratentorial white matter and globus pallidus internus.