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Karabulut S. A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine. Subst Abuse 2023; 17:11782218231175811. [PMID: 37216038 PMCID: PMC10192674 DOI: 10.1177/11782218231175811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
Objectives Methamphetamine (METH) use has been associated with impairments in a variety of cognitive functions. In this study, it was aimed to assess the relation between cognitive measures and frequency of METH use. Methods Ninety-eight participants with methamphetamine use disorder were assessed with Wisconsin Card Sorting Test (WCST), Victoria-Stroop Word Color Test (SWCT), Trail Making Test (TMT) A and B. Participants were followed up during 6-month period with multiple urine toxicology tests (at baseline, month 1, month 2, month 3 and month 6). Results Participants who had their prescriptions regularly were more likely to have higher rates of METH-negative urine results (P = .003). Participants who had more correct numbers, completed more categories and had more conceptual level responses on WCST were more likely to use lower frequency of METH (OR = 0.006, P < .01; OR = 0.171, P < .001; OR = 0.024, P < .001; respectively). The higher error numbers and perseverative error rates on WCST were associated with more frequent METH use (OR = 0.023, P < .001; OR = 0.076, P < .001). Interference factor on SWCT was related with lower frequency of METH use whereas color naming factor on SWCT was related with higher rates of urine results (OR = 0.012, P < .001; OR = 3.628, P < .001; respectively). Higher TMT B-A score was related with more frequent METH use, although the significance disappeared after adjustment (OR = 0.002, P < .001). Having psychotic symptoms predicted less frequent use, but after adjustment for other significant variables, there was no significance. Conclusion Lower frequency of METH use in the follow-up could be predicted by neurocognitive assessments. Deficits in executive functions, attention, set-shifting and mental flexibility seems to be the most effected domains and this effect may be independent from the severity of psychotic symptoms.
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Affiliation(s)
- Sercan Karabulut
- Sercan Karabulut, Centre of Alcohol and
Substance Addiction Treatment, Ataturk State Hospital, Nebiler, 7192 Sok.,
Kepez/Döşemealtı/Antalya 07192, Turkey.
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2
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Eslami Shahrbabaki M, Barfehie D, Mazhari S, Ahmadi A, Shafiee S. Comparing Cognitive Functions in Patients with Schizophrenia and Methamphetamine-Induced Psychosis with Healthy Controls. ADDICTION & HEALTH 2022; 14:239-243. [PMID: 37559792 PMCID: PMC10408749 DOI: 10.34172/ahj.2022.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/12/2020] [Indexed: 08/11/2023]
Abstract
BACKGROUND There are similar findings about the similarities and differences of cognitive dysfunctions in patients with schizophrenia and methamphetamine-induced psychosis (MIP). This study aimed to compare cognitive functioning in schizophrenia and MIP patients, using a performance-based cognitive assessment battery and an interview-based assessment of cognition. METHODS Three groups participated in this study including, (a) 30 patients with MIP, (b) 30 patients with schizophrenia, and (c) 30 healthy individuals. All participants received the Brief Assessment of Cognition in Schizophrenia (BACS), a standardized performance-based cognitive battery, the Schizophrenia Cognition Rating Scale (SCoRS), and the interview-based assessment of cognition. FINDINGS Both groups of patients with schizophrenia and MIP performed poorly on all the BACS cognitive domains compared with the healthy controls. The two patient groups were significantly different on the three BACS subscales including verbal fluency, verbal memory, and speed of information processing. Schizophrenia patients performed worse than the MIP group concerning these three subscales. However, the two patient groups were similar in executive function, working memory, and motor speed. Moreover, the SCoRS-informant, SCoRS-global, and PANSS-negative significantly differed between schizophrenia and MIP patients. CONCLUSION Although cognitive dysfunctions are mostly similar in patients with MIP and schizophrenia, there are some differences especially in the functions related to prefrontal and temporal lobes.
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Affiliation(s)
- Mahin Eslami Shahrbabaki
- Neuroscience Research Center and Institute of Neuropharmacology, Psychiatry Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Delaram Barfehie
- Neurology Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahrzad Mazhari
- Neuroscience Research Center and Institute of Neuropharmacology, Psychiatry Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Atefeh Ahmadi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Department of Counselling in Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahideh Shafiee
- Psychiatry Department, Neurology Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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3
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Khalili N, Mazhari S, Mortazavi N. Neurocognitive Functions Related to Parietal Lobe in Patients with Schizophrenia and Methamphetamine Induced Psychotic Disorder and Healthy Individuals: A Comparative Study. ADDICTION & HEALTH 2022; 14:244-249. [PMID: 37559788 PMCID: PMC10408750 DOI: 10.34172/ahj.2022.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/18/2021] [Indexed: 08/11/2023]
Abstract
BACKGROUND There are some inconsistent findings about neurocognitive functions in schizophrenia and methamphetamine induced psychosis (MIP). This study aimed to compare these two disorders in terms of neurocognitive functions related to parietal lobe. METHODS This was a cross-sectional study in which 30 patients with schizophrenia, 30 patients with MIP, and 32 healthy individuals were compared. The two groups of patients were selected through convenience sampling from among patients hospitalized in Shahid Beheshti hospital in Kerman, Iran and healthy individuals were selected via convenience sampling from among the employees of Kerman University of Medical Sciences. The three groups were administered clock-drawing test (CDT), Rey-Osterrieth complex figure (ROCF) copying test, and interlocking finger test (IFT) and their demographic and clinical data were collected. The one-way analysis of variance (ANOVA) was used to investigate the differences between the groups. Multivariate analysis of covariance was also used to examine the effects of confounding factors. Besides, follow-up pairwise comparisons were performed after adjustment for multiple testing. FINDINGS The group with schizophrenia had significantly more impairment than the group with MIP with reference to the results of IFT and the ROCF test. However, the scores of patients with MIP on these two tests were not different from those of the normal controls. With regard to the CDT, the only significant difference was observed between the group with schizophrenia and controls. CONCLUSION On the condition that the results are replicated in other studies, some parietal lobe neurocognitive tests might be used when it is difficult to differentially diagnose schizophrenia and MIP.
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Affiliation(s)
- Navid Khalili
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahrzad Mazhari
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Nahid Mortazavi
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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4
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Habibi Asgarabad M, Ruhollah Hosseini S, Salehi Yegaei P, Moradi S, Lysaker PH. Psychopathology and Poor Clinical Insight in Psychotic Patients: Does the Diagnosis Matter? J Nerv Ment Dis 2022; 210:532-540. [PMID: 35766546 DOI: 10.1097/nmd.0000000000001475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Poor clinical insight is one of the most common features of schizophrenia spectrum disorders and plays a critical role in prognosis and treatment. Considering the biological and phenomenological overlap between schizophrenia and bipolar I disorder with psychotic features (BID) and increasing incidents of methamphetamine-induced psychotic disorder (MIPD) patients in Iran, it is necessary to have a clear picture of insight among these three groups. The aim of the present study was to compare clinical insight and other aspects of illness among three different disorders: schizophrenia, BID, and MIPD. In addition, we sought to examine the relationship of the severity of psychotic symptoms with clinical insight in each group. A total of 115 male inpatients, including 48 persons diagnosed with schizophrenia, 35 persons diagnosed with BID, and 32 persons diagnosed with MIPD, were selected. All participants completed the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale. The results of analysis of variance indicated that schizophrenia patients reported higher rates of illness duration and number of hospital admissions in comparison to the MIPD and BID groups. In addition, persons diagnosed with BID reported more of these outcomes than MIPD groups. However, the three groups showed similar patterns in terms of age of onset and educational, marital, and occupational statuses. The results also revealed that awareness of the disorder was more impaired in schizophrenia patients compared with BID and MIPD patients and in MIPD compared with BID groups. However, the level of awareness of the effect of medication, the awareness of social consequences, and the total score of clinical insight were similar across the three diagnostic groups. As expected, poor clinical insight was correlated with high levels of positive, negative, and cognitive symptoms in the schizophrenia group; with high levels of positive, cognitive, and depressive symptoms in the BID group; and with high levels of positive and excitement symptoms in MIPD. In addition, hierarchical linear regression analyses revealed that only cognitive symptoms in the schizophrenia group and excitement symptoms in the MIPD group significantly predicted the overall score of clinical insight. In the BID group, both cognitive and depressive symptoms significantly predicted clinical insight. These findings suggest that there are differing levels of poor clinical insight in schizophrenia, MIPD, and BID and that poor clinical insight found within each group may have different antecedents.
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Affiliation(s)
| | | | | | - Shahram Moradi
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway
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5
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Gicas KM, Parmar PK, Fabiano GF, Mashhadi F. Substance-induced psychosis and cognitive functioning: A systematic review. Psychiatry Res 2022; 308:114361. [PMID: 34979380 DOI: 10.1016/j.psychres.2021.114361] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022]
Abstract
Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of progression depending on the type of substance used. The findings suggest SIP may be a distinct variant of a psychotic disorder, yet SIP is understudied and the disease expression is not well characterized, particularly the cognitive phenotype. There is some evidence for cognitive dysfunction in SIP, but a synthesis of this literature has not been undertaken. We systematically reviewed all empirical research (up to December 31, 2020) that examined cognition in SIP using clinical neuropsychological measures. The cognitive outcomes are summarized by type of SIP (methamphetamine, other stimulants, alcohol, cannabis, undifferentiated). There was evidence for global and domain-specific cognitive dysfunction in SIP compared to controls and non-psychotic persons who use substances. Impairments were of similar magnitude compared to persons with schizophrenia. Delineation of a specific cognitive profile in SIP was precluded by lack of literature with comparable study designs and outcomes. Variation in visual-based cognition may be a distinct feature of SIP, but this requires further investigation. More rigorously controlled studies of cognition in SIP are needed to inform differential diagnosis and identify the unique clinical needs of this population.
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6
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Liu Y, Zhu J, Li Q, Wang Y, Li Y, Chen J, Dang S, Chen J, Shi H, Xue J, Li W, Wang W. Differences in the amplitude of low-frequency fluctuation between methamphetamine and heroin use disorder individuals: A resting-state fMRI study. Brain Behav 2020; 10:e01703. [PMID: 32666687 PMCID: PMC7507466 DOI: 10.1002/brb3.1703] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 04/29/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Methamphetamine has surpassed heroin as the most popular abused drug in China. Although the use of both heroin and methamphetamine leads to use disorders through dysfunction of the dopamine pathway, the incidence of psychiatric disorder caused by methamphetamine abuse is higher than the incidence of psychiatric disorder caused by heroin abuse. The difference in resting-state function between heroin use disorder (HUD) and methamphetamine use disorder (MAUD) and the relationship between resting-state function and psychiatric disorder related to MAUD are unknown. METHODS In the present study, 21 male individuals with MAUD, 21 demographically matched individuals with HUD, and 21 normal controls (NC) were recruited. The amplitude of low-frequency fluctuation (ALFF) during resting-state brain function was measured by magnetic resonance imaging. Psychiatric status was evaluated by the Symptom Checklist-90 (SCL90). RESULTS Individuals with MAUD had increased SCL90 scores compared to those of the NC for anxiety, paranoia, and additional items, and the hostility score was significantly increased compared to that of individuals with HUD. There is no significant difference between HUD and NC individuals. Individuals with MAUD had increased ALFF compared to those of the NC for thalamus, right postcentral, and right inferior temporal gyri, but a decreased ALFF in the cerebellum. Individuals with HUD had significantly increased ALFF compared to those of the NC for left middle frontal gyrus but a decreased ALFF in the left postcentral gyrus. Individuals with MAUD had significantly increased ALFF compared to those of the HUD for thalamus, the right inferior temporal, and bilateral postcentral gyri, and the ALFF of cerebellum and left middle frontal was significantly increased. CONCLUSIONS Methamphetamine can induce more serious psychiatric disorders than heroin. The resting-state function involved in mood adjustment, the auditory, and memory-related brain regions may affect psychotic symptoms related to MAUD.
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Affiliation(s)
- Yan Liu
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China.,Department of Radiology, Xi'an Gem Flower Changqing Hospital, Xi'an, China
| | - Jia Zhu
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Qiang Li
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Yarong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yongbin Li
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Jiajie Chen
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Shan Dang
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Jing Chen
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Hong Shi
- Xi'an No.1 Hospital, Xi'an, China
| | | | - Wei Li
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Wei Wang
- Department of Radiology, Tangdu Hospital, The Air Force Medical University, Xi'an, China
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7
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A comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia. Psychopharmacology (Berl) 2019; 236:3385-3399. [PMID: 31230145 DOI: 10.1007/s00213-019-05298-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/05/2019] [Indexed: 12/31/2022]
Abstract
RATIONALE Schizophrenia and stimulant-induced psychosis (SIP) represent two different forms of psychotic disorder, with different etiologies. While many of the symptoms of psychosis are common to both disorders, there have been few direct comparisons between these conditions, especially when controlling for stimulant use in individuals with schizophrenia. OBJECTIVES We directly compared both psychotic disorders with a comprehensive battery of clinical, neurocognitive and neuroanatomical measures. This included one group with SIP (and concurrent stimulant dependence) and two groups with schizophrenia (either with or without concurrent stimulant dependence). METHODS Ninety-six participants were recruited from a marginalized urban population, which included 39 with SIP (and concurrent stimulant dependence), 18 with schizophrenia (without stimulant dependence), and 39 with schizophrenia (with concurrent stimulant dependence). All subjects had extensive clinical and neurocognitive evaluations, complemented with structural MRI including diffusion tensor imaging (DTI) sequences to determine regional brain volumes and white matter connectivity. RESULTS Both positive and negative symptoms were greater in the SZ-dependent group than the other two. Neurocognitive function was broadly similar. The structural brain imaging revealed lateralized changes to the left parietal/temporal lobe, in which regional volumes were smaller in the SZ-dependent than the SZ-non-dependent group. DTI analysis indicated extensive decreases in fractional anisotropy, with parallel increases in radial diffusivity, in the SIP group compared to the SZ-dependent group. CONCLUSIONS These findings reveal both similarities and differences between SIP and schizophrenia. Furthermore, schizophrenia with concurrent stimulant dependence may be associated with a different clinical and neuroanatomical profile as compared to schizophrenia alone.
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8
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Zhao T, Zhai C, Song H, Wu Y, Ge C, Zhang Y, Xu H, Chi Z, Chu H, Shi W, Cheng X, Li X, Ma M, Xu M, Hu J, Xie Y, Lin Y, Chen H, Li Y, Jiao D. Methamphetamine-Induced Cognitive Deficits and Psychiatric Symptoms Are Associated with Serum Markers of Liver Damage. Neurotox Res 2019; 37:67-76. [PMID: 31691188 DOI: 10.1007/s12640-019-00115-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/08/2019] [Accepted: 09/16/2019] [Indexed: 12/17/2022]
Abstract
Cognitive deficits and psychiatric disorders have been regarded as the most common clinical symptoms of methamphetamine (MA) users. Accumulating evidence has shown that liver disease may be involved in cognitive deficits and psychiatric disorders. This study examines whether cognitive deficits and psychiatric symptoms are associated with serum levels of liver biomarkers in MA users. Cognition was assessed by the Repeatable Battery for the Assessment of neuropsychological Status (RBANS). Psychiatric symptoms were assessed by the Symptom Checklist-90 (SCL-90). Liver function was assessed by serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, albumin, globulin, Apolipoprotein B (ApoB), triglyceride, total cholesterol, and glucose concentrations in 106 MA addicts and 76 controls. Compared to control subjects, MA users had greater severity of psychotic symptoms on the dimension of somatization, depression, anxiety, psychoticism, addiction, and global severity index in SCL-90, and lower scores of cognition, including the total RBANS score and all five subscales. The globulin levels were increased, while the albumin, albumin/globulin, and ApoB levels were decreased. ApoB levels were positively correlated with immediate memory, attention, and total RBANS score. Furthermore, stepwise multivariate regression analysis indicated that ApoB levels were associated with immediate memory, attention, and total RBANS score. The findings of this study suggest that MA addicts might experience cognitive deficits, psychiatric disorders, and liver damage. Serum ApoB levels may be involved in cognitive deficits; thus, improving liver function may help to treat cognitive deficits and psychiatric disorders in MA addicts.
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Affiliation(s)
- Tingting Zhao
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | | | - Hongmei Song
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Yanhai Wu
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Chuanhui Ge
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Yonglin Zhang
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Hongxia Xu
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Zhengsuo Chi
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Hui Chu
- Anhui Province Veterans Hospital, Bengbu, Anhui, China
| | - Wei Shi
- Compulsory Isolated Drug Rehabilitation Center, Bengbu, Anhui, China
| | - Xiaodong Cheng
- Compulsory Isolated Drug Rehabilitation Center, Bengbu, Anhui, China
| | - Xin Li
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Mengdi Ma
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Mengyuan Xu
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Jiaqi Hu
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Ya Xie
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Yanan Lin
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Hongxu Chen
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Yiting Li
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Dongliang Jiao
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China.
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9
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Zhai C, Cui M, Cheng X, Ao X, Zhao T, Wu W, Shao Q, Ge D, Song H, Qi F, Ling Q, Ma M, Xu M, Jiao D. Vitamin B12 Levels in Methamphetamine Addicts. Front Behav Neurosci 2019; 12:320. [PMID: 30618670 PMCID: PMC6305445 DOI: 10.3389/fnbeh.2018.00320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 12/05/2018] [Indexed: 12/20/2022] Open
Abstract
Objective: It has been established that reduced vitamin B12 serum levels are associated with cognitive decline and mental illness. The chronic use of methamphetamine (MA), which is a highly addictive drug, can induce cognitive impairment and psychopathological symptoms. There are few studies addressing the association of MA with vitamin B12 serum levels. This study examined whether the serum levels of B12 are associated with MA addiction. Methods: Serum vitamin B12, homocysteine (Hcy), glucose and triglyceride concentrations were measured in 123 MA addicts and 108 controls. In addition, data were collected on their age, marital status, level of education and Body Mass Index (BMI) for all participants. In the patient group, the data for each subject were collected using the Fagerstrom Test for Nicotine Dependence (FTND), the Alcohol Use Disorders Identification Test (AUDIT), and a drug use history, which included the age of onset, total duration of MA use, the number of relapses and addiction severity. Results: Our results showed that MA addicts had lower vitamin B12 levels (p < 0.05) than those of healthy controls, but Hcy levels were not significantly different between the two groups (p > 0.05). Serum B12 levels were negatively correlated with the number of relapses in the MA group. Furthermore, binary logistics regression analysis indicated that the B12 was an influencing factor contributing to addiction severity. Conclusion: The findings of this study suggest that some MA addicts might have vitamin B12 deficiency, and serum B12 levels may be involved in the prognosis of MA addiction.
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Affiliation(s)
| | - Ming Cui
- Anhui Province Veterans Hospital, Bengbu, China
| | - Xiaodong Cheng
- Compulsory Isolated Drug Rehabilitation Center, Bengbu, China
| | - Xiang Ao
- Anhui Province Veterans Hospital, Bengbu, China
| | | | - Wei Wu
- Anhui Province Veterans Hospital, Bengbu, China
| | - Qun Shao
- Anhui Province Veterans Hospital, Bengbu, China
| | - Dexue Ge
- Anhui Province Veterans Hospital, Bengbu, China
| | | | - Fangzhi Qi
- Compulsory Isolated Drug Rehabilitation Center, Bengbu, China
| | - Qiang Ling
- Compulsory Isolated Drug Rehabilitation Center, Bengbu, China
| | - Mengdi Ma
- Department of Psychiatry, Bengbu Medical College, Bengbu, China
| | - Mengyuan Xu
- Department of Psychiatry, Bengbu Medical College, Bengbu, China
| | - Dongliang Jiao
- Department of Psychiatry, Bengbu Medical College, Bengbu, China
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10
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Arunogiri S, Verdejo-Garcia A, McKetin R, Rubenis AJ, Fitzpatrick RE, Lubman DI. Emotion Recognition and Impulsive Choice in Relation to Methamphetamine Use and Psychosis Symptoms. Front Psychiatry 2019; 10:889. [PMID: 31920746 PMCID: PMC6923220 DOI: 10.3389/fpsyt.2019.00889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/12/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: The cognitive profiles of people with methamphetamine use disorder are characterized by impulsivity and impairment in social cognition. However, previous studies have not fully accounted for the presence and impact of co-occurring mental health problems on these domains. For instance, psychotic symptoms are commonly experienced by people who use methamphetamine and may influence cognitive performance. We aimed to examine decision making and emotion recognition in individuals with methamphetamine use, compared to healthy controls, to map the nature and degree of impairments in relation to the presence of psychotic symptoms. Method: In this naturalistic study, we assessed reward-based decision-making and facial emotion recognition across three groups, methamphetamine-using individuals with (MAP, n = 29) and without psychotic symptoms (MNP, n = 70), and healthy controls (HC, n = 32). Results: In comparison to healthy controls, methamphetamine-using individuals presented with poorer performance on tasks of decision-making and emotion recognition. Emotion recognition was impaired across all methamphetamine-using individuals, with significantly poorer recognition of anger and sadness in those with psychotic symptoms. Conclusion: We found specific impairments in emotion recognition in relation to psychotic symptoms in people who use methamphetamine regularly. This builds on previous evidence on cognitive profiles in methamphetamine use disorder, highlighting the need to assess co-morbid mental health and psychotic symptoms. Our finding that methamphetamine-using individuals with psychotic symptoms present with particular difficulties recognizing anger has implications for frontline clinicians.
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Affiliation(s)
- Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Adam J Rubenis
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Rebecca E Fitzpatrick
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
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11
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Khalkhali M, Golshahi M, Hasandokht T, Kafie M, Zare R. Cognitive Functioning in Schizophrenia, Methamphetamine-induced Psychotic Disorder, and Healthy People: A Comparative Study. Adv Biomed Res 2018; 7:123. [PMID: 30211136 PMCID: PMC6124221 DOI: 10.4103/abr.abr_14_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Methamphetamine-induced psychotic disorder (MIP) cannot be easily differentiated from other psychotic disorders. Some studies have reported that patients with MIP and schizophrenia have differences in their cognitive functioning. We hypothesized that their performance would be different on neuropsychological tests which assess executive functions and visual memory. Materials and Methods: In a cross-sectional study, 30 patients with MIP, 31 patients with schizophrenia, and 31 healthy controls were assessed by Rey–Osterrieth complex figure (ROCF) test and visual search and attention test (VSAT). One-way analysis of variance was performed to compare the mean scores of tests. Tukey's HSD test was used for post hoc analysis. Results: Three groups had significant differences according to ROCF test (F = 15.76, P < 0.0001), VSAT (F = 39.78, P < 0.0001), left VSAT (F = 37.96, P < 0.0001), right VSAT (F = 40.40, P < 0.0001), and the time of the test administration (F = 3.26, P = 0.04). The post hoc analysis showed that the mean score of ROCF test and VSAT (total, right, and left) was significantly higher in the control group than in the other two groups. The time of administering the test in the control group was significantly shorter than in the MIP group (P < 0.03) and nonsignificantly shorter than in the schizophrenia group (P = 0.54). The mean score of right side VSAT was significantly higher in the MIP group than in the schizophrenia group. Conclusion: ROCF could not differentiate MIP from schizophrenia. The better performance of patients with MIP on right side VSAT that is reported in this and in the previous study needs to be reevaluated in more controlled studies.
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Affiliation(s)
- Mohammadrasoul Khalkhali
- Department of Psychiatry, Shafa Psychiatry Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahboobeh Golshahi
- Department of Psychiatry, Shafa Psychiatry Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Moosa Kafie
- Department of Psychology, University of Guilan, Rasht, Iran
| | - Roghaye Zare
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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12
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Arunogiri S, McKetin R, Verdejo-Garcia A, Lubman DI. The Methamphetamine-Associated Psychosis Spectrum: a Clinically Focused Review. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-9934-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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13
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Wearne TA, Cornish JL. A Comparison of Methamphetamine-Induced Psychosis and Schizophrenia: A Review of Positive, Negative, and Cognitive Symptomatology. Front Psychiatry 2018; 9:491. [PMID: 30364176 PMCID: PMC6191498 DOI: 10.3389/fpsyt.2018.00491] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/19/2018] [Indexed: 01/12/2023] Open
Abstract
Methamphetamine is a potent psychostimulant that can induce psychosis among recreational and chronic users, with some users developing a persistent psychotic syndrome that shows similarities to schizophrenia. This review provides a comprehensive critique of research that has directly compared schizophrenia with acute and chronic METH psychosis, with particular focus on psychiatric and neurocognitive symptomatology. We conclude that while there is considerable overlap in the behavioral and cognitive symptoms between METH psychosis and schizophrenia, there appears to be some evidence that suggests there are divergent aspects to each condition, particularly with acute METH psychosis. Schizophrenia appears to be associated with pronounced thought disorder, negative symptoms more generally and cognitive deficits mediated by the parietal cortex, such as difficulties with selective visual attention, while visual and tactile hallucinations appear to be more prevalent in acute METH-induced psychosis. As such, acute METH psychosis may represent a distinct psychotic disorder to schizophrenia and could be clinically distinguished from a primary psychotic disorder based on the aforementioned behavioral and cognitive sequelae. Preliminary evidence, on the other hand, suggests that chronic METH psychosis may be clinically similar to that of primary psychotic disorders, particularly with respect to positive and cognitive symptomatology, although negative symptoms appear to be more pronounced in schizophrenia. Limitations of the literature and avenues for future research are also discussed.
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Affiliation(s)
- Travis A Wearne
- Department of Psychology, Macquarie University, Sydney, NSW, Australia.,School of Psychology, University of New South Wales, Sydney, NSW, Australia
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14
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Willi TS, Barr AM, Gicas K, Lang DJ, Vila-Rodriguez F, Su W, Thornton AE, Leonova O, Giesbrecht CJ, Procyshyn RM, Rauscher A, MacEwan WG, Honer WG, Panenka WJ. Characterization of white matter integrity deficits in cocaine-dependent individuals with substance-induced psychosis compared with non-psychotic cocaine users. Addict Biol 2017; 22:873-881. [PMID: 26833821 DOI: 10.1111/adb.12363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/10/2015] [Accepted: 12/11/2015] [Indexed: 01/19/2023]
Abstract
With sufficient drug exposure, some individuals develop transient psychotic symptoms referred to as 'substance-induced psychosis' (SIP), which closely resemble the symptoms observed in schizophrenia spectrum disorders. The comparability in psychotic presentation between SIP and the schizophrenias suggests that similar underlying neural deficits may contribute to the emergence of psychosis across these disorders. Only a small number of studies have investigated structural alterations in SIP, and all have been limited to volumetric imaging methods, with none controlling for the effects of chronic drug exposure. To investigate white matter abnormalities associated with SIP, diffusion tensor imaging was employed in a group of individuals with cocaine-associated psychosis (CAP; n = 24) and a cocaine-dependent non-psychotic (CDN) group (n = 43). Tract-based spatial statistics was used to investigate group differences in white matter diffusion parameters. The CAP group showed significantly lower fractional anisotropy values than the CDN group (p < 0.05) in voxels within white matter tracts of fronto-temporal, fronto-thalamic and interhemispheric pathways. The greatest differences in white matter integrity were present in the corpus callosum, corona radiata, bilateral superior longitudinal fasciculi and bilateral inferior longitudinal fasciculi. Additionally, the CAP group had voxels of significantly higher radial diffusivity in a subset of the previously mentioned pathways. These results are the first description of white matter integrity abnormalities in a SIP sample and indicate that differences in these pathways may be a shared factor in the expression of different forms of psychosis.
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Affiliation(s)
- Taylor S. Willi
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | - Alasdair M. Barr
- Department of Pharmacology; University of British Columbia; Vancouver Canada
| | - Kristina Gicas
- Department of Psychology; Simon Fraser University; Burnaby Canada
| | - Donna J. Lang
- Department of Radiology; University of British Columbia; Vancouver Canada
| | | | - Wayne Su
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | | | - Olga Leonova
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | | | - Ric M. Procyshyn
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | - Alexander Rauscher
- Department of Radiology; University of British Columbia; Vancouver Canada
| | - William G. MacEwan
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | - William G. Honer
- Department of Psychiatry; University of British Columbia; Vancouver Canada
| | - William J. Panenka
- Department of Psychiatry; University of British Columbia; Vancouver Canada
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15
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A comparison of psychotic symptoms in subjects with methamphetamine versus cocaine dependence. Psychopharmacology (Berl) 2017; 234:1535-1547. [PMID: 28190084 DOI: 10.1007/s00213-017-4551-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/25/2017] [Indexed: 01/02/2023]
Abstract
RATIONALE The psychostimulant drugs cocaine and methamphetamine are potent indirect dopamine receptor agonists which act through similar but not identical mechanisms. Studies in humans have observed that a large proportion of those who chronically use these drugs experience psychotic symptoms. However, direct comparisons of psychotic symptom severity between cocaine and methamphetamine users are lacking. OBJECTIVES The goal of the present study was to directly compare severity of psychotic symptoms between cocaine- and methamphetamine-dependent individuals. Additionally, we sought to determine how concurrent cocaine + methamphetamine dependence would influence psychotic symptoms. METHODS We recruited 153 polysubstance-using subjects meeting DSM-IV-TR criteria for cocaine dependence, 38 with methamphetamine dependence, and 32 with cocaine + methamphetamine dependence. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) and analyzed using a five-factor model. All participants were also assessed for physical and mental illnesses as well as recent substance use. Most subjects completed a comprehensive neurocognitive battery. RESULTS While all three groups exhibited high total PANSS scores, the positive symptom subscale was significantly higher in the methamphetamine-dependent (17.03 ± 6.3) than the cocaine-dependent group (13.51 ± 4.12) and non-significantly higher (p = 0.08) than the cocaine + methamphetamine group (14.44 ± 5.50). Groups also differed on demographic variables, viral infection, and other indices of substance use, which were unlikely to account for the difference in positive symptoms. There were only modest differences between groups in neurocognitive function. CONCLUSIONS Methamphetamine dependence was associated with more severe positive symptoms of psychosis than cocaine dependence. Concurrent cocaine + methamphetamine dependence did not increase psychosis severity.
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16
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GABAergic mRNA expression is differentially expressed across the prelimbic and orbitofrontal cortices of rats sensitized to methamphetamine: Relevance to psychosis. Neuropharmacology 2016; 111:107-118. [PMID: 27580848 DOI: 10.1016/j.neuropharm.2016.08.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 12/30/2022]
Abstract
Psychotic disorders, such as schizophrenia, are characterized by prevalent and persistent executive deficits that are believed to be the result of dysfunctional inhibitory gamma-aminobutyric acid (GABA) processing of the prefrontal cortex (PFC). Methamphetamine (METH) is a commonly used psychostimulant that can induce psychotic and cognitive symptoms that are indistinguishable to schizophrenia, suggesting that METH-induced psychosis may have a similar GABAergic profile of the PFC. As the PFC consists of multiple subregions, the aim of the current study was to investigate changes to GABAergic mRNA expression in the prelimbic (PRL) and orbitofrontal (OFC) cortices of the PFC in rats sensitized to repeated METH administration. Male Sprague Dawley rats underwent daily METH or saline injections for 7 days. Following 14 days of withdrawal, rats were challenged with acute METH administration, RNA was isolated from the PRL and OFC and quantitative PCR was used to compare the relative expression of GABA enzymes, transporters, metabolites and receptor subunits. GAD67, GAD65, GAT1, GAT3, VGAT and GABAT mRNA expression were upregulated in the PRL. Ionotropic GABAA receptor subunits α1, α3, α5 and β2 were specifically upregulated in the OFC. These findings suggest that alterations to GABAergic mRNA expression following sensitization to METH are biologically dissociated between the OFC and PRL, suggesting that GABAergic gene expression is significantly altered following chronic METH exposure in a brain-region and GABA-specific manner. These changes may lead to profound consequences on central inhibitory mechanisms of localized regions of the PFC and may underpin common behavioral phenotypes seen across psychotic disorders.
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17
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Bousman CA, McKetin R, Burns R, Woods SP, Morgan EE, Atkinson JH, Everall IP, Grant I. Typologies of positive psychotic symptoms in methamphetamine dependence. Am J Addict 2016; 24:94-97. [PMID: 25864598 DOI: 10.1111/ajad.12160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/31/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Understanding methamphetamine associated psychotic (MAP) symptom typologies could aid in identifying individuals at risk of progressing to schizophrenia and guide early intervention. METHODS Latent class analysis (LCA) of psychotic symptoms collected from 40 (n = 40) methamphetamine dependent individuals with a history of psychotic symptoms but no history of a primary psychotic disorder. RESULTS Three typologies were identified. In one, persecutory delusions dominated (Type 1), in another persecutory delusions were accompanied by hallucinations (Type 2), and in the third a high frequency of all the assessed hallucinatory and delusional symptoms was observed (Type 3). DISCUSSION AND CONCLUSION MAP is a heterogeneous syndrome with positive symptom typologies. SCIENTIFIC SIGNIFICANCE This study represents the first attempt at identifying typologies of MAP and highlights the potential utility of LCA in future large-scale studies.
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Affiliation(s)
- Chad A Bousman
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Department of General Practice, University of Melbourne, Parkville, VIC, Australia.,Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Rebecca McKetin
- Centre for Research on Ageing, Health and Wellbeing, Australia National University, Canberra, ACT, Australia
| | - Richard Burns
- Centre for Research on Ageing, Health and Wellbeing, Australia National University, Canberra, ACT, Australia
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Erin E Morgan
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - J Hampton Atkinson
- Department of Psychiatry, University of California, San Diego, San Diego, California.,Veterans Administration San Diego Healthcare System, San Diego, California
| | - Ian P Everall
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, San Diego, California
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18
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Manning EE, van den Buuse M. Altered social cognition in male BDNF heterozygous mice and following chronic methamphetamine exposure. Behav Brain Res 2016; 305:181-5. [PMID: 26965573 DOI: 10.1016/j.bbr.2016.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/01/2016] [Accepted: 03/05/2016] [Indexed: 11/29/2022]
Abstract
Growing clinical evidence suggests that persistent psychosis which occurs in methamphetamine users is closely related to schizophrenia. However, preclinical studies in animal models have focussed on psychosis-related behaviours following methamphetamine, and less work has been done to assess endophenotypes relevant to other deficits observed in schizophrenia. Altered social behaviour is a feature of both the negative symptoms and cognitive deficits in schizophrenia, and significantly impacts patient functioning. We recently found that brain-derived neurotrophic factor (BDNF) heterozygous mice show disrupted sensitization to methamphetamine, supporting other work suggesting an important role of this neurotrophin in the pathophysiology of psychosis and the neuronal response to stimulant drugs. In the current study, we assessed social and cognitive behaviours in methamphetamine-treated BDNF heterozygous mice and wildtype littermate controls. Following chronic methamphetamine exposure male wildtype mice showed a 50% reduction in social novelty preference. Vehicle-treated male BDNF heterozygous mice showed a similar impairment in social novelty preference, with a trend for no further disruption by methamphetamine exposure. Female mice were unaffected in this task, and no groups showed any changes in sociability or short-term spatial memory. These findings suggest that chronic methamphetamine alters behaviour relevant to disruption of social cognition in schizophrenia, supporting other studies which demonstrate a close resemblance between persistent methamphetamine psychosis and schizophrenia. Together these findings suggest that dynamic regulation of BDNF signalling is necessary to mediate the effects of methamphetamine on behaviours relevant to schizophrenia.
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Affiliation(s)
- Elizabeth E Manning
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; Translational OCD Laboratory, Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Maarten van den Buuse
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
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19
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Wearne TA, Parker LM, Franklin JL, Goodchild AK, Cornish JL. GABAergic mRNA expression is upregulated in the prefrontal cortex of rats sensitized to methamphetamine. Behav Brain Res 2016; 297:224-30. [PMID: 26475507 DOI: 10.1016/j.bbr.2015.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/11/2015] [Accepted: 10/08/2015] [Indexed: 11/25/2022]
Abstract
Inhibitory gamma-aminobutyric acid (GABA)-mediated neurotransmission plays an important role in the regulation of the prefrontal cortex (PFC), with increasing evidence suggesting that dysfunctional GABAergic processing of the PFC may underlie certain deficits reported across psychotic disorders. Methamphetamine (METH) is a psychostimulant that induces chronic psychosis in a subset of users, with repeat administration producing a progressively increased vulnerability to psychotic relapse following subsequent drug administration (sensitization). The aim here was to investigate changes to GABAergic mRNA expression in the PFC of rats sensitized to METH using quantitative polymerase chain reaction (qPCR). Male Sprague-Dawley rats (n=12) underwent repeated methamphetamine (intraperitoneal (i.p.) or saline injections for 7 days. Following 14 days of withdrawal, rats were challenged with acute methamphetamine (1mg/kg i.p.) and RNA was isolated from the PFC to compare the relative mRNA expression of a range of GABA enzymes, transporters and receptors subunits. METH challenge resulted in a significant sensitized behavioral (locomotor) response in METH pre-treated animals compared with saline pre-treated controls. The mRNAs of transporters (GAT1 and GAT3), ionotropic GABAA receptor subunits (α3 and β1), together with the metabotropic GABAB1 receptor, were upregulated in the PFC of sensitized rats compared with saline controls. These findings indicate that GABAergic mRNA expression is significantly altered at the pre and postsynaptic level following sensitization to METH, with sensitization resulting in the transcriptional upregulation of several inhibitory genes. These changes likely have significant consequences on GABA-mediated neurotransmission in the PFC and may underlie certain symptoms conserved across psychotic disorders, such as executive dysfunction.
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Affiliation(s)
- Travis A Wearne
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Lindsay M Parker
- Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
| | - Jane L Franklin
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ann K Goodchild
- Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
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20
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Differential patterns of blood oxygenation in the prefrontal cortex between patients with methamphetamine-induced psychosis and schizophrenia. Sci Rep 2015; 5:12107. [PMID: 26178613 PMCID: PMC4503985 DOI: 10.1038/srep12107] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/07/2015] [Indexed: 11/09/2022] Open
Abstract
Despite some slight differences in symptomatology, differential diagnosis of methamphetamine-induced psychosis (MAP) versus schizophrenia can be challenging because both disorders present a large overlap in their clinical symptoms. However, a recent study has shown that near-infrared spectroscopy (NIRS) performed during a cognitive task can be a powerful tool to differentiate between these two disorders. Here, we evaluated verbal fluency task performance during NIRS in 15 patients diagnosed with MAP and 19 with schizophrenia matched for age and sex. We used prefrontal probes and a 24-channel NIRS machine to measure the relative concentrations of oxyhaemoglobin every 0.1 s during the task. For each patient, the neurocognitive function and clinical psychopathology were evaluated using the Positive and Negative Symptom Scale (PANSS), and the Brief Assessment of Cognition in Schizophrenia (BACS). Oxyhaemoglobin changes in the prefrontal cortex were significantly higher in the MAP group compared to those in the schizophrenia group, particularly in the right dorsolateral prefrontal cortex. In contrast, we found no significant difference in PANSS and BACS scores. Our findings suggest that NIRS measurement could be applied to differentiate patients with MAP from those with schizophrenia, even in cases where clinical symptoms are similar.
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21
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Jiao D, Liu Y, Li X, Liu J, Zhao M. The role of the GABA system in amphetamine-type stimulant use disorders. Front Cell Neurosci 2015; 9:162. [PMID: 25999814 PMCID: PMC4419710 DOI: 10.3389/fncel.2015.00162] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/13/2015] [Indexed: 11/22/2022] Open
Abstract
Abuse of amphetamine-type stimulants (ATS) has become a global public health problem. ATS causes severe neurotoxicity, which could lead to addiction and could induce psychotic disorders or cognitive dysfunctions. However, until now, there has been a lack of effective medicines for treating ATS-related problems. Findings from recent studies indicate that in addition to the traditional dopamine-ergic system, the GABA (gamma-aminobutyric acid)-ergic system plays an important role in ATS abuse. However, the exact mechanisms of the GABA-ergic system in amphetamine-type stimulant use disorders are not fully understood. This review discusses the role of the GABA-ergic system in ATS use disorders, including ATS induced psychotic disorders and cognitive dysfunctions. We conclude that the GABA-ergic system are importantly involved in the development of ATS use disorders through multiple pathways, and that therapies or medicines that target specific members of the GABA-ergic system may be novel effective interventions for the treatment of ATS use disorders.
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Affiliation(s)
- Dongliang Jiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Yao Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Xiaohong Li
- Department of Neurochemistry, NY State Institute for Basic Research in Developmental Disabilities New York, NY, USA
| | - Jinggen Liu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Shanghai, China
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22
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Chen CK, Lin SK, Chen YC, Huang MC, Chen TT, Ree SC, Wang LJ. Persistence of psychotic symptoms as an indicator of cognitive impairment in methamphetamine users. Drug Alcohol Depend 2015; 148:158-64. [PMID: 25601645 DOI: 10.1016/j.drugalcdep.2014.12.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/31/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Prolonged exposure to methamphetamine (meth) has neurotoxic effects and impairs neurocognitive functions. This study aims to ascertain whether meth users who experience persistent psychosis suffer more severe cognitive impairment than those not experiencing persistent psychosis. METHODS This cross-sectional study includes 252 participants: 25 meth users without psychosis (METH-P), 50 with brief psychosis (METH+BP), and 56 with persistent psychosis (METH+PP), as well as 54 patients with schizophrenia and 67 healthy controls. The neurocognitive function and clinical psychopathology of each patient were evaluated with the Brief Assessment of Cognition in Schizophrenia (BACS) and the Brief Psychiatric Rating Scale (BPRS), respectively. RESULTS All cognitive domains evaluated with BACS (verbal memory, working memory, motor speed, verbal fluency, attention and processing speed, executive function, and composite scores) in METH+PP patients were similar to those in the schizophrenia patients and were worse than those in METH-P, METH+BP, and the healthy control subjects. Furthermore, cognitive functioning in meth users that did not experience persistent psychosis showed no statistically significant difference compared with the healthy control subjects. Among the meth users in this study, the negative symptom scores in the BPRS correlated to cognitive performance on the BACS, with the exception of motor speed. CONCLUSIONS Meth users display heterogeneity in their psychotic symptoms and cognitive profiles. Therefore, persistent psychotic symptoms may denote a risk for cognitive decline among meth users. Further longitudinal studies should be performed in the future to clarify the causal relationship between cognitive deficits and the development of persistent psychosis.
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Affiliation(s)
- Chih-Ken Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Shih-Ku Lin
- Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
| | - Yi-Chih Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Ming-Chy Huang
- Taipei City Hospital and Psychiatric Center, Taipei, Taiwan; Taipei Medical University, Taipei, Taiwan
| | - Tzu-Ting Chen
- Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Shao Chun Ree
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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23
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Chen YC, Wang LJ, Lin SK, Chen CK. Neurocognitive Profiles of Methamphetamine Users: Comparison of Those With or Without Concomitant Ketamine Use. Subst Use Misuse 2015; 50:1778-85. [PMID: 26625283 DOI: 10.3109/10826084.2015.1050110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Methamphetamine (MAMP) and ketamine are neurotoxic drugs whose chronic use has been linked with a cognitive decline in some users. This paper aims to assess the possible effect of concomitant ketamine use on the neurocognitive performance of MAMP users. METHODS This study divides 42 MAMP users into MAMP users who use ketamine (MAMP+K, n = 16) and MAMP users who do not use ketamine (MAMP-K, n = 26). The performance of these two groups was compared using the Brief Assessment of Cognition in Schizophrenia (BACS), Conners' Continuous Performance Tests (CPT), the Wisconsin Card Sorting Test (WCST), the Iowa Gambling Task (IGT), and the Barratt Impulsiveness Scale (BIS). RESULTS In comparison to the MAMP-K group, the MAMP+K group showed worse performances in verbal fluency, executive function and composite score in BACS; worse performances in total errors, perseverative errors, nonperseverative errors and conceptual level response in WCST; and greater levels of total scores and novelty-seeking in BIS. Neither the attention function evaluated with CPT nor the decision-making behavior evaluated with IGT was associated with previous ketamine use. CONCLUSION This study detected worse executive function and higher impulsivity level among MAMP users with additional ketamine use versus their counterparts without ketamine use. Further studies with a longitudinal design and a large sample size are necessary to clarify the connection between cognitive deficits and concomitant use of MAMP and ketamine.
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Affiliation(s)
- Yi-Chih Chen
- a Department of Psychiatry , Chang Gung Memorial Hospital , Keelung , Taiwan.,b Chang Gung University School of Medicine , Taoyuan , Taiwan
| | - Liang-Jen Wang
- c Department of Child and Adolescent Psychiatry , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung , Taiwan
| | - Shih-Ku Lin
- d The Taipei City Hospital, Songde Branch , Taipei , Taiwan
| | - Chih-Ken Chen
- a Department of Psychiatry , Chang Gung Memorial Hospital , Keelung , Taiwan.,b Chang Gung University School of Medicine , Taoyuan , Taiwan
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24
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Long-lasting alterations in 5-HT2A receptor after a binge regimen of methamphetamine in mice. Int J Neuropsychopharmacol 2014; 17:1647-58. [PMID: 24763081 DOI: 10.1017/s1461145714000455] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The repeated administration of methamphetamine (MA) to animals in a single-day 'binge' dosing regimen produces damage to dopamine and serotonin terminals and psychosis-like behaviours similar to those observed in MA abusers. The present study aimed to examine the effects of MA binge exposure on 5-HT2A receptors, the subtype of serotonin receptors putatively involved in psychosis. ICR male mice were treated with MA (4 × 5 mg/kg) or saline at 2 h intervals. Recognition memory and social behaviours were sequentially evaluated by a novel location recognition test, a novel object recognition test, a social interaction and a nest-building test to confirm the persistent cognitive and behavioural impairments after this dosing regimen. Subsequently, a hallucinogenic 5-HT2A/2C receptor agonist 2,5-dimethoxy-4-iodoamphetamine (DOI)-induced head-twitch, molecular and electrophysiological responses were monitored. Finally, the levels of 5-HT2C, 5-HT1A, 5-HT2A and mGlu2 receptors in the medial prefrontal cortex were determined. MA binge exposure produced recognition memory impairment, reduced social behaviours, and increased DOI-induced head-twitch response, c-Fos and Egr-2 expression and field potentials in the medial prefrontal cortex. Furthermore, MA binge exposure increased 5-HT2A and decreased mGlu2 receptor expression in the medial frontal cortex, whereas 5-HT2C and 5-HT1A receptors were unaffected. These data reveal that the increased behavioural, molecular and electrophysiological responses to DOI might be associated with an up-regulation of 5-HT2A receptors in the medial prefrontal cortex after MA binge exposure. Identifying the biochemical alterations that parallel the behavioural changes in a mouse model of MA binge exposure may facilitate targeting therapies for treatment of MA-related psychiatric disorders.
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25
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Hsieh JH, Stein DJ, Howells FM. The neurobiology of methamphetamine induced psychosis. Front Hum Neurosci 2014; 8:537. [PMID: 25100979 PMCID: PMC4105632 DOI: 10.3389/fnhum.2014.00537] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 07/01/2014] [Indexed: 11/18/2022] Open
Abstract
Chronic methamphetamine abuse commonly leads to psychosis, with positive and cognitive symptoms that are similar to those of schizophrenia. Methamphetamine induced psychosis (MAP) can persist and diagnoses of MAP often change to a diagnosis of schizophrenia over time. Studies in schizophrenia have found much evidence of cortical GABAergic dysfunction. Methamphetamine psychosis is a well studied model for schizophrenia, however there is little research on the effects of methamphetamine on cortical GABAergic function in the model, and the neurobiology of MAP is unknown. This paper reviews the effects of methamphetamine on dopaminergic pathways, with focus on its ability to increase glutamate release in the cortex. Excess cortical glutamate would likely damage GABAergic interneurons, and evidence of this disturbance as a result of methamphetamine treatment will be discussed. We propose that cortical GABAergic interneurons are particularly vulnerable to glutamate overflow as a result of subcellular location of NMDA receptors on interneurons in the cortex. Damage to cortical GABAergic function would lead to dysregulation of cortical signals, resulting in psychosis, and further support MAP as a model for schizophrenia.
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Affiliation(s)
- Jennifer H. Hsieh
- Department of Psychiatry and Mental Health, University of Cape TownWestern Cape, South Africa
| | | | - Fleur M. Howells
- Department of Psychiatry and Mental Health, University of Cape TownWestern Cape, South Africa
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26
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Gururajan A, Manning EE, Klug M, van den Buuse M. Drugs of abuse and increased risk of psychosis development. Aust N Z J Psychiatry 2012; 46:1120-35. [PMID: 22833579 DOI: 10.1177/0004867412455232] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is considerable evidence to suggest that the abuse of illicit drugs, particularly cannabis and methamphetamine, has aetiological roles in the pathogenesis of psychosis and schizophrenia. Factors that may increase susceptibility to the propsychotic effects of these drugs include the age at which the abuse starts as well as family history of genetic polymorphisms relevant to the pathophysiology of this disorder. However, the neurobiological mechanisms involved in drug abuse-associated psychosis remain largely unclear. METHODS AND RESULTS This paper presents an overview of the available evidence, including clinical, animal model, and molecular studies, with a focus on brain regions and neurotransmitters systems, such as dopamine and glutamate, previously implicated in psychosis. CONCLUSION It is clear that further studies are urgently needed to provide a greater insight into the mechanisms that mediate the long-term and neurodevelopmental effects of cannabis and methamphetamine. A dialogue between basic science and clinical research may help to identify at-risk individuals and novel pathways for treatment and prevention.
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Affiliation(s)
- Anand Gururajan
- Mental Health Research Institute, University of Melbourne, Melbourne, Australia
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Vearrier D, Greenberg MI, Miller SN, Okaneku JT, Haggerty DA. Methamphetamine: history, pathophysiology, adverse health effects, current trends, and hazards associated with the clandestine manufacture of methamphetamine. Dis Mon 2012; 58:38-89. [PMID: 22251899 DOI: 10.1016/j.disamonth.2011.09.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Salo R, Ravizza S, Fassbender C. Overlapping cognitive patterns in schizophrenia and methamphetamine dependence. Cogn Behav Neurol 2011; 24:187-93. [PMID: 22123586 PMCID: PMC3269832 DOI: 10.1097/wnn.0b013e31823fc1d0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To examine whether overlapping cognitive deficits exist in currently drug-abstinent chronic methamphetamine (MA) abusers and schizophrenia (SZ) patients. BACKGROUND Both SZ and chronic MA abuse are associated with frontostriatal disruption as well as deficits in cognitive control, such as selective attention. To identify overlapping cognitive profiles, we compared performance of the 2 groups on the Stroop attention task. METHODS Data were analyzed from 69 MA abusers who had been MA-abstinent for differing periods of time and from 23 SZ patients and 38 non-substance-abusing controls. RESULTS The MA abusers in early abstinence displayed more Stroop interference than the SZ patients (P=0.004), long-term abstinent MA abusers (P=0.009), and controls (P=0.002). In the MA abusers, the magnitude of Stroop interference correlated positively with longer drug use (P=0.01) and negatively with longer drug abstinence (P=0.04). No correlations were found between psychotic symptoms and task performance. CONCLUSIONS On this task of attentional selection, only the MA abusers in early stages of abstinence showed performance deficits compared with controls. More research is needed to further elucidate overlapping patterns between MA abuse and SZ.
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Affiliation(s)
- Ruth Salo
- Department of Psychiatry, UC Davis Medical Center, University of California, Sacramento, CA, USA.
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Herin DV, Rush CR, Grabowski J. Agonist-like pharmacotherapy for stimulant dependence: preclinical, human laboratory, and clinical studies. Ann N Y Acad Sci 2010; 1187:76-100. [PMID: 20201847 DOI: 10.1111/j.1749-6632.2009.05145.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A variety of natural and synthetic agents have long been used for stimulant properties, with nontherapeutic use producing multiple waves of stimulant abuse and dependence. The multitude of effects of stimulants exist on continua, and accordingly, here we characterize stimulant abuse/dependence and candidate pharmacotherapies in this manner. Behavioral therapy and medications have been investigated for treatment of stimulant abuse/dependence. Effectiveness of some behavioral interventions has been demonstrated. Most medications studied have been found to lack efficacy. However, an expanding literature supports use of agonist-like medications to treat stimulant abuse/dependence, a strategy effective for nicotine and opiate dependence. The agonist-like conceptualization for stimulant dependence posits that medications with properties similar to that of the abused drug, but possessing lesser abuse liability, will normalize neurochemistry and stabilize behavior, thus reducing drug use. Data suggest use of a range of medications, from l-dopa/carbidopa to amphetamine preparations, depending on the severity of use. This report reviews preclinical, human laboratory, and clinical trial data supporting the agonist-like approach, including risks and benefits. Future directions for development of agonist-like medications are also discussed.
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Affiliation(s)
- David V Herin
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
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