title: Decreased gray matter concentration in the insular, orbitofrontal, cingulate, and temporal cortices of cocaine patients.
abstract: BACKGROUND
  Structural deficiencies within limbic and prefrontal regions may contribute to the characteristic drug-seeking and drug-taking behaviors that prevail in persons dependent on cocaine. To date, a focal structural analysis of the brains of cocaine patients has not been undertaken.
  
  
  METHODS
  We used voxel based morphometry in conjunction with statistical parametric mapping on the structural magnetic resonance images of cocaine-dependent (n = 13) and cocaine-naive individuals (n = 16) to assess differences between the two groups in gray and white matter concentration.
  
  
  RESULTS
  We report a decrease in gray matter concentration in the ventromedial orbitofrontal, anterior cingulate, anteroventral insular, and superior temporal cortices of cocaine patients in comparison to controls (p <.01 corrected for multiple comparisons). The average percentage decrease in gray matter concentration within a region ranged from 5% to 11%. White matter concentration did not differ between groups.
  
  
  CONCLUSIONS
  We conclude that the brains of cocaine patients are structurally dissimilar from those of nondrug-using controls. The differences were detected in regions involved in decision-making, behavioral inhibition and assignation of emotional valence to environmental stimuli and, hence, may contribute to some of the behavioral deficits characteristic of chronic cocaine users.
authors.affiliation: Addiction Treatment Research Center, Department of Psychiatry, University of Pennsylvania and Philadelphia VA Medical Center, Philadelphia, PA 19104-6178, USA.
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Franklin
authors.forename: Paul D
authors.initials: PD
authors.lastname: Acton
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Maldjian
authors.forename: Jason D
authors.initials: JD
authors.lastname: Gray
authors.forename: Jason R
authors.initials: JR
authors.lastname: Croft
authors.forename: Charles A
authors.initials: CA
authors.lastname: Dackis
authors.forename: Charles P
authors.initials: CP
authors.lastname: O'Brien
authors.forename: Anna Rose
authors.initials: AR
authors.lastname: Childress
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology*; D019970:Cocaine-Related Disorders / Q000473:pathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000473:pathology; D012016:Reference Values; D013702:Temporal Lobe / Q000473:pathology