title: Reduced frontal white matter integrity in cocaine dependence: a controlled diffusion tensor imaging study.
abstract: BACKGROUND
  In vivo magnetic resonance studies have found that cocaine dependence is associated with T2 signal hyperintensities and metabolite abnormalities in cerebral white matter (WM). Functional neuroimaging studies have suggested that chronic cocaine use is primarily associated with frontal lobe deficits in regional cerebral blood flow and brain glucose metabolism levels; however, the effects of cocaine dependence, if any, on frontal WM microstructure are unknown. Thus, we sought to examine the effects of cocaine dependence on frontal WM integrity.
  
  
  METHODS
  Diffusion tensor imaging was employed to examine the WM integrity of frontal regions at four levels: 10 mm above, 5 mm above, 0 mm above, and 5 mm below the anterior commissure-posterior commissure (AC-PC) plane. The fractional anisotropy (FA) of 12 cocaine-dependent patients and 13 age-similar control subjects was compared.
  
  
  RESULTS
  The cocaine-dependent patients had significantly reduced FA in the frontal WM at the AC-PC plane and a trend toward reduced FA at 5 mm below the AC-PC plane, suggestive of reduced WM integrity in these regions.
  
  
  CONCLUSIONS
  These findings were consistent with the hypothesis that cocaine dependence involves alterations in orbitofrontal connectivity, which may be involved in the decision-making deficits seen in this disorder.
authors.affiliation: Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA.
authors.forename: Kelvin O
authors.initials: KO
authors.lastname: Lim
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Choi
authors.forename: Nunzio
authors.initials: N
authors.lastname: Pomara
authors.forename: Adam
authors.initials: A
authors.lastname: Wolkin
authors.forename: John P
authors.initials: JP
authors.lastname: Rotrosen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000473:pathology; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male