Platelet abnormalities associated with cerebral perfusion defects in cocaine dependence.
BACKGROUND
This study assessed whether reduced regional cerebral blood flow (rCBF; hypoperfusion) in cocaine-dependent (CD) patients is associated with platelet abnormalities and whether these platelet abnormalities predict improvement in hypoperfusion after 1 month of abstinence.


METHODS
We correlated platelet number and aggregation with rCBF hypoperfusion in 54 CD patients at baseline and after a month of abstinence while taking either 325 mg aspirin or placebo. We measured rCBF by (SPECT) with (Tc-HMPAO). Platelet aggregation to adenosine diphosphate was compared at baseline and after treatment.


RESULTS
At baseline the number of hypoperfused voxels positively correlated with higher platelet aggregation, and five brain regions (bilateral frontal, right insula, right cingulate, left temporal lobes) showed significantly more hypoperfusion in the high than low platelet aggregation group. After abstinence, hypoperfusion significantly improved regardless of treatment assignment, and greater platelet aggregation at baseline predicted greater improvement in hypoperfusion. After abstinence, only the cingulate continued to show more hypoperfusion in the high- than low-aggregation group.


CONCLUSIONS
Because platelet function was related to hypoperfusion primarily in the distribution of the middle cerebral artery, where CD patients most commonly have strokes, more potent antiplatelet agents than aspirin might be effective.
Kosten
Thomas R
TR
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Tucker
Karen
K
Gottschalk
P Christopher
PC
Rinder
Christine S
CS
Rinder
Henry M
HM
D000328:Adult; D001792:Blood Platelets / Q000502:physiology*; D001921:Brain / Q000098:blood supply* / Q000378:metabolism / Q000503:physiopathology*; D002449:Cell Aggregation / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D019970:Cocaine-Related Disorders / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D010091:Oximes / Q000378:metabolism; D019275:Radiopharmaceuticals / Q000378:metabolism; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon
D010091:Oximes; D019275:Radiopharmaceuticals; C068296:hexamethylpropyleneamine oxime