Brain abnormalities detected on magnetic resonance imaging of amphetamine users presenting to an emergency department: a pilot study.
OBJECTIVE
To determine the prevalence of occult brain abnormalities in magnetic resonance imaging of active amphetamine users.


METHODS
Prospective convenience study in a tertiary hospital emergency department (ED). Patients presenting to the ED for an amphetamine-related reason were eligible for inclusion. We collected demographic data, drug use data, and performed a mini-mental state examination (MMSE).


METHODS
The proportion of patients with an abnormality on their MRI scan.


RESULTS
Of 38 patients enrolled, 30 had MRI scans. Nineteen were male and their mean age was 26.7 +/- 5.4 years (range 19-41 years). The mean age of first amphetamine use was 18 years (range 13-26 years). Sixteen patients used crystal methamphetamine (mean amount 2.5 g/week), nine used amphetamine ("speed") (mean amount 2.9 g/week), and 23 used ecstasy (mean amount 2.3 tablets/week). Marijuana was smoked by 26 (mean amount 5.9 g/week), and 28 drank alcohol (mean amount 207 g/week). The median MMSE score was 27/30 (interquartile range, 26-29). Abnormalities on brain MRI scans were identified in six patients, most commonly an unidentified bright object (n = 4).


CONCLUSIONS
In this pilot study of brain MRI of young people attending the ED with an amphetamine-related presentation, one in five had an occult brain lesion. While the significance of this is uncertain, it is congruent with evidence that amphetamines cause brain injury.
Fatovich
Daniel M
DM
Royal Perth Hospital, Perth, WA, Australia. daniel.fatovich@health.wa.gov.au
McCoubrie
David L
DL
Song
Swithin J
SJ
Rosen
David M
DM
Lawn
Nick D
ND
Daly
Frank F
FF
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications* / Q000453:epidemiology; D001927:Brain Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult