title: Increased reflection impulsivity in patients with ephedrone-induced Parkinsonism.
abstract: OBJECTIVE
  To examine a syndrome of chronic manganism that occurs in drug addicts in eastern Europe who use intravenous methcathinone (ephedrone) contaminated with potassium permanganate. In many cases the basal ganglia, especially the globus pallidus and the putamen, are damaged irreversibly. Routine neuropsychological assessment has revealed no cognitive deficits, despite widespread abnormalities on brain imaging studies and severe extrapyramidal motor handicap on clinical examination.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Ephedrone patients and patients with opioid dependence were recruited from Lviv, Ukraine.
  
  
  METHODS
  We tested 15 patients with ephedrone-induced toxicity, 13 opiate-dependent patients who were receiving opioid replacement therapy and 18 matched healthy volunteers.
  
  
  METHODS
  The 'beads task', an information-gathering task to assess reflection impulsivity, was used and feedback learning, working memory and risk-taking were also assessed.
  
  
  RESULTS
  Opiate-dependent patients differed from controls on three of four tasks, whereas ephedrone patients differed from controls on only one task. More specifically, both patient groups were more impulsive and made more irrational choices on the beads task than controls (P < 0.001). However, ephedrone patients had no deficits in working memory (P > 0.1) or risk-taking (P > 0.1) compared with controls. Opioid-dependent patients had significantly worse working memory (P < 0.001) and were significantly more risk-prone than controls (P = 0.002).
  
  
  CONCLUSIONS
  Ephedrone patients may have similar deficits in information-gathering and decision-making to opiate-dependent patients, with preservation of working memory and risk-taking. This may reflect specific damage to anterior cingulate- basal ganglia loops.
authors.affiliation: Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK.
authors.forename: Atbin
authors.initials: A
authors.lastname: Djamshidian
authors.forename: Yanosh
authors.initials: Y
authors.lastname: Sanotsky
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Matviyenko
authors.forename: Sean S
authors.initials: SS
authors.lastname: O'Sullivan
authors.forename: Stephen
authors.initials: S
authors.lastname: Sharman
authors.forename: Marianna
authors.initials: M
authors.lastname: Selikhova
authors.forename: Ludmyla
authors.initials: L
authors.lastname: Fedoryshyn
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Filts
authors.forename: Jenny
authors.initials: J
authors.lastname: Bearn
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lees
authors.forename: Bruno B
authors.initials: BB
authors.lastname: Averbeck
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000523:psychology; D016022:Case-Control Studies; D003657:Decision Making / Q000187:drug effects; D004340:Drug Contamination; D030141:Feedback, Psychological / Q000187:drug effects; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000139:chemically induced*; D057226:Information Seeking Behavior / Q000187:drug effects; D008297:Male; D020149:Manganese Poisoning / Q000150:complications; D008570:Memory, Short-Term / Q000187:drug effects; D009483:Neuropsychological Tests; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000523:psychology; D011196:Potassium Permanganate / Q000633:toxicity; D011427:Propiophenones / Q000009:adverse effects*; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology
chemical_list: D011427:Propiophenones; D011196:Potassium Permanganate; C047806:monomethylpropion