title: Grey matter abnormalities in methcathinone abusers with a Parkinsonian syndrome.
abstract: A permanent Parkinsonian syndrome occurs in intravenous abusers of the designer psychostimulant methcathinone (ephedrone). It is attributed to deposition of contaminant manganese, as reflected by characteristic globus pallidus hyperintensity on T1-weighted MRI.
  
  
  
  We have investigated brain structure and function in methcathinone abusers (n= 12) compared to matched control subjects (n= 12) using T1-weighted structural and resting-state functional MRI.
  
  
  
  Segmentation analysis revealed significant (p< .05) subcortical grey matter atrophy in methcathinone abusers within putamen and thalamus bilaterally, and the left caudate nucleus. The volume of the caudate nuclei correlated inversely with duration of methcathinone abuse. Voxel-based morphometry showed patients to have significant grey matter loss (p< .05) bilaterally in the putamina and caudate nucleus. Surface-based analysis demonstrated nine clusters of cerebral cortical thinning in methcathinone abusers, with relative sparing of prefrontal, parieto-occipital, and temporal regions. Resting-state functional MRI analysis showed increased functional connectivity within the motor network of patients (p< .05), particularly within the right primary motor cortex.
  
  
  
  Taken together, these results suggest that the manganese exposure associated with prolonged methcathinone abuse results in widespread structural and functional changes affecting both subcortical and cortical grey matter and their connections. Underlying the distinctive movement disorder caused by methcathinone abuse, there is a more widespread pattern of brain involvement than is evident from the hyperintensity restricted to the basal ganglia as shown by T1-weighted structural MRI.
authors.affiliation: Department of Neurology and Neurosurgery University of Tartu Tartu Estonia.
authors.forename: Julius
authors.initials: J
authors.lastname: Juurmaa
authors.affiliation: Nuffield Department of Clinical Neurosciences (NDCN) Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) University of Oxford Oxford UK; Department of Psychiatry University of Oxford Oxford UK.
authors.forename: Ricarda A L
authors.initials: RA
authors.lastname: Menke
authors.affiliation: Nuffield Department of Clinical Neurosciences (NDCN) Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) University of Oxford Oxford UK.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vila
authors.affiliation: Radiology Clinic Tartu University Hospital Tartu Estonia.
authors.forename: Andreas
authors.initials: A
authors.lastname: Müürsepp
authors.affiliation: Radiology Clinic Tartu University Hospital Tartu Estonia.
authors.forename: Tiiu
authors.initials: T
authors.lastname: Tomberg
authors.affiliation: Radiology Clinic Tartu University Hospital Tartu Estonia.
authors.forename: Pilvi
authors.initials: P
authors.lastname: Ilves
authors.affiliation: Radiology Clinic Tartu University Hospital Tartu Estonia.
authors.forename: Mait
authors.initials: M
authors.lastname: Nigul
authors.affiliation: Nuffield Department of Clinical Neurosciences (NDCN) Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) University of Oxford Oxford UK.
authors.forename: Heidi
authors.initials: H
authors.lastname: Johansen-Berg
authors.affiliation: NDCN University of Oxford Oxford UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Donaghy
authors.affiliation: Nuffield Department of Clinical Neurosciences (NDCN) Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) University of Oxford Oxford UK; Department of Psychiatry University of Oxford Oxford UK.
authors.forename: Charlotte J
authors.initials: CJ
authors.lastname: Stagg
authors.affiliation: Laboratory for Research in Rehabilitation Riga Stradins University Riga Latvia.
authors.forename: Ainārs
authors.initials: A
authors.lastname: Stepens
authors.affiliation: Department of Neurology and Neurosurgery University of Tartu Tartu Estonia.
authors.forename: Pille
authors.initials: P
authors.lastname: Taba
mesh_terms: D000328:Adult; D001284:Atrophy / Q000139:chemically induced; D001921:Brain / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D066128:Gray Matter / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D020149:Manganese Poisoning / Q000097:blood / Q000209:etiology; D020734:Parkinsonian Disorders / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D011427:Propiophenones / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D011427:Propiophenones; C047806:monomethylpropion
keywords: MRI; Parkinsonism; ephedrone; manganese toxicity; methcathinone