title: Disrupted iron regulation in the brain and periphery in cocaine addiction.
abstract: Stimulant drugs acutely increase dopamine neurotransmission in the brain, and chronic use leads to neuroadaptive changes in the mesolimbic dopamine system and morphological changes in basal ganglia structures. Little is known about the mechanisms underlying these changes but preclinical evidence suggests that iron, a coenzyme in dopamine synthesis and storage, may be a candidate mediator. Iron is present in high concentrations in the basal ganglia and stimulant drugs may interfere with iron homeostasis. We hypothesised that morphological brain changes in cocaine addiction relate to abnormal iron regulation in the brain and periphery. We determined iron concentration in the brain, using quantitative susceptibility mapping, and in the periphery, using iron markers in circulating blood, in 44 patients with cocaine addiction and 44 healthy controls. Cocaine-addicted individuals showed excess iron accumulation in the globus pallidus, which strongly correlated with duration of cocaine use, and mild iron deficiency in the periphery, which was associated with low iron levels in the red nucleus. Our findings show that iron dysregulation occurs in cocaine addiction and suggest that it arises consequent to chronic cocaine use. Putamen enlargement in these individuals was unrelated to iron concentrations, suggesting that these are co-occurring morphological changes that may respectively reflect predisposition to, and consequences of cocaine addiction. Understanding the mechanisms by which cocaine affects iron metabolism may reveal novel therapeutic targets, and determine the value of iron levels in the brain and periphery as biomarkers of vulnerability to, as well as progression and response to treatment of cocaine addiction.
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.|The Behavioural and Clinical Neuroscience Institute, The Wellcome Trust-MRC Institute of Metabolic Science, The John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK.
authors.forename: K D
authors.initials: KD
authors.lastname: Ersche
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Acosta-Cabronero
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: P S
authors.initials: PS
authors.lastname: Jones
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.|The Behavioural and Clinical Neuroscience Institute, The Wellcome Trust-MRC Institute of Metabolic Science, The John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK.|CAMEO Early Intervention Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
authors.forename: H
authors.initials: H
authors.lastname: Ziauddeen
authors.affiliation: Radboud University Medical Center, Department of Laboratory Medicine, Nijmegen, The Netherlands.|Hepcidinanalysis.com, Nijmegen, The Netherlands.
authors.forename: R P L
authors.initials: RP
authors.lastname: van Swelm
authors.affiliation: Radboud University Medical Center, Department of Laboratory Medicine, Nijmegen, The Netherlands.|Hepcidinanalysis.com, Nijmegen, The Netherlands.
authors.forename: C M M
authors.initials: CM
authors.lastname: Laarakkers
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: R
authors.initials: R
authors.lastname: Raha-Chowdhury
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: G B
authors.initials: GB
authors.lastname: Williams
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000378:metabolism*; D003677:Deficiency Diseases / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000378:metabolism*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000378:metabolism; D064451:Hepcidins / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D000090463:Iron Deficiencies; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011699:Putamen / Q000000981:diagnostic imaging / Q000473:pathology; D012012:Red Nucleus / Q000000981:diagnostic imaging / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism*
chemical_list: D064451:Hepcidins; D014168:Transferrin; C545475:hepcidin 25, human; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron