Detecting Small Vessel Pathology in Cocaine Use Disorder.
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Öchsner, M., Mak, E., & Ersche, K. (2021). Detecting Small Vessel Pathology in Cocaine Use Disorder.. Front Neurosci https://doi.org/10.3389/fnins.2021.827329
BACKGROUND: Cocaine use is associated with an increased risk of cerebrovascular accidents. Small vessel pathology has been linked to the risk of stroke in cocaine users, but can be challenging to detect on conventional magnetic resonance (MR) scans. Fluid-attenuated inversion recovery (FLAIR) scans permit better resolution of small vessel lesions. OBJECTIVES: FLAIR scans are currently only acquired based on the subjective judgement of abnormalities on MR scans at face value. We sought to evaluate this practice and the added value of FLAIR scans for patients with cocaine use disorder (CUD), by comparing microbleeds detected by MR and FLAIR scans. We hypothesised that microbleeds are more pronounced in CUD patients, particularly so in participants who had been selected for a FLAIR scan by radiographers. METHODS: Sixty-four patients with CUD and 60 control participants underwent a brain scan. The MR of 20 CUD patients and 16 control participants showed indicators of cerebral infarction at face value and were followed up by a FLAIR scan. We determined the volume of microbleeds in both MR and FLAIR scans and examined associations with various risk factors. RESULTS: While MR lesion volumes were significantly increased in CUD patients, no significant differences in lesion volume were found in the subgroup of individuals who received a FLAIR. CONCLUSION: The current practice of subjectively evaluating MR scans as a basis for the follow-up FLAIR scans to detect vascular pathology may miss vulnerable individuals. Hence, FLAIR scans should be included as a routine part of research studies.
We thank all the participants for their contributions to this research, staff at the NIHR Cambridge Clinical Research Facility and the Wolfson Brain Imaging Centre for their dedicated support. This work was funded by research grants from the Medical Research Council (G0701497 and MR/JO12084/1) and supported by the NIHR Cambridge Biomedical Research Centre and conducted within the Behavioural Clinical Neuroscience Institute (which was supported by a joint award from the Medical Research Council and the Wellcome Trust). E.M. was supported by an Alzheimer’s Society Junior Research Fellowship (443 AS JF 18017) and KDE was supported by an Alexander von Humboldt Fellowship for senior researchers (GBR 1202805 HFST-E).
Medical Research Council (MR/J012084/1)
Medical Research Council (G0701497)
External DOI: https://doi.org/10.3389/fnins.2021.827329
This record's URL: https://www.repository.cam.ac.uk/handle/1810/331743
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