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CNS metabolism in high-risk drug abuse

Insights gained from 1H-, 31P-MRS and PET

ZNS-Stoffwechsel bei Missbrauch von Hochrisikodrogen

Erkenntnisse durch 1H- und 31P-MRS sowie PET

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Abstract

Background

High-risk drug consumption is a matter of great concern for public health actors in industrialised countries. The latest trends show a market tendency towards diversification and increasing demand for high-purity synthetic drugs. While most consumers seek medical help after cannabis use, it is high-risk drugs like cocaine, heroin and amphetamines that account for most of the 1000 drug-related deaths that occur in Germany every year.

Purpose

This article presents the most prominent in vivo cerebral metabolic information in cocaine, heroin and methamphetamine users provided by MRI spectroscopy and PET imaging.

Materials and methods

We reviewed the literature reporting neuroimaging studies of in vivo metabolic data for methamphetamine, cocaine and heroin consumption published up to March 2017. The search was conducted using PubMed and a combination of the following key words: methamphetamine, cocaine, heroin, MR spectroscopy, PET.

Conclusion

MRI and PET are indispensable tools in gauging brain metabolic response to illegal drug abuse. Future breakthroughs in this field will most likely come from the investigation of novel neurotransmitter systems in PET and imaging phosphorus and carbon metabolites in MRI.

Zusammenfassung

Hintergrund

In den Industrieländern ist der Konsum von Hochrisikodrogen ein erhebliches Problem für das gesamte Gesundheitssystem. Neueste Entwicklungen zeigen eine Tendenz zu immer größerer Diversifikation und eine erhöhte Nachfrage nach synthetischen Drogen von hohem Reinheitsgrad. Während die meisten Konsumenten medizinische Hilfe nach Cannabisverbrauch suchen, sind es die Hochrisikodrogen wie Heroin, Kokain und Amphetamine, an denen die meisten der 1000 Drogentoten pro Jahr in Deutschland sterben.

Ziel

In diesem Artikel werden die auffälligsten, mittels Magnetresonanzspektroskopie (MRS) und Positronenemissionstomographie (PET) erfassten In-vivo-Daten zum Hirnstoffwechsel bei Konsumenten von Kokain, Heroin und Methamphetaminen vorgestellt.

Material und Methoden

Die Literatur über den zerebralen Energiestoffwechsel bei Methamphetamin‑, Kokain- und Heroinkonsumenten bis März 2017 wurde über PubMed-Recherchen erforscht. Suchbegriffe wie „methamphetamine“, „cocaine“, „heroin“, „MR spectroscopy“, „PET“ wurden benutzt.

Schlussfolgerung

MRT- und PET-Verfahren sind unerlässliche Werkzeuge bei der Erforschung der zerebralen Reaktionen auf illegale Drogen. Zukünftige Durchbrüche werden voraussichtlich durch die Untersuchung neuer Neurotransmittersysteme in der PET sowie die Abbildung von Phosphor- und Kohlenstoffmetaboliten in der MRT erfolgen.

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Correspondence to S. Bodea MD.

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S. Bodea declares that he has no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Bodea, S. CNS metabolism in high-risk drug abuse. Radiologe 58 (Suppl 1), 34–39 (2018). https://doi.org/10.1007/s00117-017-0255-6

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