Is chronic opioid abuse associated with cerebral atrophy? An observational study

Abstract

Background: Recreational drug abuse is a serious health problem that poses detrimental effects on central nervous system. Neuroimaging plays a pivotal role in the detection of these abnormal changes in the brain associated with the drug abuse. This study focuses on the grading of cerebral atrophy in the opioid-addicted patients and their association with the age and duration of opioid abuse. Objectives: Grading of cerebral atrophy in opioid-addicted patients and to assess the probable association between chronic opioid abuse and cerebral atrophy in patients admitted to the intensive care unit (ICU) of a tertiary care hospital. Materials and methods: A retrospective study was carried out on 40 patients of opioid abuse who were admitted in the ICU of the hospital over a period of 2 years. Magnetic resonance imaging (MRI) scan of these patients was done using Siemens Avanto 1.5 Tesla scanner. Results: All the patients were male with 25 patients having varying degrees of cerebral atrophy as assessed from Pasquier scale. Majority of the patients (n = 14) on chronic opioid abuse had global cortical atrophy (GCA) score of 1 indicative of mild cerebral atrophy. The associated factors like the duration of abuse and age of presentation had significant association with the cerebral atrophic changes in the brain (p < 0.05). Conclusion: Opioid-dependent patients with long-term substance abuse had probable association with the atrophic changes in brain as assessed from neuroimaging. The progressing age and longer duration of drug abuse may foster significant alterations to the brain structure leading to varied degree of cerebral atrophy.