SAR-39684-the-neurocircuitry-of-illicit-psychostimulant-addiction--an-_020713.pdf

120 interestingly cocaine and meth dependent women

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120 Interestingly, cocaine- and METH-dependent women are more likely than men to experience a variety of psychotic symptoms, including delusions of grandeur and tactile hallucinations. 121 Chronic use of psychostimulants is also associated with various other psychiatric disorders, including mood and anxiety disorders. METH users are more likely than cocaine users to have a comorbid psychiatric diagnosis, such as major depression, bipolar disorder, and anxiety disorders. 122 A separate study found that METH-dependent submit your manuscript | Dove press Dove press 34 Taylor et al Substance Abuse and Rehabilitation downloaded from by 71.51.178.127 on 08-Aug-2018 For personal use only. 1 / 1
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Substance Abuse and Rehabilitation 2013:4 subjects reported increased depressive symptoms and acute affective distress compared to control subjects, and that these symptoms improved following a period of abstinence. 114 A more unusual effect of chronic psychostimulant use is formication, the sensation of organisms crawling under one’s skin, which has been reported by both chronic METH and cocaine users. 94 These “meth mites” or “crank bugs” frequently lead to excessive skin picking, sores, and infections. 123,124 Other neurological effects of chronic psychostimulant use include punding (engagement in purposeless and repetitive activities, such as assembling and disassembling electronics), grooming behaviors, and dyskinesias. 125–127 With regard to the latter, choreoathetoid movements (involuntary and aimless movements; also known as “crack dancing”) are associated with both AMPH and cocaine abuse. 128 Interestingly, many of the neurological and psychiatric effects of chronic psychostimulant use, with the exception of altered mood and psychosis, are symptoms related to altered functioning in the striatal region of the basal ganglia and are likely a result of damage to dopaminergic terminals. Neurocircuitry: brain imaging Functional effects Chronic psychostimulant use is associated with alterations in functional connectivity, white- and gray-matter densities, and activation of distinct brain regions underlying reward and cognitive function. Connectivity and activation studies are conducted with various iterations of magnetic resonance imaging (MRI), while density studies utilize either MRI or diffusion tensor imaging. A greater number of studies have been conducted in cocaine-dependent individuals than AMPH or METH users. In a detailed study using resting- state functional MRI connectivity analysis with seed voxels, cocaine users exhibited decreased connectivity between (1) the VTA and the region encompassing the thalamus/ lentiform nucleus/NAc, (2) the AMG and mPFC, and (3) between the HPC and dorsal mPFC. 129 These changes in the neurocircuitry of the cocaine-addicted brain are consistent with maladaptive or impaired reward processing, learning, memory, and emotional regulation. 129 Interestingly, connectivity between the NAc and cortical regions was not reduced, potentially lending credence to the role of habitual
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