ACTA FAC MED NAISS 2008; 25 (1): 35-40

Original article

INFLUENCE OF CERTAIN PARAMETERS OF CHRONIC HEROIN ABUSE (AGE, BEGINNING AND LENGTH OF ABUSE, PSYCHOORGANIC SYNDROME) ON DEVELOPMENT OF CEREBRAL ATROPHY DIAGNOSED BY COMPUTED TOMOGRAPHY

Radisa Vojinovic
Ljiljana Vasic

Clinical Center ''Kragujevac''
Radiology Diagnostic Center

SUMMARY

Cerebral atrophy is a morphological brain damage caused by the effects of heterogeneous etiological factors. Loss of neurons and neuroglia, as well as the degree and speed of this deterioration depend on the type, concentration and the length of effect of one or more etiological agents. Cerebral atrophy is clinically accompanied by development of the psychoorganic syndrome. Methods of choice for diagnosing cerebral atrophy are CT (Computed Tomography) and MR (Magnetic Resonance) endocranium examinations. Although the degree of mental deterioration corresponds to the degree of endocranium changes as seen on CT scans, variations within this range are so great that in some patients only the ratio between diagnostic and clinical examinations can point to diagnosis of cerebral atrophy.

The aim of the paper was to establish the correlation between CT-diagnosed cerebral atrophy and the age of the addict, the age of first heroin use, the length of abuse and the psychoorganic syndrome if it has developed.         

This paper is a retrospective study carried out from January 2006 till July 2007 among patients at the Psychiatric Clinic of the Clinical Center ''Kragujevac''. We examined CT scans of endocranium of 38 heroin addicts (7 women and 31 men). The estimate of cerebral atrophy was based on dilatation of cerebral ventricles and outer liquor space (cortical sulci and cisterns). The data related to the age of the addicts, the type of the substance abused, the length of abuse, the age of first heroin use and psychoorganic syndrome, which was estimated by minimental scale (MM), were taken from the addicts' files of the Clinic Methadone Programme.

We found a statistically significant relation between the degree of cerebral atrophy and the age of the subjects (r= -0.498, p= 0.001) and between and the age of first heroin use and the degree of cerebral atrophy (r = -0.727, p = 0.000). We found a statistically significant relation neither to the length of heroin abuse (r = 0.283, p= 0.085), nor to the value of MM test. ( r = 0. 156, p= 0.350).        

CT examination should be performed only in addicts with shorter periods of abuse, because at this stage, atrophy is reversible. The paper has confirmed that cerebral atrophy, from the clinical aspect, does not include only morphological deterioration of the brain tissue if it is not accompanied with a clinical presentation of the psychoorganic syndrome. Its diagnosis implies the obligatory presence of both criteria, since no statistically significant relation was found.

Key words: cerebral atrophy, heroin addiction, computed tomography