Reduced frontal white matter integrity in cocaine dependence: A controlled diffusion tensor imaging study

Kelvin O Lim, Steven J. Choi, Nunzio Pomara, Adam Wolkin, John P. Rotrosen

Research output: Contribution to journalArticlepeer-review

195 Scopus citations


Background: In vivo magnetic resonance studies have found that cocaine dependence is associated with T2 signal hyperintensities and metabolite abnormalities in cerebral white matter (WM). Functional neuroimaging studies have suggested that chronic cocaine use is primarily associated with frontal lobe deficits in regional cerebral blood flow and brain glucose metabolism levels; however, the effects of cocaine dependence, if any, on frontal WM microstructure are unknown. Thus, we sought to examine the effects of cocaine dependence on frontal WM integrity. Methods: Diffusion tensor imaging was employed to examine the WM integrity of frontal regions at four levels: 10 mm above, 5 mm above, 0 mm above, and 5 mm below the anterior commissure-posterior commissure (AC-PC) plane. The fractional anisotropy (FA) of 12 cocaine-dependent patients and 13 age-similar control subjects was compared. Results: The cocaine-dependent patients had significantly reduced FA in the frontal WM at the AC-PC plane and a trend toward reduced FA at 5 mm below the AC-PC plane, suggestive of reduced WM integrity in these regions. Conclusions: These findings were consistent with the hypothesis that cocaine dependence involves alterations in orbitofrontal connectivity, which may be involved in the decision-making deficits seen in this disorder.

Original languageEnglish (US)
Pages (from-to)890-895
Number of pages6
JournalBiological psychiatry
Issue number11
StatePublished - Jun 1 2002

Bibliographical note

Funding Information:
This work was supported in part by the Department of Veterans Affairs. We would like to thank Ms. Caroline Woo and Mr. Sandor Szilagyi for their efforts in the recruitment of subjects.


  • Cocaine dependence
  • Diffusion tensor imaging
  • Fractional anisotropy
  • Frontal lobes
  • Magnetic resonance imaging
  • White matter integrity


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