Cognitive Deficits in Methamphetamine Users: How Strong is The Evidence?

Abstract

Methamphetamine use has spread in many European countries and the United States. The current review provides a summary and critical analysis of research on cognitive deficits associated with methamphetamine, also known as “crystal meth.” The literature search performed for this review led us to the hypothesis that methamphetamine use is associated with persistent changes in brain metabolism that result in various impairments, such as deficits in memory, attention, and concentration. The dopaminergic system in particular seems to be affected. Some studies indicate that cognitive impairments may improve when users become abstinent, but results of other studies are conflicting. This review discusses these findings and the consequences for the development of a specific addiction treatment for methamphetamine.

Key words

methamphetamine - cognition - deficits - cognitive impairment - executive function

• References

• 1 Barr A, Panenka W, MacEwan G. et al. The need for speed: an update on methamphetamine addiction. J Psychiatry Neurosci. 2006; 31: 301-313
• 2 Matos E, Atzendorf J, Kraus L. et al. Substanzkonsum in der Allgemeinbevölkerung in Deutschland. SUCHT 2016; 62: 271-281
• 3 Pabst A, Kraus L, Matos E. et al. Substanzkonsum und substanzbezogene Störungen in Deutschland im Jahr 2012. SUCHT 2013; 59: 321-331
• 4 European Monitoring Centre for Drugs and Drug Addiction . Exploring methamphetamine trends in Europe. EMCDDA Papers Luxembourg: Publications Office of the European Union; 2014
• 5 European Monitoring Centre for Drugs and Drug Addiction . European Drug Report 2016: Trends and Developments. EMCDDA Papers Luxembourg: Publications Office of the European Union; 2016;
• 6 Cretzmeyer M, Sarrazin M, Huber D. et al. Treatment of methamphetamine abuse. Research findings and clinical directions. J Subst Abuse Treat. 2003; 24: 267-277
• 7 Hart C, Ward A, Haney M. et al. Methamphetamine self-administration by humans. Psychopharmacology (Berl) 2001; 157: 75-81
• 8 Härtel-Petri R. Crystal-Meth als Herausforderung für das Suchthilfesystem – Klinische Empfehlungen. Suchttherapie 2016; 17: 10-16
• 9 Volkow N, Fowler J, Wang G. et al. Distribution and pharmacokinetics of methamphetamine in the human body: Clinical implications. PloS One 2010; 5: e15269
• 10 Förstl H. Neuro-Enhancement. Gehirndoping. Nervenarzt 2009; 80: 840-846
• 11 Franke A, Bonertz C, Christmann M. et al. Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany. Pharmacopsychiatry 2011; 44: 60-66
• 12 Brecht M, O’Brien A, Mayrhauser C. et al. Methamphetamine use behaviors and gender differences. Addict Behav. 2004; 29: 89-106
• 13 Cruickshank C, Dyer K. A review of the clinical pharmacology of methamphetamine. Addiction 2009; 104: 1085-1099
• 14 Newton T, Kalechstein A, Duran S. et al. Methamphetamine abstinence syndrome: preliminary findings. Am J Addict. 2004; 13: 248-255
• 15 Aharonovich E. Cognitive impairment, retention and abstinence among cocaine abusers in cognitive-behavioral treatment. Drug Alcohol Depend. 2003; 71: 207-211
• 16 Scott J, Woods S, Matt G. et al. Neurocognitive effects of methamphetamine: a critical review and meta-analysis. Neuropsychol Rev. 2007; 17: 275-297
• 17 Hart C, Marvin C, Silver R. et al. Is cognitive functioning impaired in methamphetamine users? A critical review. Neuropsychopharmacology 2012; 37: 586-608
• 18 Nordahl T, Salo R, Leamon M. Neuropsychological effects of chronic methamphetamine use on neurotransmitters and cognition: a review. J Neuropsychiatry Clin Neurosci 2003; 15: 317-325
• 19 Dalley W, Fryer T, Brichard L. et al. Nucleus accumbens D2/3 receptors predict trait impulsivity and cocaine reinforcement. Science 2007; 315: 1267-1270
• 20 Reichel C, Gilstrap M, Ramsey L. et al. Modafinil restores methamphetamine induced object-in-place memory deficits in rats independent of glutamate N-methyl-D-aspartate receptor expression. Drug Alcohol Depend. 2014; 134: 115-122
• 21 Kesby J, Heaton R, Young J. et al. Methamphetamine exposure combined with HIV-1 disease or gp120 expression: comparison of learning and executive functions in humans and mice. Neuropsychopharmacology 2015; 40: 1899-1909
• 22 Bernheim A, See R, Reichel C. Chronic methamphetamine self-administration disrupts cortical control of cognition. Neurosci Biobehav Rev. 2016; 69: 36-48
• 23 Meredith C, Jaffe C, Kathleen S. Implications of chronic methamphetamine use: a literature review. Harv Rev Psychiatry 2005; 13: 141-154
• 24 Sulzer D, Sonders M, Poulsen N. et al. Mechanisms of neurotransmitter release by amphetamines: A review. Prog Neurobiol. 2005; 75: 406-433
• 25 Miller D, O’Callaghan J. Elevated environmental temperature and methamphetamine neurotoxicity. Environ Res. 2003; 92: 48-53
• 26 Cho A, Melega W. Patterns of methamphetamine abuse and their consequences. J Addict Dis. 2000; 21: 21-34
• 27 Hornung J. The human raphe nuclei and the serotonergic system. J Chem Neuroanat. 2003; 26: 331-343
• 28 Volkow N, Chang L, Wang G. et al. Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers. Am J Psychiatry. 2001; 158: 377-382
• 29 Chang L, Alicata D, Ernst T. et al. Structural and metabolic brain changes in the striatum associated with methamphetamine abuse. Addiction 2007; 102 (Suppl. 01) 16-32
• 30 Sekine Y, Minabe Y, Ouchi Y. et al. Association of dopamine transporter loss in the orbitofrontal and dorsolateral prefrontal cortices with methamphetamine-related psychiatric symptoms. Am J Psychiatry. 2003; 160: 1699-1701
• 31 Mackey S, Stewart J, Connolly C. et al. A voxel-based morphometry study of young occasional users of amphetamine-type stimulants and cocaine. Drug Alcohol Depend. 2014; 135: 104-111
• 32 Hall M, Alhassoon O, Stern M. et al. Gray matter abnormalities in cocaine versus methamphetamine-dependent patients: a neuroimaging meta-analysis. Am J Drug Alcohol Abuse. 2015; 41: 290-299
• 33 London E, Kohno M, Morales A. et al. Chronic methamphetamine abuse and corticostriatal deficits revealed by neuroimaging. Brain Res. 2015; 1628: 174-185
• 34 Johnson B, Roache J, Ait-Daoud N. et al. Effects of isradipine on methamphetamine-induced changes in attentional and perceptual-motor skills of cognition. Psychopharmacology (Berl) 2005; 178: 296-302
• 35 Mohs R, Tinklenberg J, Roth W. et al. Methamphetamine and diphenhydramine effects on the rate of cognitive processing. Psychopharmacology (Berl) 1978; 59: 13-19
• 36 Mohs R, Tinklenberg J, Roth W. et al. Sensitivity of some human cognitive functions to effects of methamphetamine and secobarbital. Drug Alcohol Depend. 1980; 5: 145-150
• 37 Silber B, Croft R, Papafotiou K. et al. The acute effects of d-amphetamine and methamphetamine on attention and psychomotor performance. Psychopharmacology (Berl) 2006; 187: 154-169
• 38 Lyoo I, Yoon S, Kim T. et al. Predisposition to and effects of methamphetamine use on the adolescent brain. Mol Psychiatry. 2015; 20: 1516-1524
• 39 Cloak C, Alicata D, Chang L. et al. Age and sex effects levels of choline compounds in the anterior cingulate cortex of adolescent methamphetamine users. Drug Alcohol Depend. 2011; 119: 207-215
• 40 Thompson P, Hayashi K, Simon S. et al. Structural abnormalities in the brains of human subjects who use methamphetamine. J Neurosci. 2004; 24: 6028-6036
• 41 Casaletto K, Obermeit L, Morgan E. et al. Depression and executive dysfunction contribute to a metamemory deficit among individuals with methamphetamine use disorders. Addict Behav. 2015; 40: 45-50
• 42 Paulus M. Behavioral and functional neuroimaging evidence for prefrontal dysfunction in methamphetamine-dependent subjects. Neuropsychopharmacology 2002; 26: 53-63
• 43 Panenka W, Procyshyn R, Lecomte T. et al. Methamphetamine use: a comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend. 2013; 129: 167-179
• 44 Marshall J, O’Dell S. Methamphetamine influences on brain and behavior: unsafe at any speed?. Trends Neurosci 2012; 35: 536-545
• 45 North A, Swant J, Salvatore M. et al. Chronic methamphetamine exposure produces a delayed, long-lasting memory deficit. Synapse 2013; 67: 245-257
• 46 Huckans M, Fuller B, Chalker A. et al. Plasma inflammatory factors are associated with anxiety, depression, and cognitive problems in adults with and without methamphetamine dependence: an exploratory protein array study. Front Psychiatry 2015; 6: 178
• 47 Simon S, Dacey J, Glynn S. et al. The effect of relapse on cognition in abstinent methamphetamine abusers. J Subst Abuse Treat. 2004; 27: 59-66
• 48 Drechsler R. Exekutive Funktionen. Z Neuropsychol 2007; 18: 233-248
• 49 Everitt B, Robbins T. From the ventral to the dorsal striatum: devolving views of their roles in drug addiction. Neurosci Biobehav Rev. 2013; 37: 1946-1954
• 50 Garavan H, Stout J. Neurocognitive insights into substance abuse. Trends Cogn Sci. 2005; 9: 195-201
• 51 Verdejo-Garcia A, Bechara A, Recknor E. et al. Executive dysfunction in substance dependent individuals during drug use and abstinence: An examination of the behavioral, cognitive and emotional correlates of addiction. J Int Neuropsychol Soc. 2006; 12: 405-415
• 52 May A, Stewart J, Migliorini R. et al. Methamphetamine dependent individuals show attenuated brain response to pleasant interoceptive stimuli. Drug Alcohol Depend. 2013; 131: 238-246
• 53 Chen Y, Chen C, Wang L. Predictors of relapse and dropout during a 12-week relapse prevention program for methamphetamine users. J Psychoactive Drugs. 2015; 47: 317-324
• 54 Rusyniak D. Neurologic manifestations of chronic methamphetamine abuse. Psychiatr Clin North Am. 2013; 36: 261-275
• 55 Hosak L, Preiss M, Bazant J. et al. Comparison of Wisconsin Card Sorting Test results between Czech subjects dependent on methamphetamine versus healthy volunteers. Psychiatr Danub 2012; 24: 188-193
• 56 Kane M, Engle R. Working-memory capacity and the control of attention. The contributions of goal neglect, response competition, and task set to Stroop interference. J Exp Psychol Gen 2003; 132: 47-70
• 57 Salo R, Nordahl T, Natsuaki Y. et al. Attentional control and brain metabolite levels in methamphetamine abusers. Biol Psychiatry. 2007; 61: 1272-1280
• 58 Salo R, Nordahl T, Possin K. et al. Preliminary evidence of reduced cognitive inhibition in methamphetamine-dependent individuals. Psychiatry Res. 2002; 111: 65-74
• 59 Salo R, Nordahl T, Galloway G. et al. Drug abstinence and cognitive control in methamphetamine-dependent individuals. J Subst Abuse Treat. 2009; 37: 292-297
• 60 Jaffe C, Bush K, Straits-Troster K. et al. A comparison of methamphetamine-dependent inpatients childhood attention deficit hyperactivity disorder symptomatology. J Addict Dis. 2015; 24: 133-152
• 61 Wang G, Volkow N, Chang L. et al. Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence. Am J Psychiatry. 2004; 161: 242-248
• 62 Boileau I, Rusjan P, Houle S. et al. Increased vesicular monoamine transporter binding during early abstinence in human methamphetamine users: Is VMAT2 a stable dopamine neuron biomarker?. J Neurosci 2008; 28: 9850-9856
• 63 Kalechstein A, Newton T, Green M. Methamphetamine dependence is associated with neurocognitive impairment in the initial phases of abstinence. J Neuropsychiatry Clin Neurosci 2003; 15: 215-220
• 64 Ersche K, Clark L, London M. et al. Profile of executive and memory function associated with amphetamine and opiate dependence. Neuropsychopharmacology 2006; 31: 1036-1047
• 65 Chang L, Ernst T, Speck O. et al. Perfusion MRI and computerized cognitive test abnormalities in abstinent methamphetamine users. Psychiatry Res. 2002; 114: 65-79
• 66 Homer B, Solomon T, Moeller R. et al. Methamphetamine abuse and impairment of social functioning: A review of the underlying neurophysiological causes and behavioral implications. Psychol Bull. 2008; 134: 301-310
• 67 Zhong N, Jiang H, Du J. et al. The cognitive impairments and psychological wellbeing of methamphetamine dependent patients compared with health controls. Prog Neuropsychopharmacol Biol Psychiatry. 2016; 69: 31-37
• 68 Janetsian S, McCane A, Linsenbardt D. et al. Methamphetamine-induced deficits in social interaction are not observed following abstinence from single or repeated exposures. Behav Pharmacol. 2015; 26: 786-797
• 69 Cherner M, Suarez P, Casey C. et al. Methamphetamine use parameters do not predict neuropsychological impairment in currently abstinent dependent adults. Drug Alcohol Depend. 2010; 106: 154-163
• 70 Rezapour T, DeVito E, Sofuoglu M. et al. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: from cognitive improvement to relapse prevention. Prog Brain Res. 2016; 224: 345-369
• 71 Dean A, London E, Sugar C. et al. Predicting adherence to treatment for methamphetamine dependence from neuropsychological and drug use variables. Drug Alcohol Depend. 2009; 105: 48-55
• 72 Streeter C, Terhune D, Whitfield T. et al. Performance on the Stroop predicts treatment compliance in cocaine-dependent individuals. Neuropsychopharmacology 2008; 33: 827-836
• 73 Soyka M, Koller G, Proebstl L. et al. [Prevalence and therapy of crystal methamphetamine dependence]. Fortschr Neurol Psychiatr. 2017; 85: 92-99
• 74 Lawton-Craddock A, Nixon S, Tivis R. Cognitive efficiency in stimulant abusers with and without alcohol dependence. Alcohol Clin Exp Res. 2003; 27: 457-464
• 75 Agrawal A, Neale M, Prescott C. et al. A twin study of early cannabis use and subsequent use and abuse/dependence of other illicit drugs. Psychol Med. 1999; 34: 1227-1237
• 76 Gonzalez R, Rippeth J, Carey C. et al. Neurocognitive performance of methamphetamine users discordant for history of marijuana exposure. Drug Alcohol Depend. 2004; 76: 181-190
• 77 Cuzen N, Koopowitz S, Ferrett H. et al. Methamphetamine and cannabis abuse in adolescence: A quasi-experimental study on specific and long-term neurocognitive effects. BMJ Open 2015; 5: e005833
• 78 Cadet J, Krasnova I. Interactions of HIV and methamphetamine: cellular and molecular mechanisms of toxicity potentiation. Neurotox Res. 2007; 12: 181-204
• 79 van Gorp W, Hinkin C. Triple trouble: Cognitive deficits from hepatitis C, HIV, and methamphetamine. Neurology 2005; 64: 1328-1329
• 80 Rippeth J, Heaton R, Carey C. et al. Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. J Int Neuropsychol Soc. 2004; 10: 1-14
• 81 Sofuoglu M, DeVito E, Waters A. et al. Cognitive enhancement as a treatment for drug addictions. Neuropharmacology 2013; 64: 452-463
• 82 Brewer J, Worhunsky P, Carroll K. et al. Pretreatment brain activation during Stroop task is associated with outcomes in cocaine-dependent patients. Biol Psychiatry. 2008; 64: 998-1004
• 83 Hentschel H. Ecstasy und co. – sind Partydrogen wirklich harmlos? Refresher course. Aktuelles Wissen für Anästhesisten 2001; 27: 157-172
• 84 Bray G. Use and abuse of appetite-suppressant drugs in the treatment of obesity. Ann Intern Med. 1993; 7: 707-713
• 85 Perez-Reyes M, White W, McDonald S. et al. Clinical effects of daily amphetamine administration. Clin Neuropharmacol. 1991; 14: 352-358
• 86 Logan B. Methamphetamine – effects on human performance and behavior. Forensic Sci Rev 2002; 14: 133-151
• 87 Dirks H, Esser S, Brockmeyer N. et al. Dramatic changes over time of methamphetamine intake in a German, HIV-positive, sample of men who have sex with men (MSM). Pharmacopsychiatry 2017; 50: 123-124
• 88 Dinger J, Hinner D, Reichert J. et al. Methamphetamine consumption during pregnancy – effect on child health. Pharmacopsychiatry 2017; 50: 107-113