These authors contributed equally to this study.
Increased reflection impulsivity in patients with ephedrone-induced Parkinsonism
Article first published online: 11 FEB 2013
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 108, Issue 4, pages 771–779, April 2013
How to Cite
Djamshidian, A., Sanotsky, Y., Matviyenko, Y., O'Sullivan, S. S., Sharman, S., Selikhova, M., Fedoryshyn, L., Filts, Y., Bearn, J., Lees, A. J. and Averbeck, B. B. (2013), Increased reflection impulsivity in patients with ephedrone-induced Parkinsonism. Addiction, 108: 771–779. doi: 10.1111/add.12080
- Issue published online: 18 MAR 2013
- Article first published online: 11 FEB 2013
- Accepted manuscript online: 11 DEC 2012 06:15AM EST
- Manuscript Accepted: 29 NOV 2012
- Manuscript Revised: 21 AUG 2012
- Manuscript Received: 25 MAY 2012
- PSP Association, Weston Trust—the Reta Lila Howard Foundation
- Intramural Research Program of the NIH, NIMH
- Beads task;
- ephedrone-induced Parkinsonism;
- reflection impulsivity;
- substance abuse;
- working memory
To examine a syndrome of chronic manganism that occurs in drug addicts in eastern Europe who use intravenous methcathinone (ephedrone) contaminated with potassium permanganate. In many cases the basal ganglia, especially the globus pallidus and the putamen, are damaged irreversibly. Routine neuropsychological assessment has revealed no cognitive deficits, despite widespread abnormalities on brain imaging studies and severe extrapyramidal motor handicap on clinical examination.
Ephedrone patients and patients with opioid dependence were recruited from Lviv, Ukraine.
We tested 15 patients with ephedrone-induced toxicity, 13 opiate-dependent patients who were receiving opioid replacement therapy and 18 matched healthy volunteers.
The ‘beads task’, an information-gathering task to assess reflection impulsivity, was used and feedback learning, working memory and risk-taking were also assessed.
Opiate-dependent patients differed from controls on three of four tasks, whereas ephedrone patients differed from controls on only one task. More specifically, both patient groups were more impulsive and made more irrational choices on the beads task than controls (P < 0.001). However, ephedrone patients had no deficits in working memory (P > 0.1) or risk-taking (P > 0.1) compared with controls. Opioid-dependent patients had significantly worse working memory (P < 0.001) and were significantly more risk-prone than controls (P = 0.002).
Ephedrone patients may have similar deficits in information-gathering and decision-making to opiate-dependent patients, with preservation of working memory and risk-taking. This may reflect specific damage to anterior cingulate– basal ganglia loops.