Neuroimagen y alteraciones del funcionamiento cerebral, asociadas al consumo de cocaína

Autores/as

  • José Guardia Serecigni Enviar correspondencia a: Unidad de Conductas Adictivas. Servicio de Psiquiatría. Hospital de la Santa Creu i Sant Pau. C/ San Antonio María Claret, 167. 08025 BARCELONA. Tel. 93 2919131. Fax: 93 2919178.
  • L. Segura Unidad de Conductas Adictivas. Servicio de Psiquiatría. Hospital de la Santa Creu i Sant Pau. Barcelona.
  • B. Gonzalvo Unidad de Conductas Adictivas. Servicio de Psiquiatría. Hospital de la Santa Creu i Sant Pau. Barcelona.
  • L. Iglesias Unidad de Conductas Adictivas. Servicio de Psiquiatría. Hospital de la Santa Creu i Sant Pau. Barcelona.
  • C. Roncero Unidad de Conductas Adictivas. Servicio de Psiquiatría. Hospital de la Santa Creu i Sant Pau. Barcelona.

DOI:

https://doi.org/10.20882/adicciones.556

Palabras clave:

Abuso de cocaína, neuroimagen estructural, neuroimagen funcional, disfunción cognitiva, alteraciones del funcionamiento cerebral

Resumen

El abuso de cocaína puede inducir un deterioro neuro-psiquiátrico de tipo hipofrontalidad, que puede manifestarse clínicamente por desinhibición conductual, inestabilidad emocional, impulsividad, depresión, anhedonia, paranoidismo y deterioro cognitivo. Mediante las diversas técnicas de neuroimagen estructural se han detectado atrofia y otras altraciones cerebrales. La resonancia magnética espectroscópica ha encontrado indicios de lesión neuronal y proliferación glial, de predominio en el lóbulo frontal. Las técnicas de neuroimagen funcional han detectado déficits en la perfusión cerebral, que pueden persistir durante meses, después de la desintoxicación, y que se han asociado a la presencia de disfunción cognitiva y otros déficits neuropsicológicos. Además se ha encontrado una reducción de la densidad de receptores dopaminérgicos D2 en el córtex cerebral y una disminución del enlace al transportador de dopamina, en el tálamo y ganglios basales, que podrían estar relacionados con un estado de hipodopaminergia cerebral, debido al consumo crónico de cocaína. Los citados síntomas cognitivos, afectivos y las alteraciones conductuales que presentan los pacientes dependientes de cocaína, que se encuentran en programa de recuperación, pueden estar relacionados con alteraciones cerebrales orgánicas, inducidas por la propia droga, y pueden aumentar el riesgo de recaída precoz.

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2001-12-01

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