Effects of stimulant drug use on the dopaminergic system: A systematic review and meta-analysis of in vivo neuroimaging studies

Eur Psychiatry. 2019 Jun:59:15-24. doi: 10.1016/j.eurpsy.2019.03.003. Epub 2019 Apr 11.

Abstract

Background: Stimulant drugs can cause persistent changes in the brain. Imaging studies show that these changes are most apparent in dopamine transporter (DAT) or receptor availability within the striatum.

Methods: This work focuses on influences of stimulant use on dopaminergic function assessed using nuclear-medicine imaging (PET/SPECT). Included are 39 studies on 655 cocaine, amphetamine, methamphetamine or nicotine users, as well as 690 healthy controls. Metaanalyses were conducted separately for D2/D3 receptors and dopamine transporters of the entire striatum, its subregions caudate and putamen respectively.

Results: Meta-analyses results regarding nicotine did not show significant effects between smokers and nonsmokers. In cocaine users there was a significant decrease in dopamine receptor availability in all regions. The striatal DAT availability was significantly increased in cocaine users. Methamphetamine users showed a significantly decreased dopamine receptor and transporter density in all regions. Significant results also indicate a lower transporter availability in all regions. Amphetamine users showed reduced DAT availability in the striatum, as well as in the sub regions.

Conclusion: This meta-analysis provides evidence that there are ongoing changes in the dopaminergic system associated with the use of stimulants. Especially the results of cocaine, methamphetamine and amphetamine use mainly showed a downregulation. In addition, this meta-analysis is the first to include nicotine. This subset of studies showed evidence for a decreased receptor and DAT availability but no significant results were found in the metaanalyses.

Keywords: Amphetamines; Cocaine; DAT; Dopamine; Neuroimaging; Neurotransmitters; Nicotine; PET; SPECT; Striatum.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Amphetamine-Related Disorders / metabolism*
  • Brain / metabolism
  • Central Nervous System Stimulants / pharmacology
  • Dopamine
  • Dopamine Plasma Membrane Transport Proteins / drug effects
  • Dopamine Plasma Membrane Transport Proteins / metabolism*
  • Heroin Dependence / metabolism*
  • Humans
  • Methamphetamine / metabolism*
  • Neostriatum / metabolism
  • Receptors, Dopamine D2 / metabolism*
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Central Nervous System Stimulants
  • Dopamine Plasma Membrane Transport Proteins
  • Receptors, Dopamine D2
  • Methamphetamine
  • Dopamine