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Women dependent on cocaine or meth have less grey matter

New Scientist, July 14, 2015

Don’t do drugs, kids. Especially if you’re female. Women dependent on stimulants like cocaine and methamphetamine appear to have less grey matter, even after they stop using them. Weirdly, men’s brains don’t show this difference.

The brain regions most affected are those involved in reward, emotion and learning – although it isn’t clear yet whether the smaller than average size of these brain areas could be a cause or effect of addiction. Jody Tanabe, at the University of Colorado Hospital in Aurora, hopes these results will help lead to a better understanding of sex differences in substance abuse, and better, more distinct treatments for women.

Tanabe’s team used MRI scans to measure the brain volumes of 59 people previously dependent on stimulants and compared them with people who have never been dependent on these kinds of drugs. On average, the 28 women who had formerly been dependent on a stimulant drug had a smaller volume of grey matter in their prefrontal cortices, temporal lobes, insulae and other regions. This effect was not seen in men.

The women who had been addicted also differed in their personalities – on average, they were more impulsive and more reward-driven. We already know that women respond differently to stimulants: they start taking the drugs earlier, use larger quantities and may have more difficulty quitting. It’s possible that this pattern of female addiction could be linked to the brain size difference.

However, it’s unclear whether less grey matter causes female addictive behaviours, or if addiction might shrink these brain regions. “The question of causality is complex. There is evidence for both pre-existing and post-drug changes in brain structure and function,” says Tanabe.

Mitul Mehta from King’s College London says longitudinal studies, which follow the same people over time, are necessary to untangle the causes and effects before any treatment decisions could be based on this research.

Currently, men and women receive the same treatment for stimulant dependence. Kelly Cosgrove from Yale University suggests that the female brain may be more vulnerable to toxic effects of drugs and this study “would suggest extended treatment is necessary – perhaps more so for women”.