Platelet abnormalities associated with cerebral perfusion defects in cocaine dependence

Biol Psychiatry. 2004 Jan 1;55(1):91-7. doi: 10.1016/s0006-3223(03)00706-6.


Background: This study assessed whether reduced regional cerebral blood flow (rCBF; hypoperfusion) in cocaine-dependent (CD) patients is associated with platelet abnormalities and whether these platelet abnormalities predict improvement in hypoperfusion after 1 month of abstinence.

Methods: We correlated platelet number and aggregation with rCBF hypoperfusion in 54 CD patients at baseline and after a month of abstinence while taking either 325 mg aspirin or placebo. We measured rCBF by (SPECT) with (Tc-HMPAO). Platelet aggregation to adenosine diphosphate was compared at baseline and after treatment.

Results: At baseline the number of hypoperfused voxels positively correlated with higher platelet aggregation, and five brain regions (bilateral frontal, right insula, right cingulate, left temporal lobes) showed significantly more hypoperfusion in the high than low platelet aggregation group. After abstinence, hypoperfusion significantly improved regardless of treatment assignment, and greater platelet aggregation at baseline predicted greater improvement in hypoperfusion. After abstinence, only the cingulate continued to show more hypoperfusion in the high- than low-aggregation group.

Conclusions: Because platelet function was related to hypoperfusion primarily in the distribution of the middle cerebral artery, where CD patients most commonly have strokes, more potent antiplatelet agents than aspirin might be effective.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Platelets / physiology*
  • Brain / blood supply*
  • Brain / metabolism
  • Brain / physiopathology*
  • Cell Aggregation / physiology
  • Cerebrovascular Circulation / physiology
  • Cocaine-Related Disorders / blood*
  • Cocaine-Related Disorders / diagnosis
  • Cocaine-Related Disorders / physiopathology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Oximes / metabolism
  • Radiopharmaceuticals / metabolism
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon


  • Oximes
  • Radiopharmaceuticals
  • hexamethylpropyleneamine oxime