Since the first study in stimulant-dependent individuals using structural MRI was published fifteen years ago, much evidence has accumulated on brain abnormalities associated with stimulant drug dependence. Here we conducted a voxel-based morphometry meta-analysis of published MRI data in stimulant-dependent individuals to clarify the most robust abnormalities underlying the disorder. We found that neuroimaging studies in stimulant-dependent individuals consistently report a gray matter decline in the prefrontal cortex regions associated with self-regulation and self-awareness. One of the next key questions that neuroimaging research today needs to address is the question of causality, namely to what extent these brain abnormalities are caused by the toxic effects of drug exposure, or the possibility that these may have predated drug-taking and even predisposed individuals for the development of drug dependence. Although the question of causality has not yet been answered completely, there has been significant progress made to date.
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