CNS metabolism in high-risk drug abuse: Insights gained from 1H-, 31P-MRS and PET

Background. High-risk drug consumption is a matter of great concern for public health actors in industrialised countries. The latest trends show a market tendency towards diversification and increasing demand for high-purity synthetic drugs. While most consumers seek medical help after cannabis use, it is high-risk drugs like cocaine, heroin and amphetamines that account for most of the 1000 drug-related deaths that occur in Germany every year. Purpose. This article presents the most prominent in vivo cerebralmetabolic information in cocaine, heroin and methamphetamine users provided by MRI spectroscopy and PET imaging. Materials and methods. We reviewed the literature reporting neuroimaging studies of in vivo metabolic data for methamphetamine, cocaine and heroin consumption published up to March 2017. The search was conducted using PubMed and a combination of the following key words: methamphetamine, cocaine, heroin, MR spectroscopy, PET. Conclusion. MRI and PET are indispensable tools in gauging brain metabolic response to illegal drug abuse. Future breakthroughs in this field will most likely come from the investigation of novel neurotransmitter systems in PET and imaging phosphorus and carbon metabolites in MRI.