Espessura do cíngulo no transtorno por uso de cocaína-crack : mediação entre estresse precoce e consumo de cocaína ao longo da vida

Abstract

Early life stress (ELS) is an important environmental risk factor for crack-cocaine use disorder (CUD). Thus, we investigated the effect of CUD on the cortical thickness (CT) of 4 cingulate areas in both hemispheres and tested whether a history of ELS could influence CUD effects. The participants were 78 patients with CUD and 53 healthy participants (HC). The magnetic resonance imaging (MRI) examination of the cingulate CT (rostral anterior, caudal anterior, posterior, and isthmus regions) occurred 2 weeks after admission to the detoxification unit. The Childhood Trauma Questionnaire (CTQ) was used to assess ELS, and the Addiction Severity Index (ASI) was performed to evaluate drug use patterns. The cingulate regions with significant group differences and with significant associations with CTQ score were inserted in a mediation model in which lifetime cocaine consumption, CTQ score, and CT were, respectively, the independent variable, intermediary variable, and outcome. Group comparisons revealed significant differences in 6 regions out of 8, showing significantly lower CT in the CUD group compared with the HC group. Negative correlations were found between CTQ score and isthmus cingulate (right hemisphere), and with rostral anterior cingulate (left hemisphere). In the mediation analysis, we found a negative significant direct effect of cocaine consumption on isthmus cingulate and an indirect effect of cocaine consumption mediated by CTQ score, suggesting partial mediation. This supports the role of ELS as a key environmental stressor that influences brain developmental trajectories associated with drug addiction.