White matter changes caused by chronic solvent abuse

• Published in: American journal of neuroradiology : AJNR Vol. 16; no. 8; pp. 1643 - 1649
• Main Authors: Yamanouchi, N, Okada, S, Kodama, K, Hirai, S, Sekine, H, Murakami, A, Komatsu, N, Sakamoto, T, Sato, T
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.09.1995; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Atrophy; Biological and medical sciences; Brain - drug effects; Brain - pathology; Brain Damage, Chronic - chemically induced; Brain Damage, Chronic - pathology; Brain Stem - drug effects; Brain Stem - pathology; Cerebellum - drug effects; Cerebellum - pathology; Cerebral Cortex - drug effects; Cerebral Cortex - pathology; Chemical and industrial products toxicology. Toxic occupational diseases; Corpus Callosum - drug effects; Corpus Callosum - pathology; Female; Hippocampus - drug effects; Hippocampus - pathology; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Neurologic Examination - drug effects; Research Support, Non-U.S. Gov't; Solvents; Solvents - adverse effects; Substance-Related Disorders - diagnosis; Toluene - adverse effects; Toxicology; Asia; Japan; Human; Nervous system diseases; Toxicity; Encephalopathy; Toluene; Central nervous system disease; Central nervous system; Exploration; Nuclear magnetic resonance imaging; White matter; Cerebral disorder
• ISSN: 0195-6108; 1936-959X

To examine the brain damage of solvent abusers in Japan, where pure industrial toluene is frequently abused. Twenty solvent abusers 17 to 33 years of age with 7.2 +/- 4.0 years of abuse were examined with a 1.5-T MR imaging system. White matter hyperintensities in cerebrum, brain stem, and cerebellum on T2-weighted images were found in seven cases. The extent of white matter change was most clearly shown on proton density-weighted images. The patients with restricted white matter change and intermediate white matter change showed white matter hyperintensities in the brain stem and cerebellum on T2-weighted images, in some cases, with additional hypointensities in the corresponding T1-weighted images. These patients had mainly abused pure toluene. The patients with diffuse white matter change showed obvious brain atrophy, including hippocampal atrophy and thinning of the corpus callosum. These patients had mainly abused lacquer thinner. There are some patients with restricted but severe enough change to cause the neurologic symptoms in specific regions, such as the brain stem and/or cerebellum, before the brain atrophy becomes apparent. This suggests that the restricted white matter change represents not only an early change of diffuse white matter change, but at least in some cases also represents a qualitatively different change than that of diffuse white matter change. We suggest that pure toluene has a possible relation to this qualitative difference.