This study will examine the neuropsychological and cerebral perfusion consequences of chronic cocaine abuse in a sample of African-American and Euro-American male and female cocaine abusers. The use of cocaine, particularly in segments of African-American populations, continues to be a major health concern accounting for significant increases in the incidence of medical and neurobehavioral pathology. Moreover, this trend is especially ominous for African-American women, where the rate of addiction and accompanying neuropathologic disturbance may be most pronounced. Concurrent with these observations, a related and rapidly developing body of evidence now suggests that ethnicity and gender may represent important mediators for differential neurobehavioral outcome secondary to cocaine abuse. In the three-year between- and within- subject repeated-measures design we propose here, we will employ selected neuropsychological measures, MRI, and SPECT to perform detailed serial evaluations of the neurocognitive, cerebral blood flow, and neurological status of African-American and Euro-American male and female cocaine abusers between the ages of 21 and 30 at two, five, and eight months post detoxification and treatment for cocaine dependence. These patients will be compared to African-American and Euro-American male and female age matched normal controls.
Specific aims are: (1) to identify and define the variance in response to chronic cocaine use on neuropsychological function and brain perfusion as mediated by ethnicity; and (2) to identify and define the differences to chronic cocaine use on cerebral perfusion and neuropsychological status as a function of gender. In the absence of sufficient evidence no specific hypotheses about gender by ethnicity interactions are offered. However, possible interactive effects on each of the dependent variables will be explored. The proposed study will significantly improve our knowledge of the potential similarities and differences in neurobehavioral pathology among African-American and Euro-American cocaine abusers after a period of prolonged abstinence. Also, the project will generate new information concerning socioenvironmental factors which may influence neuropsychological and neurologic outcomes relative to treatment.
