A meta-analysis of tract-based spatial statistics studies examining white matter integrity in cocaine use disorder

Abstract

Tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) studies have consistently shown diminished white matter (WM) integrity for individuals with cocaine use disorder (CUD). The present study used seed-based d mapping (SDM) to determine the extent to which a systematic difference in the WM integrity of cocaine users may exist (as compared with that of healthy controls). Articles from 2006 (when TBSS was first developed) to present were reviewed, with eight selected for inclusion. Meta-analysis found lower fractional anisotropy (FA) in the genu of the corpus callosum for cocaine users, with a small-to-moderate peak effect size (Hedge's g = -0.331). Sensitivity analyses mostly supported the robustness of the obtained difference. Differences detected at exploratory thresholds for significance suggested insult to WM integrity extending beyond the corpus callosum. The present results compliment a previous region-of-interest (ROI)-based meta-analysis of DTI studies in individuals with CUD. These findings have significant implications for the potential role of neuroprotective agents in the treatment of CUD and merit additional iteration as more studies accrue in the literature.

Keywords: cocaine use disorder; diffusion tensor imaging; fractional anisotropy; meta-analysis; seed-based d mapping; tract-based spatial statistics.

Figure 1.. PRISMA flow diagram.

PRISMA flow chart for identifying TBSS studies.

Figure 2.. Lower FA in the corpus callosum of individuals with cocaine use disorder (relative to healthy controls).

Meta-analysis found lower FA across studies in the genu of the corpus callosum for individuals with CUD relative to HC, with a maximum peak difference at MNI coordinates x = −6, y = 24, z = 12.