Screening Tool Identifies Cocaine-Related Brain Changes

Habitual users of the stimulant drug cocaine can experience a number of brain changes that decrease their ability to do such things as form memories, think logically and use language. Doctors can use tests called screening tools or screening procedures to detect the presence of these and other changes in brain function. In a study published in June 2014 in The American Journal of Drug and Alcohol Abuse, researchers from three U.S. institutions evaluated the effectiveness of a screening tool called the Neuropsychological Assessment Battery – Screening Module (S – NAB) in identifying some of the key brain function alterations that can appear in cocaine users.

Cocaine and the Brain

After gaining access to the brain, cocaine creates changes in a part of the brain known as the pleasure center and produces an intense sensation called euphoria. If a person keeps taking the drug repeatedly over time, the short-term pleasure center changes associated with isolated exposure to cocaine can become lasting and set the stage for both physical dependence and cocaine addiction. However, cocaine-related brain change is not limited to the pleasure center. Instead, chronic exposure to the drug has an impact on multiple brain areas and triggers a range of alterations that support ongoing addiction or otherwise impair the day-to-day function of the affected individual. For example, according to the results of a study published in 2014 in the journal Addiction, chronic cocaine use interferes with the ability to maintain behavioral control and increases the brain’s sensitivity to drug use cues. These changes can appear even in people who don’t qualify for a diagnosis of cocaine addiction.

The Neuropsychological Assessment Battery

The Neuropsychological Assessment Battery – Screening Module is part of a larger group of screening procedures, known as the Neuropsychological Assessment Battery or NAB, designed to test the higher-level mental abilities of people affected by substance problems or otherwise susceptible to some form of damage in the central nervous system (brain and spinal cord). All told, the NAB has six modules that contain a total of 33 tests. The NAB – Screening Module is intended to give doctors the basic information needed to identify the potential causes of any damaging changes in brain function and make initial plans for effective treatment. The procedure lasts about 35 to 45 minutes, and it’s typically used when health professionals need a fairly quick, convenient way to assess their clients’/patients’ mental abilities. Specific abilities assessed by the screening tool include memory and language skills, the ability to focus and pay attention, the ability to think logically about visual information and a group of planning, behavioral control and judgment skills collectively referred to as executive function.

Detecting Cocaine-Related Brain Changes

In the study published in The American Journal of Drug and Alcohol Abuse, researchers from Columbia University’s Mailman School of Public Health, Columbia University Medical Center and the New York State Psychiatric Institute tested the relative effectiveness of the NAB – Screening Module with the help of 145 adults seeking treatment for their cocaine use. All of these individuals took part in the screening procedure and also answered questionnaires that let them evaluate their own mental skill levels. The study participants were mostly male and African American, although women and people from other racial/ethnic backgrounds were also involved.

Using the S – NAB as a benchmark, the researchers concluded that 44 percent of the study participants had changes in brain function that were significant enough to qualify as a form of meaningful brain impairment. After evaluating the areas of brain function probed by the screening procedure, they also concluded that cocaine use appears to produce a greater degree of memory-related impairment than either visual logic impairment or language skill impairment.

The study’s authors note that the areas of cocaine-related brain impairment identified through use of the Neuropsychological Assessment Battery – Screening Module are in line with the areas of impairment identified with other widely used assessment tools. They also note that the impairments they identified are similar to the impairments found in users of other substances who took the S – NAB. Overall, they believe that the NAB – Screening Module can likely be used in place of other screening procedures for cocaine-related brain impairment, or as part of a larger grouping of screening procedures. These final conclusions specifically apply to detection of the mental skill changes found in adults who use cocaine.