Lower cortical thickness and increased brain aging in adults with cocaine use disorder.

Background: Cocaine use disorder (CUD) is a global health issue with severe behavioral and cognitive sequelae. While previous evidence suggests a variety of structural and age-related brain changes in CUD, the impact on both, cortical thickness and brain age measures remains unclear. Methods: Derived from a publicly available data set (SUDMEX_CONN), 74 CUD patients and 62 matched healthy controls underwent brain MRI and behavioral-clinical assessment. We determined cortical thickness by surface-based morphometry using CAT12 and Brain Age Gap Estimate (BrainAGE) via relevance vector regression. Associations between structural brain changes and behavioral-clinical variables of patients with CUD were investigated by correlation analyses. Results: We found significantly lower cortical thickness in bilateral prefrontal cortices, posterior cingulate cortices, and the temporoparietal junction and significantly increased BrainAGE in patients with CUD [mean (SD) = 1.97 (±3.53)] compared to healthy controls (p < 0.001, Cohen's d = 0.58). Increased BrainAGE was associated with longer cocaine abuse duration. Conclusion: Results demonstrate structural brain abnormalities in CUD, particularly lower cortical thickness in association cortices and dose-dependent, increased brain age.