EEG and evoked potentials alterations in cocaine-dependent individuals.

After two decades of epidemic cocaine use and extensive animal research, what is known about the effects of prolonged exposure to cocaine on the central nervous system (CNS) comes from human findings. Reports of neurological and cerebrovascular infarcts attributed to cocaine abuse and studies investigating CNS function of abstinent cocaine-dependent patients provide important insights into prolonged effects of cocaine on the human brain. The neurological and cerebrovascular infarcts investi-gated include strokes (Sloan and Mattioni 1992), seizures (Holand et al. 1992), transient ischemic attacks (Spivey and Euerle 1990), and headaches (Dhopesh et al. 1990). The studies of abstinent cocaine-dependent patients used neuropsychological evaluations, electroencephalogram (EEG), single photon emission computed tomography (SPECT), and positron emission tomography (PET) methodologies. The neurological infarcts appear to be at the one end of a continuum with subtle, but not trivial, CNS alterations at the other. These alterations, whether residual or permanent, may complicate treatment for cocaine dependence. The importance of treating these alterations needs to be addressed.