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7217820 
Journal Article 
Life-time lead exposure and its association with cognitive function and resting-state connectivity in cocaine addiction 
Zilverstand, A; Horton, M; Colicino, E; Hazeltine, D; Schneider, KM; Alia-Klein, N; Todd, AC; Goldstein, RZ; , 
2019 
Yes 
Biological Psychiatry
ISSN: 0006-3223 
85 
10 
S356-S356 
English 
WOS:000472661000871 
Background: Life-time lead exposure detrimentally impacts cognitive function in the general population. Cognitive function is associated with drug use and predicts initiation and escalation of drug use, length of use and treatment outcomes. The link between life-time lead exposure, cognitive function, its neural correlates and drug use has not been investigated in cocaine-addicted individuals.

Methods
We acquired in vivo tibia lead levels (using x-ray fluorescence), a measure of cognitive function (WAIS Matrix Reasoning) and drug use variables from 20 individuals with Cocaine Use Disorder (iCUD) and 17 healthy controls (HC), matched for gender and race. Age was included as a covariate in all analyses. In a subsample (N=15 iCUD; N=11 HC) that underwent a resting-state functional magnetic resonance imaging scan, we applied Graph theory methods to extract whole-brain resting-state connectivity (Global Efficiency; 638-region parcellation).
Results: Across participants, higher tibia lead levels were associated with lower cognitive function (P=0.009). Within iCUD, lower cognitive function showed a trend for an association with life-time cocaine use (years of use; P=0.05). Whole-brain analysis of resting-state connectivity revealed that across participants higher tibia lead levels were linked to decreased global efficiency, with the largest effects being focused in the ventral basal ganglia (pallidum, putamen; P=0.04, FWE-corrected). In HC, higher efficiency of the ventral basal ganglia was linked to better cognitive function, while there was no such relationship in iCUD.
Conclusions: Higher tibia lead levels were linked to impaired basal ganglia and cognitive function, which in turn was associated with higher drug use, providing a potential mechanism underlying drug use. 
Addiction; lead; cognitive function; resting state fMRI; environmental risk factors 
74th Annual Meeting of the Society-of-Biological-Psychiatry (SOBP) 
Chicago, IL 
May 16-18, 2019