Cognitive, imaging, and psychiatric changes associated with chronic toluene use: case report and literature review

Abstract

Inhalant misuse and inhalant use disorder are global public health concern that impacts adolescents but can occur throughout life. Toluene is the most commonly misused inhalant. Toluene use leads to significant neuroanatomic, cognitive, and psychiatric deficits. The purpose of this study was to review and summarize the effects of toluene and present a case of a middle-aged patient with an inhalant use disorder. A literature review was conducted to evaluate imaging, neurocognitive, and psychiatric consequences of toluene misuse. The common imaging findings amongst those who misuse toluene were cerebral and cerebellar atrophy, ventricular dilation, loss of gray-white matter differentiation, corpus callosum thinning, and diffuse white matter changes. Concerning cognition, toluene misusers were shown to have deficits in intelligence, attention, memory, visuospatial function, and complex cognition. In addition, toluene users also commonly presented with apathy, flat affect, hallucinations, delusions, anxiety, depression, and insomnia. The neuroanatomical, neurocognitive, and psychiatric effects of toluene misuse are profound. These deficits can make inhalant use disorder difficult to treat. Therefore, evidence-based treatments that recognize and address these domain-specific neurocognitive deficits are needed.

Keywords:

• Toluene
• inhalants
• inhalant use disorder
• toluene use disorder
• brain imaging
• cognitive effects
• case report

Acknowledgements

The authors would like to thank Amanda Mendelsohn for the scientific illustrations provided in this paper and Loren Hacket for helping to develop a comprehensive search strategy.

Authors’ contributions

All authors contributed to the design and conception, data collection, manuscript preparation and all revisions.

Disclosure statement

The other authors report no potential conflicts of interest.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.