Summary
For more than a century we have known the deleterious effects of alcohol on the brain regions surrounding the third ventricle and on the cerebellum. But it was only recently that we gained clearer evidence that the cortex is affected as well. Our imaging studies show that brain shrinkage is at least partially reversible once abstinence is maintained. They confirm results obtained in different laboratories from all over the world. Although our data contradict the rehydration hypothesis and thus lend credence to the idea of regeneration and neuroplasticity, the nature of reversibility is still a matter of debate.
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References
Acker C (1986) Neuropsychological deficits in alcoholics, the relative contributions of gender and drinking history. Br J Addict 81: 395–403
Agartz I, Saaf J, Wahlund LO, Wetterberg L (1991) T 1 and T2 relaxation time estimates in the normal human brain. Radiology 181: 537–543
Artmann H, Gall MV, Hacker H, Herrlich J (1981) Reversible enlargement of cerebral spinal fluid spaces in chronic alcoholics. Am J Neuroradiol 2: 23–27
Bergman H, Borg S, Hindmarsh T, Idestrom OM, Mutzell S (1980) Computed tomography of the brain and neuropsychological assessment of male alcoholic patients and a random sample from the general male population. Acta Psychiatr Scand 62 [Suppl 286]: 47–56
Bergman H, Axelsson G, Idestrom CM (1983) Alcohol consumption, neuropsychological status and computer-tomographic findings in a random sample of men and women from the general population. Pharmacol Biochem Behav 18: 501–505
Besson JAO, Glen AIM, Foreman EL, MacDonald A, Smith FW, Hutchison JMS, Mallard JR, Ashcroft GW (1981) Nuclear magnetic resonance observations in alcoholic cerebral disorder and the role of vasopressin. Lancet ii: 923–924
Besson JAO, Crawford JR, Parker DM, Smith FW (1989) Magnetic resonance imaging in Alzheimer's disease, multi-infarct dementia, alcoholic dementia and Korsakoff's psychosis. Acta Psychiatr Scand 80: 451–458
Blum K, Noble EP, Sheridan PJ, Montgomery A, Ritchie T, Jagadeeswaran P, Nogami H, Briggs AH, Cohn JB (1990) Association of human dopamine D2 receptor gene in alcoholism. JAMA 263: 2055–2060
Bottomley PA, Foster TH, Argersinger RE, Pfeifer LM (1984) A review of normal tissue hydrogen NMR relaxation times and relaxation mechanisms from 1-100 MHz: dependence on tissue type, NMR frequency, temperature, species, excision, and age. Med Phys 11: 425–448
Carlen PL, Wortzman G, Holgate RC, Wilkinson DA, Rankin JG (1978) Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. Science 200: 1076–1078
Carlen PL, Wilkinson DA, Wortzman G, Holgate R (1984) Partially reversible cerebral atrophy and functional improvement in recently abstinent alcoholics. Can J Neurol Sci 11: 441–446
Charness M, DeLaPaz R (1987) Mamillary body atrophy in Wernicke's encephalopathy: antemortem identification using magnetic resonance imaging. Ann Neurol 22: 595–600
Charness ME, Gordon AS, Diamond I (1983) Alcohol produces acute and chronic changes in opiate receptors which may correspond to intoxication, tolerance and withdrawal. Neurology 33 [Suppl 2]: p 175
Chick JD, Smith MA, Engleman HM, Kean DM, Mander AJ, Douglas RHB, Best JJK (1989) Magnetic resonance imaging of the brain in alcoholics: cerebral atrophy, lifetime alcohol consumption, and cognitive deficits. Alcoholism: Clin Exp Res 13: 512–518
Claus D, Wille H, Neundörfer B, Gmelin E (1987) Ist die Zunahme des Hirnvolumens abstinenter Alkoholiker Rehydratationsfolge? Klin Wochenschr 65: 185–193
Courville CB (1955) Effects of alcohol on the nervous system of man. San Lucas Press, Los Angeles
de la Monte SM (1988) Disproportionate atrophy of cerebral white matter in chronic alcoholics. Arch Neurol 45: 990–992
Edwards G, Gross MM (1977) Alcohol dependence: provisional description of a clinical syndrome. Br Med J 1: 1058–1061
Ferrer I, Fabregues I, Rairiz J, Galofre E (1986) Decreased numbers of dendritic spines on cortical pyramidal neurons in human chronic alcoholism. Neurosci Lett 69: 115–119
Frezza M, diPadova C, Pozzato G, Terpin M, Baraona E, Lieber CS (1990) High blood alcohol levels in women. N Engl J Med 322: 95–99
Glenn SW, Parsons OA, Stevens L (1989) Effects of alcohol abuse and familial alcoholism on physical health in men and women. Health Psychol 8: 325–341
Gurling HMD, Murray RM, Ron MA (1986) Increased brain radiodensity in alcoholism. A co-twin control study. Arch Gen Psychiatry 43: 764–767
Harper C, Kril J (1989) Patterns of neuronal loss in the cerebral cortex in chronic alcoholic patients. J Neurol Sci 92: 81–89
Harper C, Corbett D (1990) Changes in the basal dendrites of cortical pyramidal cells from alcoholic patients — a quantitative Golgi study. J Neurol Neurosurg Psychiatry 53: 856–861
Harper C, Kril J, Daly J (1987) Are we drinking our neurones away? Br Med J 294: 534–536
Harper CG, Kril JJ, Daly JM (1988) Brain shrinkage in alcoholics is not caused by changes in hydration: a pathological study. J Neurol Neurosurg Psychiatry 51: 124–127
Hochla NA, Parsons OA (1982) Premature aging in female alcoholics. A neuropsychological study. J Nerv Ment Dis 170: 241–245
Jacobson R (1986) The contributions of sex and drinking history to the CT brain scan changes in alcoholics. Psychol Med 16: 547–559
Jensen G, Pakkenberg B (1993) Are alcoholics drinking their neurons away? Lancet: 1201–1204
Jernigan TL, Butters N, DiTraglia G, Schafer K, Smith T, Irwin M, Grant I, Schuckit M, Cermak LS (1991) Reduced cerebral grey matter observed in alcoholics using magnetic resonance imaging. Alcoholism: Clin Exp Res 15: 418–427
Jones-Saumty DJ, Fabian MS, Parsons OA (1981) Medical status and cognitive functioning in alcoholic women. Alcoholism 5: 372–377
Korsakoff SS (1887) Disturbance of psychic function in alcoholic paralysis and its relation to the disturbance of the psychic sphere in multiple neuritis of non-alcoholic origin. Vestn Klin Sudebnoi Psychiatr Nevropatol 4, 2
Krieg J-C, Lauer C, Pirke K-M (1989) Structural brain abnormalities in patients with bulimia nervosa. Psychiatry Res 27: 39–48
Kroft CL, Gescuk B, Woods BT, Mello NK, Weiss RD, Mendelson JH (1991) Brain ventricular size in female alcoholics.— An MRI study. Alcohol 8: 31–34
Lieber CS (1989) Alcohol and nutrition: an overview. Alcohol Health Res World 13: 197–205
Lim KO, Pfefferbaum A (1989) Segmentation of MR brain images into cerebrospinal fluid spaces, white and gray matter. J Comput Assist Tomogr 13: 588–593
Lim KO, Zipursky RB, Murphy GM, Pfefferbaum A (1990) In vivo quantification of the limbic system using MRI: effects of normal aging. Psychiatry Res Neuroimaging 35: 15–26
Lishman WA (1990) Alcohol and the brain. Br J Psychiatry 156: 635–644
Littleton J (1978) Alcohol and neurotransmitters. Clin Endocrinol Metab 7: 369–384
MacDonald HL, Bell BA, Smith MA, Kean DM, Tocher JL, Douglas RHB, Miller JD, Best JJK (1986) Correlation of human NMR T l values measured in vivo and brain water content. Br J Radiol 59: 355–357
Mander AJ, Young A, Chick JD, Ridgway J, Best JJK (1989) NMR T l relaxation time of the brain during alcohol withdrawal and its lack of relationship with symptom severity. Br J Addict 84: 669–672
Mann K (1992) Alkohol und Gehirn — über strukturelle und funktioneile Veränderungen nach erfolgreicher Therapie. Springer, Berlin Heidelberg New York Tokyo
Mann K, Bartels M (1992) The impact of magnetic resonance imaging and magnetic resonance spectroscopy on psychiatry. Fortschr Neurol Psychiat 60: 308–314
Mann K, Opitz H, Petersen D, Schroth G, Heimann H (1989) Intracranial CSF-volumetry in chronic alcoholics: studies with MRI and CT. Psychiatry Res 29: 277–279
Mann K, Schroth G, Stetter F, Schied H, Bartels M, Batra A, Heimann H (1991) Thia-minmangel und Hirnatrophie bei Alkoholabhängigen. Nervenarzt 62: 177–181
Mann K, Batra A, Günther A, Schroth G (1992) Do women develop alcoholic brain damage more readily than men? Alcohol Clin Exp Res 16: 1052–1056
Mann K, Mundle G, Längle G, Petersen D (1993) The reversibility of alcoholic brain damage is not due to rehydration: a CT study. Addiction 88: 649–653
Mann K, Dengler W, Klose U, Nägele T, Petersen D, Schmid H, Schroth G (1993) Liquorvolumetrie und spektroskopische T l-Messungen — eine MR-Verlaufsstudie bei Alkoholabhängigen. In: Baumann P (Hrsg) Biologische Psychiatrie der Gegenwart. Springer, Wien New York, pp 547–550
Mann K, Dengler W, Klose U, Nägele T, Mundle G (1994) MR spectroscopy in alcoholics. No shift of brain water in abstinence. Alcohol Clin Exp Res 18, 2: 35 (abstract)
Mayes AR, Meudell PR, Mann D, Pickering A (1988) Locations of the lesions in Korsakoff s syndrome: neuropathological data on two patients. Cortex 24: 367–388
Melgaard B, Danielsen UT, Sörensen H, Ahlgren P (1986) The severity of alcoholism and its relation to intellectual impairment and cerebral atrophy. Br J Addict 81: 77–80
Muuronen A, Bergman H, Hindmarsh T, Telakivi T (1989) Influence of improved drinking habits on brain atrophy and cognitive performance in alcoholic patients: a 5-year follow-up study. Alcohol Clin Exp Res 13: 137–141
Pentney RJ, Quackenbush LJ (1990) Dendritic hypertrophy in Purkinje neurons of old Fischer 344 rats after long-term ethanol treatment. Alcohol Clin Exp Res 14: 878–886
Pfefferbaum A, Zatz L, Jernigan TL (1986) Computer-interactive method for quantifying cerebrospinal fluid and tissue in brain CT scans: effects of aging. J Comput Assist Tomogr 10: 571–578
Pfefferbaum A, Rosenbloom MJ, Crusan K, Jernigan TL (1988) Brain CT changes in alcoholics. The effects of age and alcohol consumption. Alcohol Clin Exp Res 12: 81–87
Popova EN, Frumkina LE (1985) Changes in neurons and interneural connections of the higher sections of the motor system in the progeny of alcoholized male and female rats. Neurosci Behav Physiol 15: 476–479
Pratt OE, Rooprai HK, Shaw GK, Thomson AD (1990) The genesis of alcoholic brain tissue injury. Alcohol Alcohol 25: 217–230
Roach MK (1979) Changes in the activity of NA+/K+-ATPhase during acute and chronic administration of ethanol. In: Majchrowicz E, Noble EP (eds) Biochemistry and pharmacology of ethanol. Plenum Press, New York, pp 67–80
Ron MA (1983) The alcoholic brain: CT and psychological findings. Psychol Med (Monogr Suppl) 3: 1–33
Ron MA, Acker W, Shaw GK, Lishman WA (1982) Computerized tomography of the brain in chronic alcoholism. A survey and follow-up study. Brain 105: 479–514
Schmidt C, Klee L, Ames G (1990) Review and analysis of literature on indicators of women's drinking problems. Br J Addict 85: 179–192
Schroth G, Mann K (1989) Computertomographische und Kernspintomographie in der klinischen Diagnostik und Erforschung der Alkoholkrankheit. In: Schied HW, Heimann H, Mayer K (Hrsg) Der Chronische Alkoholismus. Gustav Fischer, Stuttgart, pp 121–140
Schroth G, Remmes U, Schupmann A (1985) Computertomographische Verlaufsuntersuchung von Hirnvolumenschwankungen vor und nach Alkoholentzugsbehandlung. Fortschr Röntgenstrahlkunde 142: 363–369
Schroth G, Naegele T, Klose U, Mann K, Petersen D (1988) Reversible brain shrinkage in abstinent alcoholics, measured by MRI. Neuroradiology 30: 121–126
Scitz HK, Egerer G, Simanowski UA, Waldherr R, Eckey R, Agarwal DP, Goedde HW, von Wartburg JP (1993) Human gastric alcohol dehydrogenase activity: effect of age, sex, and alcoholism. GUT 34: 1433–1437
Shear PK, Jernigan TL, Butters N, Cermak LS (1992) MRI examinations of regional brain volumes in chronic alcoholics (Abstract). 31st Annual Meeting of American College of Neuropsychopharmacology (Abstracts, p 55)
Smith MA, Chick J, Kean DM, Douglas RHB, Singer A, Kendell R, Best JJK (1985) Brain water in chronic alcoholic patients measured by magnetic resonance imaging. Lancet 1: 1273–1274
Smith MA, Chick JD, Engleman HM, Kean DM, Mander AJ, Douglas RHB (1988) Brain hydration during alcohol withdrawal in alcoholics measured by magnetic resonance imaging. Drug Alcohol Depend 21: 25–28
Terry RD, Hansen LA (1987) Neocortical cell counts in normal human adult aging. Ann Neurol 21: 530–539
Terry RD, Peck A, DeTeresa R, Schechter R, Horoupian DS (1981) Some morphological aspects of the brain in senile dementia of the Alzheimer type. Ann Neurol 10: 184–192
Van Thiel DH, Gavaler JS (1988) Ethanol metabolism and hepatotoxicity: does sex make a difference? In: Galanter M (ed) Recent developments in alcoholism. Plenum Press, New York, pp 291–304
Victor M, Adams RE, Collins GH (1971) The Wernicke-Korsakoff Syndrome. Davis, Philadelphia
Walsh KW (1985) Understanding brain damage. A primer of neuropsychological evaluation. Churchill Livingstone, Edinburgh
Wernicke C (1881) Lehrbuch der Gehirnkrankheiten für Ärzte und Studierende, Fischer, Kassel Berlin
Zipursky RB, Lim KO, Pfefferbaum A (1989) MRI study of brain changes with shortterm abstinence from alcohol. Alcohol Clin Exp Res 13: 664–666
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Mann, K., Mundle, G., Strayle, M. et al. Neuroimaging in alcoholism: CT and MRI results and clinical correlates. J. Neural Transmission 99, 145–155 (1995). https://doi.org/10.1007/BF01271475
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DOI: https://doi.org/10.1007/BF01271475