Brain atrophy and cognitive function in older abstinent alcoholic men

Abstract

We used computer-aided magnetic resonance image analysis and an age-normed battery of neuropsychological tests to measure brain atrophy and cognitive function in 14 older abstinent alcoholic men and 11 older controls in the expectation that these subject groups would show the greatest and most persistent cerebral effects consequent to chronic alcoholism. The abstinent alcoholics exhibited cognitive impairments (primarily in memory and visual-spatial-motor skills) compared with the controls. In contrast, we found no difference in global cerebral atrophy between the groups, although two alcoholics had extensive atrophy compared with all other subjects. However, there was a stronger association between age and ventricular dilation in the alcoholic sample compared with controls. We conclude that a substrate other than magnetic resonance imaging-detectable global atrophy must underlie the persistent cognitive impairments evident in the sampled alcoholics. Furthermore, if there are global atrophic changes in the brain associated with chronic alcoholism, these effects are not ubiquitous and/or may be reversible in most patients with sufficient abstinence.

Fig. 1

Segmentation of magnetic resonance images. Segmented image shows white matter with an abnormally high signal in the areas below the occipital horns of the lateral ventricles.

Fig. 2

GIR scores from controls and alcoholics. Alcoholics have much higher GIR scores than controls.

Fig. 3

Ventricular and sulcal CSF volumes as a percentage of total brain volume for controls and alcoholics. There is no significant difference in ventricular or sulcal volumes between groups. Two alcoholics have ventricular atrophy 40% and 82% greater than any control.

Fig. 4

Ventricular volume (as a percentage of total brain volume) versus age. The association between age and ventricular dilation is stronger in alcoholics than in controls. ○, older alcoholics; ●, controls.