Central Nervous System Alterations in Alcohol Abuse

Büttner, Andreas; Weis, Serge

doi:10.1007/978-1-59745-110-9_5

Cited by 8 publications

(12 citation statements)

References 130 publications

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“…Therefore, despite a large body of literature on animal models, the following review will focus on the relevant human CNS findings. The pharmacology and CNS alterations in alcohol and nicotine abuse are reviewed elsewhere [3,24–27].…”

Section: Introductionmentioning

confidence: 99%

Review: The neuropathology of drug abuse

Büttner

2011

Neuropathology and Applied Neurobiology

151

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Drug abuse represents a significant health issue. The major substances abused include cannabis, opiates, cocaine, amphetamine, methamphetamine and 'ecstasy'. Alterations of intracellular messenger pathways, transcription factors and immediate early genes within the brain reward system seem to be fundamentally important for the development of addiction and chronic drug abuse. Genetic risk factors and changes in gene expression associated with drug abuse are still poorly understood. Besides cardiovascular complications, psychiatric and neurologic symptoms are the most common manifestations of drug toxicity. A broad spectrum of changes affecting the central nervous system is seen in drug abusers. The major findings result from the consequences of ischaemia and cerebrovascular diseases. Except for a few observations of vasculitis, the aetiology of these cerebrovascular accidents is not fully understood. The abuse of amphetamine, methamphetamine and MDMA has been related to neurotoxicity in human long-term abusers and to the risk of developing Parkinson's disease. However, whether such neurotoxicity occurs remain to be established. Systematic histological, immunohistochemical and morphometric investigations have shown profound morphological alterations in the brains of polydrug abusers. The major findings comprise neuronal loss, neurodegenerative alterations, a reduction of glial fibrillary acidic protein-immunopositive astrocytes, widespread axonal damage with concomitant microglial activation as well as reactive and degenerative changes of the cerebral microvasculature. These observations demonstrate that drugs of abuse initiate a cascade of interacting toxic, vascular and hypoxic factors, which finally result in widespread disturbances within the complex network of central nervous system cell-to-cell interactions.

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Section: Introductionmentioning

confidence: 99%

Review: The neuropathology of drug abuse

Büttner

2011

Neuropathology and Applied Neurobiology

151

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“…The disorder appears to be caused in some cases by an electrolyte disturbance in the sense of hyponatremia and by its rapid clinical correction [1,3]. Pathological conditions frequently associated with hyponatremia are (alcoholic) liver damage, extensive skin burns, inappropriate secretion of antidiuretic hormone, psychogenic polydipsia, malnutrition (anorexia and bulimia), sepsis, HIV infection and autoimmune diseases [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…CPM is a monophasic demyelinating disease predominantly involving the central portion of the base of the pons [1]. First described by Adams and colleagues in 1959, the first patients reported had a history of long-standing alcohol abuse and malnutrition [2].…”

Section: Discussionmentioning

confidence: 99%

Central pontine myelinolysis

Fersini

Govi

Tsokos

2014

Forensic Sci Med Pathol

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A 45-year-old woman was found dead on a sofa in her flat by her male partner. She was known as a chronic alcoholic with nearly three decades of heavy alcohol abuse and more than 40 clinical treatments for alcohol withdrawal in her previous medical history. Because of the young age of the deceased, the unknown circumstances surrounding her death and both an undetermined cause and manner of death, a medicolegal autopsy was performed.External examination of the body showed an overweight adult female (body mass index: 29) without any external injuries. At autopsy, all inner organs appeared pale. Several mucosal lacerations of the lower esophagus were present. 150 ml of bloody fluid were found in the stomach. A large amount of tarry stool was present in the small and large bowel. In addition, edema of the lungs and fatty liver were seen. The most remarkable finding was a region of gray and light brownish discoloration, measuring 1 cm in diameter, that was located in the middle of the base of the pons within the brainstem, corresponding to central pontine myelinolysis (CPM) (Figs. 1, 2). Histology of the pons lesion verified the diagnosis of CPM by revealing demyelinization with reactive astrocytes and large numbers of foamy lipid-laden macrophages and scanty lymphocytes (Figs. 3, 4).Toxicology results were negative for both alcohol and drugs.Death was attributed to exsanguination due to MalloryWeiss syndrome of the lower esophagus.

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“…Neuropathological changes have been reported to occur in up to 70% of alcoholics (5). The alterations are mainly caused by long-standing heavy alcohol consumption with or without coexisting nutritional or vitamin deficiencies (6–9). The toxic and metabolic effects of alcohol vary with brain region, age, dose, and duration of exposures.…”

Section: Introductionmentioning

confidence: 99%

Neuropathology of Chronic Alcohol Abuse

Büttner

2014

Academic Forensic Pathology

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Alcohol abuse and dependence are serious public health problems worldwide, resulting in significant morbidity, mortality, and legal implications. Therefore, sudden unexpected, suspicious, or violent death in alcohol consuming persons are frequently seen in the forensic setting. Alcohol-induced brain damage is predominantly caused by nutritional deficiencies and repeated withdrawal syndrome. Brain lesions associated with heavy alcohol consumption include brain atrophy, hepatic encephalopathy, and central pontine myelinolysis. In addition, the dementing conditions Wernicke-Korsakoff syndrome, acquired hepatocerebral degeneration, Marchiafava-Bignami disease, and pellagrous encephalopathy are closely associated with chronic alcohol consumption. In neuroradiological and autopsy studies, cerebral and cerebellar atrophy has been demonstrated in alcoholics. There is a regional selectivity, with the frontal lobes being particularly affected. Moreover, a disproportionate loss of cerebral white matter relative to cerebral cortex suggests that a major neurotoxic effect of chronic alcohol consumption predominantly affects the white matter.

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Central Nervous System Alterations in Alcohol Abuse

Cited by 8 publications

References 130 publications

Review: The neuropathology of drug abuse

Review: The neuropathology of drug abuse

Central pontine myelinolysis

Neuropathology of Chronic Alcohol Abuse

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