Cerebral atrophy and functional deficits in alcoholics without clinically apparent liver disease

Carlen, Peter L.; Wilkinson, D. Adrian; Wortzman, G; Holgate, Richard C.; Cordingley, Jeremy; Lee, M. A.; Huszár, L.; Möddel, Gabriel; Singh, Ruchi; Király, László; Rankin, James G.

doi:10.1212/wnl.31.4.377

Cited by 67 publications

(27 citation statements)

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“…In the present study, patients with good compliance showed significant cerebral reex pansion, but those with poor compliance did not, suggesting that abstinence from alcohol plays a major role in reexpansion of brain volume. Wilkinson and Carlen (1980) reported that alco holic patients with WKS showed more severe ce rebral atrophy than those without WKS; however, Carlen et al (1981) were unable to find significant correlations between cerebral atrophy and thiamine intake. In addition, all patients with chronic mal nutrition may show reexpansion of the brain during treatment by restitution of cerebral blood volume and extracellular and intracellular electrolytes.…”

Section: Brain Atrophy In Chronic Alcoholism and Wksmentioning

confidence: 91%

Cerebral Atrophy and Hypoperfusion Improve during Treatment of Wernicke-Korsakoff Syndrome

Meyer

Tanahashi

Ishikawa

et al. 1985

J Cereb Blood Flow Metab

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Nineteen patients with sudden onset of impaired recent memory, cerebellar ataxia, peripheral neuropathy, and other signs of Wernicke-Korsakoff syndrome (WKS) were treated and examined prospectively for 3 months. Serial studies included histories, neurological examinations, cognitive capacity screening examinations (CCSE), computed tomography (CT) scans, and measurements of regional CBF. Patients were detoxified and withdrawn from sedatives before CBF measurements were examined. Treatment included alcohol withdrawal, nutritious diet, and 300 mg thiamine daily. Before treatment CCSE scores and blood flow values of both white and gray matter were reduced, particularly within both temporoparietal regions. After treatment of compliant patients (n = 10), white and gray matter blood flow increased concurrently with improved CCSE scores. Abnormal eye signs, ataxia, peripheral neuropathy, and performance of activities of daily living also improved. Cerebral atrophy and ventricular enlargement measured by CT decreased. Early recognition and treatment of WKS in compliant patients permit rapid reversals of cognitive and neurological impairments associated with increased blood flow of gray and white matter and improvements of brain atrophy measured by CT scanning.

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Section: Brain Atrophy In Chronic Alcoholism and Wksmentioning

confidence: 91%

Cerebral Atrophy and Hypoperfusion Improve during Treatment of Wernicke-Korsakoff Syndrome

Meyer

Tanahashi

Ishikawa

et al. 1985

J Cereb Blood Flow Metab

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show abstract

“…Brain atrophy is reported to be affected by such factors as chronic alcoholism, 23 smoking, 24 glucocorticoid therapy, 25 and hypertension. 10 Only 2 subjects in the hypertensive group and 1 subject in the normotensive group were chronic alcoholics, so the influence of alcohol on brain atrophy could not be evaluated.…”

Section: Factors Affecting Brain Atrophymentioning

confidence: 99%

Relationship Between Brain Atrophy Estimated by a Longitudinal Computed Tomography Study and Blood Pressure Control in Patients With Essential Hypertension

et al. 1999

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ith the increase in the elderly population, the cause and treatment of senile dementia have become important issues. Because the severity of dementia is correlated with dilatation of the lateral ventricles of the brain, 1,2 it is important to evaluate the degree of brain atrophy. Essential hypertension is a risk factor for brain atrophy, 3,4 so the control of blood pressure is considered important in elderly patients with hypertension. Meta-analysis of published studies on the treatment of hypertension has shown that the control of hypertension in the elderly reduces the mortality rate. 5,6 However, the lower end of the autoregulation curve of cerebral blood flow in hypertensive patients was shifted to the right as compared with that of normotensive subjects. It has been suggested that an excessive reduction in blood pressure reduces the cerebral blood flow and increases the risk of cerebrovascular disorders. [7][8][9] In the final stage of age-related brain atrophy, the reduction in cerebral blood flow is considered to correspond with the age-related loss of brain substance, a decrease in cerebral metabolism, and an adaptation to Japanese Circulation Journal Vol.63, February 1999 diminished metabolic demands. 10 The present study evaluated retrospectively the relationship between the extent of blood pressure control and the progression of brain atrophy in hypertensive patients of different ages. We also evaluated the effects of blood pressure control on the change in brain atrophy and on blood volume in the common carotid artery. Methods Study PopulationBetween September 1977 and August 1980, the caudate head index (CHI) from brain computerized tomography (CT) and the common carotid blood volume (BF) were evaluated in 143 individuals with essential hypertension who were outpatients at the Oyodo Municipal Hospital. Of that number, 68 patients underwent serial measurements of CHI and BF. The following data were collected from the medical records of each patient: age, sex, history of smoking, use of alcohol and history of chronic alcoholics (>150 g of absolute ethanol on average for 10 years), history of diabetes mellitus, history of ischemic heart disease, history of stroke, fasting serum level of total cholesterol, fasting serum level of total triglycerides, fasting serum level of blood sugar, use of antihypertensive Jpn Circ J 1999; 63: 79 -84 (Received May 11, 1998; revised manuscript received September 17, 1998; accepted October 26, 1998 To evaluate the relationship between blood pressure control and the progression of brain atrophy in the elderly, patients with essential hypertension and brain atrophy were longitudinally evaluated using computerized tomography (CT) . The study evaluated 48 patients with essential hypertension aged 46-78 years, and 30 sex-and agematched normotensive control subjects. The extent of brain atrophy as determined by caudate head index (CHI) , the inverse cella media index (iCMI), and Evans'ratio (ER) was estimated twice at an interval of 5-9 years (mean, 6.9 years). The mean a...

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“…Ventricular dilation and cortical atrophy Ishii, 1983;Carlen et al, 1981] are common findings in computerized tomography studies, and postmortem brain weight reduction [Harper and Blumbergs, 1982;Harper et al, 1985;Torvik, 1987], selective loss of white matter and enlargement of the ventricles [Harper et al, 1985[Harper et al, , 1990De la Monte, 1988] have been found in neuropathological studies on the alcoholic brain. The computerized tomographic and neuropathological findings are supported by magnetic resonance imaging studies [Schroth et al, 1988;Jernigan et al, 1991;Shear et al, 1994;Pfefferbaum et al, 1995;Ragan et al, 1999].…”

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confidence: 99%

Acute and Chronic Effects of Alcohol on Preattentive Auditory Processing as Reflected by Mismatch Negativity

et al. 2000

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Chronic alcoholism, a major worldwide health problem, is associated with a variety of neurocognitive changes in the afflicted individuals. The precise neurophysiological basis of these changes is not yet understood. Mismatch negativity (MMN) is a preattentive event-related potential component indexing cortical auditory memory traces and automatic change detection in the brain that can be used to study the neural basis of cognitive impairments in various neurodegenerative diseases. MMN studies have revealed that even a low dose of acute alcohol significantly impairs automatic change detection and involuntary attention shifting. Recent MMN results on chronic alcoholism in turn suggest that auditory sensory traces decay slightly faster and are substantially more vulnerable to the distracting effect of backward masking in alcoholics than in healthy subjects. Furthermore, chronic alcohol abuse might accelerate the age-related impairment of automatic change detection. There is also evidence that the MMN changes might predict impaired performance in behavioral memory and attention tasks in alcoholics. In MMN studies of detoxified alcoholics, however, many confounding factors have to be taken into account. For instance, postwithdrawal brain hyperexcitability might be associated with a slightly enhanced or accelerated MMN/MMNm (the magnetic equivalent of MMN). In sum, MMN and MMNm provide an objective noninvasive tool for exploring the neurophysiological functional deficits related to both acute alcohol intoxication and chronic alcoholism.

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Cerebral atrophy and functional deficits in alcoholics without clinically apparent liver disease

Cited by 67 publications

References 0 publications

Cerebral Atrophy and Hypoperfusion Improve during Treatment of Wernicke-Korsakoff Syndrome

Cerebral Atrophy and Hypoperfusion Improve during Treatment of Wernicke-Korsakoff Syndrome

Relationship Between Brain Atrophy Estimated by a Longitudinal Computed Tomography Study and Blood Pressure Control in Patients With Essential Hypertension

Acute and Chronic Effects of Alcohol on Preattentive Auditory Processing as Reflected by Mismatch Negativity

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