Vermal atrophy of alcoholics correlate with serum thiamine levels but not with dentate iron concentrations as estimated by MRI

Abstract

Chronic alcohol consumption is frequently accompanied by cerebellar degeneration. The exact aetiology of alcoholic cerebellar degeneration is still a matter of debate. The aim of the present study was to investigate whether patients with chronic alcohol consumption exhibit a decrease in dentate nuclei intensity as measured by MRI, and if so, whether this decrease correlates with cerebellar atrophy as revealed by MR imaging or with clinical signs of cerebellar ataxia. A decrease in dentate nuclei intensity would indirectly indicate that iron accumulation, and therefore, oxidative stress may play a role in alcoholic cerebellar degeneration. MRI of 45 alcoholics and 44 age and sex-matched healthy control subjects was performed using a 3D-T1-weighted fast low angle shot (FLASH) echo sequence. Signal intensities of the dentate nuclei and cerebellar white matter were bilaterally measured. Planimetric measurements of cerebellar size were performed using a 3D-T1-weighted magnetization prepared rapid acquisition gradient echo (MPRAGE) sequence. Results demonstrated that dentate nuclei intensity was not significantly decreased in patients with chronic alcohol consumption (mean +/- SD signal intensity 65.36 +/- 13.0) if compared with control subjects (mean +/- SD signal intensity 68.95 +/- 9.4) (p = 0.15). Dentate nuclei intensity did not correlate with cerebellar size neither in control subjects nor in alcoholics. In contrast, vitamin B1 level correlated with cerebellar size in alcoholics even if the vitamin B1 concentration was within normal values (r = 0.344, p = 0.028). These results support the view that thiamine deficiency rather than direct neurotoxic effects of alcohol is the main causative factor for the development of alcoholic cerebellar degeneration.

Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy

“…Furthermore, vitamin B 1 deficiency is a rare condition in developed countries. Apart from unbalanced diet or certain diseases, alcohol consumption, which was more prevalent in the control group of this study, is usually associated with thiamine deficiency [50]. Low plasma thiamine levels have been linked to an increase in sVCAM-1 (a marker of endothelial dysfunction) in patients with type 1 and type 2 diabetes [14].…”

Magnetic resonance imaging in occupational chronic solvent encephalopathy

“…It is generally thought that cerebellar or vermian atrophy has a higher correlation with alcohol intake than other brain areas (Maschke et al 2005;Scroop et al 2002).…”

Thiamine deficiency induces endoplasmic reticulum stress in neurons

“…Taken together, sustained ER stress caused by TD may be a mechanism underlying TD damage. The most commonly acquired degenerative condition affecting the cerebellum is chronic alcoholism (Maschke et al, 2005;Mulholland et al, 2005). Chronic alcohol abuse may cause TD (Victor et al, 1989;Martin et al, 2003).…”