151
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Taki Y, Goto R, Evans A, Zijdenbos A, Neelin P, Lerch J, Sato K, Ono S, Kinomura S, Nakagawa M, Sugiura M, Watanabe J, Kawashima R, Fukuda H. Voxel-based morphometry of human brain with age and cerebrovascular risk factors. Neurobiol Aging 2004; 25:455-63. [PMID: 15013566 DOI: 10.1016/j.neurobiolaging.2003.09.002] [Citation(s) in RCA: 149] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2002] [Revised: 06/20/2003] [Accepted: 07/15/2003] [Indexed: 11/26/2022]
Abstract
The objectives of this study were to evaluate the correlations of the volumes of the gray matter and white matter with age, and the correlations of the tissue probabilities of the gray matter and white matter with age and several cerebrovascular risk factors. We obtained magnetic resonance (MR) images of the brain and clinical information from 769 normal Japanese subjects. We processed the MR images automatically by correcting for inter-individual differences in brain size and shape, and by segmenting the MR images into the gray matter and white matter. Volumetry of the brain revealed a significant negative correlation between the gray matter volume and age, which was not observed between white matter volume and age. Voxel-based morphometry showed that age, systolic blood pressure, and alcohol drinking correlated with the regional tissue probabilities of the gray matter and white matter.
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Affiliation(s)
- Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryocho, Aobaku, 980-8575 Sendai, Japan.
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152
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Sullivan EV. Compromised pontocerebellar and cerebellothalamocortical systems: speculations on their contributions to cognitive and motor impairment in nonamnesic alcoholism. Alcohol Clin Exp Res 2004; 27:1409-19. [PMID: 14506401 DOI: 10.1097/01.alc.0000085586.91726.46] [Citation(s) in RCA: 156] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Corticopontocerebellar and cerebellothalamocortical circuits underlie a wide range of neuropsychological processes compromised by alcoholism. The analyses herein tested whether abnormalities of volumes of brain structures forming nodes of these separate feed-forward and feedback systems are selectively related to each other and whether any of these noncortical regions can account for cognitive and motor deficits occurring as sequelae of chronic alcoholism. METHODS Regional brain measures originated from our prior neuroimaging studies, showing in alcoholics significant volume deficits in the principal structures of interest: cerebellar hemispheres, vermis, pons, and thalamus as well as prefrontal, frontal, and parietal cortex. Neuropsychological functions targeted for analysis-problem solving, visuospatial ability, and static postural stability-showed 0.6 to 1.6 SD deficits in these alcoholic men. RESULTS In alcoholics, the patterns of correlations were consistent with dissociation of thalamic and pontine circuitry. Pontine and thalamic volumes were not correlated with each other. Pontine volumes correlated with white matter volumes of anterior superior vermis and gray and white matter volumes of the cerebellar hemispheres but not with cortical regional volumes. Thalamic volumes correlated with gray matter volumes of the cerebellar hemispheres, parietal cortex, and inferior posterior vermian lobule, which itself correlated with parietal, prefrontal, and frontal cortical volumes. Controls did not show these correlational patterns. Brain structure-function relationships in alcoholics examined with multiple regression identified anterior vermian but not prefrontal or parietal volume as a unique predictor of balance scores; vermian and thalamic but not prefrontal cortical volumes as predictors of card sorting scores; and cerebellar hemispheric white matter but not parietal cortical volume as a predictor of visuospatial ability. CONCLUSIONS Each major node of frontocerebellar circuitry shows volume deficits in alcoholics but can be independently compromised. Disruption of these circuits may underlie alcoholism-related neuropsychological deficits, either by abnormalities present in individual nodes or by disconnection via interruption of selective circuitry.
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Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, California 94305-5723, USA.
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153
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Abstract
It is generally believed that chronic alcohol consumption results in cerebellar atrophy and Purkinje cell loss, especially in the anterior vermal region. A post-mortem stereological design was applied to cerebella from 10 chronic male alcoholics (mean age 45.5 years) with a minimum of 10 years of severe addiction and 10 male controls (mean age 42.5 years). All alcoholics had pathoanatomical evidence of alcohol abuse but no clinical signs of Wernicke's encephalopathy. Cerebellum was divided into five different areas: the anterior and posterior lobe, the anterior and posterior vermis, and the flocculonodular lobe. The total cortex and white matter volume, the cerebellar surface area, the total Purkinje and granule cell number and density, and the mean volume of Purkinje cells and their cell nuclei were measured in all five regions using stereological methods. The volume of the granular layer was increased by 13% with an increase in layer thickness by 17% possibly due to oedema. Globally, the mean volume of the Purkinje cell perikaryon was decreased by 24% with a decrease in the volume of Purkinje cell nuclei by 16%. The increase of the granular layer and the decrease of Purkinje cell size resulted in a 21% global reduction of Purkinje cell density without a concomitant loss of neurons. No significant regional or global cortical and white matter atrophy was found in cerebella from alcoholics compared to controls.
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Affiliation(s)
- Birgitte Bo Andersen
- Research Laboratory for Stereology and Neuroscience, Bispebjerg University Hospital, Copenhagen, Denmark.
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154
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Harper C, Dixon G, Sheedy D, Garrick T. Neuropathological alterations in alcoholic brains. Studies arising from the New South Wales Tissue Resource Centre. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27:951-61. [PMID: 14499312 DOI: 10.1016/s0278-5846(03)00155-6] [Citation(s) in RCA: 163] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alcohol dependence and abuse are among the most costly health problems in the world from both social and economic points of view. Patterns of drinking appear to be changing throughout the world with more women and young people drinking heavily. Excessive drinking can lead to impairment of cognitive function and structural brain changes--some permanent, some reversible. Patterns of damage appear to relate to lifetime alcohol consumption but, more importantly, to associated medical complications. The most significant of these is the alcohol-related vitamin deficient state, the Wernicke-Korsakoff syndrome (WKS), which is caused by thiamin deficiency but is seen most commonly in alcoholics. Careful selection and classification of alcoholic cases into those with and without these complications, together with detailed quantitative neuropathological analyses has provided data that gives clues to the most vulnerable regions and cells in the brain. Brain shrinkage is largely accounted for by loss of white matter. Some of this damage appears to be reversible. Alcohol-related neuronal loss has been documented in specific regions of the cerebral cortex (superior frontal association cortex), hypothalamus and cerebellum. No change is found in basal ganglia, nucleus basalis, or serotonergic raphe nuclei. Many of these regions which are normal in uncomplicated alcoholics are damaged in those with the WKS. Dendritic and synaptic changes have been documented in alcoholics and these, together with receptor and transmitter changes, may explain functional changes and cognitive deficits, which precede more severe structural neuronal changes. A resource to provide human brain tissues for these types of studies has been developed at the University of Sydney--the New South Wales Tissue Resource Centre. The aim of this facility is to provide research groups throughout the world with fresh and/or frozen tissues from well-characterized cases of alcohol-related brain damage and matched controls. The development of new technologies in pathology and molecular biology means that many more questions can be addressed using appropriately stored human brain tissues. Examples of the application of some of these techniques, involving neurochemical, neuropharmacological, neuroimaging and gene expression studies are included in this paper. Important public health outcomes have arisen from some of these studies including the enrichment of bread flour with thiamin for the whole of Australia. Researchers with an interest in alcohol studies can access tissues from this brain bank.
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Affiliation(s)
- Clive Harper
- Department of Neuropathology, Institute for Clinical Neurosciences, Central Sydney Area Health Service, Camperdown, NSW, Australia.
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155
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De Rosa E, Sullivan EV. Enhanced release from proactive interference in nonamnesic alcoholic individuals: implications for impaired associative binding. Neuropsychology 2003; 17:469-81. [PMID: 12959513 DOI: 10.1037/0894-4105.17.3.469] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Proactive interference (PI) occurs when previously learned information reduces the ability to acquire new, related information. Given that PI is modulated by the cholinergic system in rats (E. De Rosa & M. E. Hasselmo, 2000) and that chronic alcohol dependence disrupts cholinergic function in rats and humans, associative properties of PI in patients with alcoholism were examined. It was hypothesized that normal PI contingencies would be disrupted in alcoholic participants. When tested with a paired-associate simultaneous discrimination paradigm, analogous to that used in the rat model, alcoholic participants showed significantly less PI than controls yet performed comparably on a control response reversal task. The absence of PI in alcoholic participants may reflect impaired configural binding of paired-associate stimuli while sparing the elemental ability to process each stimulus component.
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Affiliation(s)
- Eve De Rosa
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA.
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156
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Lahuis B, Kemner C, Van Engeland H. Magnetic resonance imaging studies on autism and childhood-onset schizophrenia in children and adolescents - a review. Acta Neuropsychiatr 2003; 15:140-7. [PMID: 26983357 DOI: 10.1034/j.1601-5215.2003.00021.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To find out whether the neurodevelopmental disorders autism and childhood-onset schizophrenia have a common developmental pathway and whether the abnormalities detected are 'disorder-specific', by reviewing magnetic resonance imaging (MRI) studies. METHODS As a result of a Medline search, we were able to access 28 studies on autism and 12 studies on childhood-onset schizophrenia, which focused on children and adolescents. RESULTS Larger lateral ventricles were found to be a common abnormality in both disorders. 'Disorder-specific' abnormalities in patients with autism were larger brains, a larger thalamic area, and a smaller right cingulate gyrus. Subjects with childhood-onset schizophrenia were found to have smaller brains, a smaller amygdalum and thalamus, and a larger nucleus caudatus. In subjects with childhood-onset schizophrenia, abnormalities appeared to progress over a limited period of time. CONCLUSIONS Because the study designs varied so much, the results should be interpreted cautiously. Before abnormalities found in the disorders can be designated as equal or 'disorder-specific', it will be essential to perform large longitudinal and cross-sectional follow-up studies.
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Affiliation(s)
- Bertine Lahuis
- 1Department of Child and Adolescent Psychiatry, University of Utrecht, the Netherlands
| | - Chantal Kemner
- 1Department of Child and Adolescent Psychiatry, University of Utrecht, the Netherlands
| | - Herman Van Engeland
- 1Department of Child and Adolescent Psychiatry, University of Utrecht, the Netherlands
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157
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Rupp CI, Kurz M, Kemmler G, Mair D, Hausmann A, Hinterhuber H, Fleischhacker WW. Reduced olfactory sensitivity, discrimination, and identification in patients with alcohol dependence. Alcohol Clin Exp Res 2003; 27:432-9. [PMID: 12658108 DOI: 10.1097/01.alc.0000057945.57330.2c] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Various olfactory deficits have been reported in the alcohol-induced amnestic syndrome (Korsakoff's syndrome). Less is known about olfactory functioning in nonamnesic and nondemented alcoholic patients. METHODS Olfactory performance of 30 alcohol-dependent patients was assessed unirhinally using the Sniffin' Sticks (threshold, discrimination, identification, composite TDI score) and compared with that of 30 healthy controls, matched for sex, age, and smoking status. RESULTS Patients showed significantly reduced olfactory sensitivity (higher threshold), discrimination, and identification compared with controls. No group differences were observed in laterality. Identification and discrimination group differences remained significant after controlling for differences in sensitivity. Olfactory deficits in patients were present independent of age, gender, and duration of abstinence (<3 months) and were not attributable to smoking or general cognitive abilities. More than half of the patients (56.7%) could be classified as hyposmic. Lower overall olfactory functioning (TDI) was associated with longer duration of a regular alcohol intake and higher values of gamma-glutamyltransferase (GGT). CONCLUSIONS Olfactory dysfunction is common in nonamnesic and nondemented patients with alcohol dependence. Results suggest a detrimental effect of alcohol on central olfactory processing.
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Affiliation(s)
- Claudia I Rupp
- University Clinics of Innsbruck, Department of General Psychiatry, Anichstrasse 35, 6020 Innsbruck, Austria.
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158
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Harper C, Garrick T, Matsumoto I, Pfefferbaum A, Adalsteinsson E, Sullivan E, Dodd P, Lewohl J, Butterworth R. How important are brain banks for alcohol research? Alcohol Clin Exp Res 2003; 27:310-23. [PMID: 12605081 DOI: 10.1097/01.alc.0000052585.81056.ca] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article contains the proceedings of a symposium at the 2002 RSA/ISBRA Meeting in San Francisco, organized and chaired by Clive Harper and co-chaired by Izuru Matsumoto. The presentations were (1) Introduction, by Clive Harper; (2) The quality of tissue-a critical issue, by Therese Garrick; (3) The first systematic brain tissue donor program in Japan, by Izuru Matsumoto; (4) Brain scans after death-really! by Adolf Pfefferbaum, Elfar Adalsteinsson, and Edith Sullivan; (5) Capture that (genial) expression, by Joanne Lewohl and Peter Dodd; and (6) Neurochemical/pharmacological studies: experimental design and limitations, by Roger Butterworth.
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Affiliation(s)
- Clive Harper
- University of Sydney and Royal Prince Alfred Hospital, New South Wales, Australia.
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159
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Agartz I, Shoaf S, Rawlings RR, Momenan R, Hommer DW. CSF monoamine metabolites and MRI brain volumes in alcohol dependence. Psychiatry Res 2003; 122:21-35. [PMID: 12589880 DOI: 10.1016/s0925-4927(02)00084-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Correlations between cerebrospinal fluid (CSF) concentrations of monoamine metabolites (MAM) and brain structure have been described in schizophrenia, but not in alcoholism. To investigate the relationship between monoaminergic transmission and brain structure in alcoholism, the metabolites of dopamine (homovanillic acid, HVA), norepinephrenine (3-methoxy-4-hydroxyphenylethyleneglycol, MHPG) and serotonin (5-hydroxyindoleacetic acid, 5-HIAA) were measured in lumbar CSF in 54 alcohol-dependent patients and 20 healthy subjects. The volumes of the cerebrum, total grey and white matter, total and ventricular CSF, left and right hippocampus, and corpus callosum area were measured with MRI. MHPG and age were positively correlated in alcoholic women. The MAM concentrations were not significantly correlated with the MRI volumes in the subject categories. There were no differences in MAM across subjects defined by diagnosis and gender, age of onset of alcoholism or comorbidity of psychiatric disorders. Total CSF, cerebrum, and white and grey matter tissue volumes differed between patients and healthy subjects. The greatest difference was the white matter reduction in alcoholic women. In alcoholic women and men, monoaminergic neurotransmission measured by the CSF MAM HVA, MHPG, and 5-HIAA is not significantly correlated with the size of different brain structures.
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Affiliation(s)
- Ingrid Agartz
- Section on Electrophysiology and Brain Imaging, Laboratory of Clinical Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1256, USA.
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160
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Polo MD, Escera C, Yago E, Alho K, Gual A, Grau C. Electrophysiological evidence of abnormal activation of the cerebral network of involuntary attention in alcoholism. Clin Neurophysiol 2003; 114:134-46. [PMID: 12495774 DOI: 10.1016/s1388-2457(02)00336-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Increased distractibility is a common impairment in alcoholism, but objective evidence has remained elusive. Here, a task designed to investigate with event-related brain potentials (ERPs) the neural mechanism underlying distraction was used to show abnormal involuntary orienting of attention in chronic alcoholism. METHODS Fifteen alcoholics and 17 matched healthy controls were instructed to ignore auditory stimuli while concentrating in the discrimination of immediately following visual stimuli. The auditory sequences contained repetitive standard tones occasionally replaced by deviant tones of slightly higher frequency, or by complex novel sounds. RESULTS Deviant tones and novel sounds distracted visual performance, i.e. increased reaction time to visual stimuli, similarly in patients and controls. Compared to controls, however, alcoholics showed ERP abnormalities, i.e. enhanced P3a amplitudes over the left frontal region, and a positive posterior deflection instead of the frontally distributed reorienting negativity (RON). CONCLUSIONS The enhanced P3a to novelty and subsequent positive wave instead of RON in alcoholics suggests encoding into working memory of task-irrelevant auditory events and provides neurophysiological markers of impaired involuntary attention mechanisms in chronic alcoholism.
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Affiliation(s)
- Maria Dolores Polo
- Neurodynamics Laboratory, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, P. Vall d'Hebron 171, 08035, Barcelona, Spain
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161
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Fennema-Notestine C, Stein MB, Kennedy CM, Archibald SL, Jernigan TL. Brain morphometry in female victims of intimate partner violence with and without posttraumatic stress disorder. Biol Psychiatry 2002; 52:1089-101. [PMID: 12460692 DOI: 10.1016/s0006-3223(02)01413-0] [Citation(s) in RCA: 163] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND To examine neuroanatomical morphometry in adult female victims of intimate partner violence with and without posttraumatic stress disorder. METHODS Seventeen nonvictimized comparison subjects and 22 victims of intimate partner violence, 11 with and 11 without posttraumatic stress disorder, were studied. Using quantitative magnetic resonance imaging, three mesial temporal lobe areas were measured: hippocampus, amygdala, and parahippocampal gyrus. Additionally, whole brain morphometry provided fluid, gray, and white matter volumes of the cortex and cerebellum for exploratory analyses. Relationships of morphometric measures to symptoms, abuse history, and neuropsychological function were examined. RESULTS Intimate partner violence subjects with posttraumatic stress disorder did not demonstrate significantly smaller hippocampal or other mesial temporal lobe volumes. Overall, intimate partner violence subjects had smaller supratentorial cranial vaults and smaller frontal and occipital gray matter volumes relative to nonvictimized comparison subjects. Supratentorial cranial vault volume was negatively correlated with severity of childhood physical abuse, but not with intimate partner violence or posttraumatic stress disorder severity. Trails B performance was negatively correlated with frontal gray matter volume. CONCLUSIONS These findings are inconsistent with prior reports of smaller hippocampal volumes in patients with posttraumatic stress disorder. Rather, the findings point to cerebral abnormalities that may reflect the influence of early trauma on neurodevelopmental processes or denote brain morphometric characteristics of persons at increased risk for serious psychosocial adversity.
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162
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Goldstein RZ, Volkow ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry 2002; 159:1642-52. [PMID: 12359667 PMCID: PMC1201373 DOI: 10.1176/appi.ajp.159.10.1642] [Citation(s) in RCA: 1737] [Impact Index Per Article: 79.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Studies of the neurobiological processes underlying drug addiction primarily have focused on limbic subcortical structures. Here the authors evaluated the role of frontal cortical structures in drug addiction. METHOD An integrated model of drug addiction that encompasses intoxication, bingeing, withdrawal, and craving is proposed. This model and findings from neuroimaging studies on the behavioral, cognitive, and emotional processes that are at the core of drug addiction were used to analyze the involvement of frontal structures in drug addiction. RESULTS The orbitofrontal cortex and the anterior cingulate gyrus, which are regions neuroanatomically connected with limbic structures, are the frontal cortical areas most frequently implicated in drug addiction. They are activated in addicted subjects during intoxication, craving, and bingeing, and they are deactivated during withdrawal. These regions are also involved in higher-order cognitive and motivational functions, such as the ability to track, update, and modulate the salience of a reinforcer as a function of context and expectation and the ability to control and inhibit prepotent responses. CONCLUSIONS These results imply that addiction connotes cortically regulated cognitive and emotional processes, which result in the overvaluing of drug reinforcers, the undervaluing of alternative reinforcers, and deficits in inhibitory control for drug responses. These changes in addiction, which the authors call I-RISA (impaired response inhibition and salience attribution), expand the traditional concepts of drug dependence that emphasize limbic-regulated responses to pleasure and reward.
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Affiliation(s)
- Rita Z Goldstein
- Medical Research, Brookhaven National Laboratory, Bldg. 490, 30 Bell Avenue, Upton, NY 11973, USA.
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163
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Bates ME, Bowden SC, Barry D. Neurocognitive impairment associated with alcohol use disorders: implications for treatment. Exp Clin Psychopharmacol 2002; 10:193-212. [PMID: 12233981 DOI: 10.1037/1064-1297.10.3.193] [Citation(s) in RCA: 215] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Between 50% and 80% of individuals with alcohol use disorders experience mild to severe neurocognitive impairment. There is a strong clinical rationale that neurocognitive impairment is an important source of individual difference affecting many aspects of addiction treatment, but empirical tests of the direct influence of impairment on treatment outcome have yielded weak and inconsistent results. The authors address the schism between applied-theoretical perspectives and research evidence by suggesting alternative conceptual models of the relationship between neurocognitive impairment and addiction treatment outcome. Methods to promote neurocognitive recovery and ways in which addiction treatments may be modified to improve psychosocial adaptation are suggested. Specific suggestions for future research that may help clarify the complex relations between neurocognitive impairment and addiction treatment are outlined.
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Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers University, Piscataway, New Jersey 08854-8001, USA.
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164
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Pfefferbaum A, Rosenbloom M, Sullivan EV. Alcoholism and AIDS: Magnetic Resonance Imaging Approaches for Detecting Interactive Neuropathology. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02638.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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165
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Laakso MP, Gunning-Dixon F, Vaurio O, Repo-Tiihonen E, Soininen H, Tiihonen J. Prefrontal volumes in habitually violent subjects with antisocial personality disorder and type 2 alcoholism. Psychiatry Res 2002; 114:95-102. [PMID: 12036509 DOI: 10.1016/s0925-4927(02)00005-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pathology of the prefrontal cortices has been suggested to be a part of neural networks underlying deviant behavioral patterns. Recently, reduced overall prefrontal cortical volumes have been proposed in subjects with antisocial personality disorder (ASP). It is not known whether there are specific patterns of volume loss within the prefrontal regions. Nor is it known if there are correlations between the prefrontal volumes and degree of psychopathology. In this study, total prefrontal, prefrontal white, and cortical (dorsolateral, orbitofrontal, medial frontal) prefrontal volumes were measured from magnetic resonance images in 24 non-psychotic, violent male subjects who had a diagnosis of ASP in combination with type 2 alcoholism, and 33 age-matched control males. The degree of psychopathy in the ASP subjects was assessed using the Psychopathy Checklist-Revised (PCL-R). Compared with the controls, the ASP subjects had significantly smaller volumes of all three cortical regions on the left, but this significance disappeared after controlling for differences in education and duration of alcoholism. For the dorsolateral and orbitofrontal cortices, only duration of alcoholism was significantly associated with the observed volume deficit, and for the medial frontal cortex it was the difference in education. Thus, the observed volume deficits in this sample were related more to alcoholism or differences in education rather than to the diagnosis of ASP. Moreover, no significant correlations between any of the volumes and the degree of psychopathy were found.
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Affiliation(s)
- Mikko P Laakso
- Department of Neurology, Kuopio University Hospital, 70211, Kuopio, Finland.
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166
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Obernier JA, White AM, Swartzwelder HS, Crews FT. Cognitive deficits and CNS damage after a 4-day binge ethanol exposure in rats. Pharmacol Biochem Behav 2002; 72:521-32. [PMID: 12175448 DOI: 10.1016/s0091-3057(02)00715-3] [Citation(s) in RCA: 200] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Impairments of learning and memory are common neuropsychological sequelae of chronic alcohol abuse. Alcoholics often have impairments of anterograde memory, including spatial memory dysfunction, and a tendency toward response perseveration. This study was designed to assess the effects of binge ethanol exposure on neurodegeneration and cognitive function. Rats were given ethanol three times daily for 4 days. Silver staining revealed neurodegeneration in the olfactory bulb, piriform cortex, perirhinal cortex, entorhinal cortex, and dentate gyrus. After withdrawal, behavioral testing in the Morris water maze revealed significant differences in reversal learning between treatment groups. Ethanol-treated animals required more trials to learn the reversal task, entered the previously trained quadrant more often, and spent more time there than controls. [3H]PK-11195 binding, an index of CNS damage, was elevated in the piriform cortex of ethanol-treated animals. Thus, binge ethanol exposure resulted in neurodegeneration of a corticolimbic circuit with common excitatory inputs from the olfactory bulb and was associated with perseverative responding on a spatial learning task. These studies suggest that a single binge drinking episode could cause neurodegeneration and cognitive dysfunction in humans. The perseverative nature of the behavioral deficit could be related to both cognitive dysfunction and the behavioral components of the addiction process.
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Affiliation(s)
- Jennifer A Obernier
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, 27599-7178, USA
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167
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McGlinchey-Berroth R, Fortier CB, Cermak LS, Disterhoft JF. Temporal Discrimination Learning in Abstinent Chronic Alcoholics. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02608.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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168
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169
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Fein G, Sclafani V, Cardenas VA, Goldmann H, Tolou-Shams M, Meyerhoff DJ. Cortical Gray Matter Loss in Treatment-Naive Alcohol Dependent Individuals. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02574.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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170
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Bates ME, Labouvie EW, Voelbel GT. Individual differences in latent neuropsychological abilities at addictions treatment entry. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2002; 16:35-46. [PMID: 11934085 DOI: 10.1037/0893-164x.16.1.35] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The latent structure of neuropsychological abilities and risk factors for impairment were examined in 197 persons entering addictions treatment. Confirmatory factor analysis yielded 4 factors: Executive, Memory, Verbal, and Processing Speed. The measurement model was consistent with evidence that neuropsychological test performance is factorially complex and supported by multiple brain regions. Path analyses showed that risk factors explained 34%-57% of the true variance in abilities. Age, education, and medical status had the most generalized and robust associations with abilities. Drug use disorder diagnoses, childhood behavior problems, familial alcoholism, and psychopathology were also significantly related to specific latent abilities. Knowledge of neuropsychological impairment may be clinically useful, and selected risk factors may help treatment providers decide which clients should receive formal neuropsychological assessment.
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Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway 08854-8001, USA.
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O'Neill J, Cardenas VA, Meyerhoff DJ. Effects of Abstinence on the Brain: Quantitative Magnetic Resonance Imaging and Magnetic Resonance Spectroscopic Imaging in Chronic Alcohol Abuse. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02174.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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172
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O'Neill J, Cardenas VA, Meyerhoff DJ. Separate and interactive effects of cocaine and alcohol dependence on brain structures and metabolites: quantitative MRI and proton MR spectroscopic imaging. Addict Biol 2001; 6:347-361. [PMID: 11900613 DOI: 10.1080/13556210020077073] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The effects of chronic cocaine and alcohol abuse on human brain structure and metabolites are not fully known. We studied controls (n = 13) and abstinent subjects dependent on cocaine (8), alcohol (12), and cocaine and alcohol (17) using quantitative MRI and proton MR spectroscopic imaging. Talairach-based techniques yielded tissue and CSF volumes and gray- and white-matter concentrations of N-acetylaspartate (NAA), creatine and choline metabolites in multiple brain regions. Alcohol dependents had lower gray-matter NAA concentrations and more sulcal CSF than non-alcohol dependents throughout the brain. They also had less subcortical gray matter and (regionally) less white matter. Cocaine dependents compared with non-cocaine dependents had higher posterior parietal white-matter creatine concentration. They also had less gray and white matter in the prefrontal lobes and in a region encompassing the temporal lobes and cerebellum. Structural white-matter deficits in cocaine dependents were greater with longer duration of cocaine use. Subjects with concurrent cocaine and alcohol dependence had less prefrontal white matter, especially in the anterior cingulate, than subjects dependent on only one substance. Chronically abused cocaine and alcohol each leave multiple metabolic and structural brain defects after long-term abstinence. Concurrent dependence on both substances may aggravate white-matter structural defects, primarily in frontal brain.
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Affiliation(s)
- J. O'Neill
- Magnetic Resonance Unit, Department of Veterans Affairs Medical Center, Department of Radiology, University of California San Francisco, San Francisco, CA, USA
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173
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Estilaei MR, Matson GB, Payne GS, Leach MO, Fein G, Meyerhoff DJ. Effects of Abstinence From Alcohol on the Broad Phospholipid Signal in Human Brain: An In Vivo 31P Magnetic Resonance Spectroscopy Study. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02338.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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174
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Hada M, Porjesz B, Chorlian DB, Begleiter H, Polich J. Auditory P3a deficits in male subjects at high risk for alcoholism. Biol Psychiatry 2001; 49:726-38. [PMID: 11313040 DOI: 10.1016/s0006-3223(00)01049-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Substantial evidence indicates that alcoholism is biologically mediated by a genetic predisposition. As the decreased P300 (P3b) event-related brain potential component does not recover with prolonged abstinence, it is unlikely to be related to drinking history but is more likely to be genetically influenced. This is supported by findings that P3b amplitudes are reduced in subjects at high-risk compared to low-risk for alcoholism. Although there are few studies of P3a in HR subjects, lower P3a amplitudes have been reported with a novel nontarget stimulus paradigm, as well as with a difficult three-stimulus visual paradigm. Using a similar three-tone auditory paradigm in which the discriminability between the target and standard tone is difficult, the P3a component can also be reliably elicited with a rare nontarget perceptually distinct stimulus. This technique was employed in young adult subjects at low-risk and high-risk for alcoholism. METHODS A total of 17 low-risk and 24 high-risk male subjects were employed as subjects in an auditory paradigm that yielded a large amplitude P3a with a centro-frontal maximum to the nontarget and a robust low amplitude prolonged P3b with a parietal maximum amplitude to the target stimulus. Current source density maps were derived to assess topographic differences between low-risk and high-risk subjects. RESULTS The high-risk group manifested significantly lower P3a amplitudes than the low-risk group at the frontal electrodes to rare nontarget stimuli. High-risk subjects also demonstrated a more disorganized current source density map for P3a compared to low-risk subjects. CONCLUSIONS The reduction of P3a in the high-risk group may be due to cortical dysfunction including the frontal and prefrontal cortex. The lower P3a amplitude coupled with more disorganized current source density maps suggest inefficient brain functioning in high-risk subjects.
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Affiliation(s)
- M Hada
- Department of Psychiatry, SUNY Health Science Center at Brooklyn, Brooklyn, NY 11203, USA
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Abstract
Although our understanding of how human immunodeficiency virus (HIV)-related neurobehavioural deficits develop is nascent and preliminary, some clues have emerged which may clarify lingering uncertainties. In particular, HIV seems to yield brain dysfunction by mediating pathological changes upon neuronal function. HIV also compromises immunological integrity, thereby resulting in secondary infections that may further increase brain dysfunction. Notably, many individuals with HIV tend to be current or past abusers of drugs, and, in some cases, their drug use may have actually presented a pathway for initial HIV infection. Similar to HIV, many drugs tend to yield pathological changes upon neuronal function. Further paralleling HIV, some drugs seem to compromise immune function, which in turn may yield secondary detrimental effects upon the brain. Yet, despite the relatively high comorbidity rates of HIV infection and substance abuse, few investigations have addressed the potential interaction between these two factors upon neurobehavioural status. Towards this end, the present paper reviews the existing literature concerning neuropsychological effects of HIV and substance use, and suggests potential mechanisms whereby substance use may potentiate and exacerbate the onset and severity of neurobehavioural abnormalities in HIV infection.
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Affiliation(s)
- M R Basso
- Department of Psychology, University of Tulsa, OK 74104, USA.
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176
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Ambrose ML, Bowden SC, Whelan G. Working Memory Impairments in Alcohol-Dependent Participants Without Clinical Amnesia. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02197.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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177
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Tapert SF, Brown GG, Kindermann SS, Cheung EH, Frank LR, Brown SA. fMRI Measurement of Brain Dysfunction in Alcohol-Dependent Young Women. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02204.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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178
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Prendergast MA, Harris BR, Blanchard JA, Mayer S, Gibson DA, Littleton JM. In Vitro Effects of Ethanol Withdrawal and Spermidine on Viability of Hippocampus From Male and Female Rat. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb01990.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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179
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Crews FT, Braun CJ, Hoplight B, Switzer RC, Knapp DJ. Binge Ethanol Consumption Causes Differential Brain Damage in Young Adolescent Rats Compared With Adult Rats. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb01973.x] [Citation(s) in RCA: 365] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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180
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Prendergast MA, Harris BR, Mayer S, Littleton JM. Chronic, But Not Acute, Nicotine Exposure Attenuates Ethanol Withdrawal-Induced Hippocampal Damage In Vitro. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb04578.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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181
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Abstract
BACKGROUND P3a amplitude differences between alcoholic and control groups have not been well defined. Because event-related potential (ERP) differences between these groups appear to be influenced by task difficulty, the present study employed a new auditory ERP paradigm, in which target/standard tone discriminability was difficult, with infrequent nontarget stimuli used to elicit the P3a. METHODS A total of n = 27 male alcoholics and n = 25 male controls were assessed using a three-tone discrimination paradigm, in which the discriminability between the target and standard was difficult, with easily discriminable infrequent nontarget tones also presented. A P3a component with a centro-frontal maximum to the rare nontargets and a P3b with a parietal maximum amplitude to the target stimulus were obtained. Current Source Density (CSD) maps were derived from the potential data and employed to assay topographical differences between subject groups. RESULTS Alcoholics produced smaller P3a amplitudes than control subjects to the rare nontargets with no peak latency differences observed. The most prominent current sources are apparent more anteriorly for the nontarget compared to the target stimulus in both groups. There were more sources and sinks in the alcoholics than in the control subjects for P3a. A bootstrap analysis method showed that P3a CSD maps evinced distinct topographic distributions between alcoholics and control subjects in all brain regions. CONCLUSIONS The lower P3a amplitude and weaker sources in alcoholics coupled with less topographic specificity in their CSD maps, suggests disorganized inefficient brain functioning. This global electrophysiological pattern suggests cortical disinhibition perhaps reflecting underlying CNS hyperexcitability in alcoholics.
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Affiliation(s)
- M Hada
- Department of Neuropsychiatry, Nippon Medical School, (MH), Tokyo, Japan
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182
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Pfefferbaum A, Sullivan EV, Hedehus M, Adalsteinsson E, Lim KO, Moseley M. In Vivo Detection and Functional Correlates of White Matter Microstructural Disruption in Chronic Alcoholism. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb02086.x] [Citation(s) in RCA: 193] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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183
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Schweinsburg BC, Taylor MJ, Videen JS, Alhassoon OM, Patterson TL, Grant I. Elevated myo-Inositol in Gray Matter of Recently Detoxified but Not Long-Term Abstinent Alcoholics: A Preliminary MR Spectroscopy Study. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb02042.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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184
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Brown SA, Tapert SF, Granholm E, Delis DC. Neurocognitive Functioning of Adolescents: Effects of Protracted Alcohol Use. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb04586.x] [Citation(s) in RCA: 341] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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185
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Symonds LL, Archibald SL, Grant I, Zisook S, Jernigan TL. Does an increase in sulcal or ventricular fluid predict where brain tissue is lost? J Neuroimaging 1999; 9:201-9. [PMID: 10540599 DOI: 10.1111/jon199994201] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Quantitative volumes of cerebrospinal fluid (CSF) and brain tissue were measured on magnetic resonance images (MRIs) of 287 individuals from 5 diagnostic groups: Alzheimer's disease (AD), chronic alcoholics (ALC), individuals positive for human immunodeficiency virus (HIV), schizophrenia subjects (SZ), and normal comparison subjects (NC) older than 50 years of age. Within each group, mean volumes were calculated for ventricular CSF, cortical (sulcal) CSF, cortical gray matter, total white matter, basal ganglia gray matter, and thalamic gray matter. Correlations of CSF measures with brain tissue measures were determined, and multiple regression analyses were performed to try and predict volume of gray matter or white matter region from volume of CSF compartment. Results indicated the following: 1. Enlarged cortical fluid volume significantly predicts cortical gray matter deficits for subjects with AD and those who are ALC and SZ but not for subjects with HIV or NC. 2. Enlarged cortical fluid volume also significantly predicts white matter deficits in all five groups. 3. Enlarged ventricular fluid volume significantly predicts basal ganglia deficits in AD, HIV, and NC but not in SZ or ALC. 4. Enlarged ventricular volume has no predictive value for thalamic volume for any of the groups. This study supports the clinical practice of predicting brain tissue volume loss from CSF enlargement but not for all brain regions in all diagnoses.
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Affiliation(s)
- L L Symonds
- Department of Psychiatry, Michigan-State University, East Lansing 48824-1316, USA
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186
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Meyerhoff DJ, Bloomer C, Schuff N, Ezekiel F, Norman D, Clark W, Weiner MW, Fein G. Cortical metabolite alterations in abstinent cocaine and cocaine/alcohol-dependent subjects: proton magnetic resonance spectroscopic imaging. Addict Biol 1999; 4:405-19. [PMID: 20575809 PMCID: PMC2893339 DOI: 10.1080/13556219971399] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Chronic abuse of cocaine or alcohol is associated with structural, neuropathological and cognitive impairments that have been documented extensively. Little is known, however, about neurobiochemical changes in chronic substance abusers.We performed MRI and multi-slice brain proton magnetic resonance spectroscopic imaging (MRSI) to assess neuronal viability (via N-acetylaspartate (NAA)) and white matter metabolite status in 22 4-months-abstinent individuals dependent on crack cocaine only and on both crack cocaine and alcohol. Compared to 11 non-dependent controls we found (1) significantly lower NAA measures in the dorsolateral prefrontal cortex of the combined cocaine-dependent groups; (2) comparable spatial distribution and magnitude of these NAA effects for both cocaine-dependent groups; (3) higher choline-containing metabolites in frontal white matter of individuals dependent on both cocaine and alcohol; (4) absence of brain atrophy in both abstinent cocaine-dependent samples; and (5) partial recovery from prefrontal cortical NAA loss, primarily with abstinence from alcohol. The MRSI findings suggest preferential neuronal damage to the frontal cortex of both cocaine-dependent samples and gliosis in frontal white matter of individuals dependent on both alcohol and cocaine, conditions that persist for more than 4 months of abstinence.
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Affiliation(s)
- D J Meyerhoff
- Magnetic Resonance Unit, University of California San Francisco, San Francisco, CA, USA.
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187
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Sullivan EV, Lane B, Deshmukh A, Rosenbloom MJ, Desmond JE, Lim KO, Pfefferbaum A. In Vivo Mammillary Body Volume Deficits in Amnesic and Nonamnesic Alcoholics. Alcohol Clin Exp Res 1999. [DOI: 10.1111/j.1530-0277.1999.tb04054.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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188
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Ahveninen J, Jaaskelainen IP, Pekkonen E, Hallberg A, Hietanen M, Makela R, Naatanen R, Sillanaukee P. Suppression of Mismatch Negativity by Backward Masking Predicts Impaired Working-Memory Performance in Alcoholics. Alcohol Clin Exp Res 1999. [DOI: 10.1111/j.1530-0277.1999.tb04674.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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189
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Harris GJ, Oscar-Berman M, Gansler A, Streeter C, Lewis RF, Ahmed I, Achong D. Hypoperfusion of the Cerebellum and Aging Effects on Cerebral Cortex Blood Flow in Abstinent Alcoholics: A SPECT Study. Alcohol Clin Exp Res 1999. [DOI: 10.1111/j.1530-0277.1999.tb04281.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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190
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Abstract
Brain atrophy in alcoholics has been identified using both radiological and pathological techniques. However the magnitude and topography of the atrophy, and the factors which contribute to it, are unclear. This review compares the results of imaging and pathological studies in alcoholics examining variables which may contribute to any discrepancies. We conclude that significant brain damage does occur as a result of alcohol abuse per se, that the damage is regionally specific with the frontal lobes being particularly affected, and that both grey matter and white matter components are damaged.
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Affiliation(s)
- J J Kril
- Centre for Education and Research on Ageing, The University of Sydney, Concord Hospital, Australia.
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191
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Netrakom P, Krasuski JS, Miller NS, O'Tuama LA. Structural and functional neuroimaging findings in substance-related disorders. Psychiatr Clin North Am 1999; 22:313-29. [PMID: 10385936 DOI: 10.1016/s0193-953x(05)70079-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Intoxication with alcohol results in depressed global glucose metabolism that continues into the stages of withdrawal and abstinence. The decrease in metabolism, however, is not equal across the brain, with certain regions more affected than others. Such a pattern of disturbance suggests that the effect of alcohol on the brain cannot simply be a nonspecific depressant effect secondary to decreased blood flow or glucose transport into the cells but may be related to the dysfunction of the various neurotransmitter systems. Different authors have suggested the dysfunction to be related to the GABAergic, cholinergic, and dopaminergic systems. Long-term alcoholism is associated with atrophy of several brain regions. The frontal lobes and limbic structures seem to be most vulnerable. The data are encouraging with regard to the normalization in brain metabolism and in size of vulnerable brain regions with continued abstinence. In addition to findings of improvement in cognitive functioning and many health parameters, these findings arm clinicians with further data on the benefits of abstinence in the struggle to aid patients in maintaining their sobriety. Several areas remain to be addressed. In particular, clinicians are in need of data, neuroimaging and otherwise, that serve as prognostic indicators, thus allowing patients at higher risk for relapse to be identified and provided with more intensive treatment. A similar need exists for indicators of diagnostic heterogeneity that would guide the development of more highly tailored treatment regimens for identified subgroups of patients. Currently, we have rudimentary knowledge of the gender differences of the effects of alcohol and cocaine on the brain.
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Affiliation(s)
- P Netrakom
- University of Illinois at Chicago, Department of Psychiatry, USA
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192
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Ratti MT, Soragna D, Sibilla L, Giardini A, Albergati A, Savoldi F, Bo P. Cognitive impairment and cerebral atrophy in "heavy drinkers". Prog Neuropsychopharmacol Biol Psychiatry 1999; 23:243-58. [PMID: 10368867 DOI: 10.1016/s0278-5846(98)00103-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
1. Aim of the work was to verify the following three hypotheses in alcoholics: a) right hemisphere; b) diffuse brain deficit; c) anterior brain deficit, by means of a neuropsychological and a neuroradiological assessment. 2. 15 alcoholic right-hand male subjects and 15 matched controls were enrolled in the study. 3. Specifically designed neuropsychological testing was performed to investigate logical abilities, selective attention and memory. 4. Neurological investigation was performed by a standard CT scan to assess the degree and localization of brain damage. 5. Alcoholics performed worse than controls on some neuropsychological tests, i.e. Attention Matrices Test, Verbal Judgement Test, Forward Digit Span, Story Recall and Remote Memory Test. The analysis of variance adjusted by the attentional score showed no significant differences between alcoholics and controls. 6. Neuroradiological data showed a preeminent and a more frequent atrophy of the frontal region. 7. No correlations emerged between neuropsychological and neuroradiological data. 8. In conclusion, the hypothesis of anterior brain deficit seems to be confirmed by our study.
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Affiliation(s)
- M T Ratti
- Neurological Institute C. Mondino, Department of Neurological Sciences, University of Pavia, Italy.
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193
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Neuropsychological Deficits in Patients with Alcohol and Other Psychoactive Substance Abuse and Dependence. ALCOHOLISM TREATMENT QUARTERLY 1999. [DOI: 10.1300/j020v16n04_09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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194
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Lingford-Hughes AR, Acton PD, Gacinovic S, Suckling J, Busatto GF, Boddington SJ, Bullmore E, Woodruff PW, Costa DC, Pilowsky LS, Ell PJ, Marshall EJ, Kerwin RW. Reduced levels of GABA-benzodiazepine receptor in alcohol dependency in the absence of grey matter atrophy. Br J Psychiatry 1998; 173:116-22. [PMID: 9850223 DOI: 10.1192/bjp.173.2.116] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND We tested the hypothesis that reduced levels of the GABA-benzodiazepine receptor occur in alcohol dependency using single photon emission tomography (SPET) and the specific GABA-benzodiazepine ligand, 123I-iomazenil. METHOD Neurologically and cognitively unimpaired abstinent alcohol-dependent (n = 12) and non-alcohol-dependent male subject (n = 14) underwent a 123I-iomazenil SPET scan. SPET and magnetic resonance images were co-registered and voxel-based statistical tests performed. Subjects' clinical and alcohol history were obtained with standard questionnaires. The relationships between clinical and alcohol variables and the regional level of GABA-benzodiazepine receptors were investigated using multiple regression analysis. RESULTS Abstinent alcohol-dependent subjects had decreased levels of GABA-benzodiazepine receptor compared with non-alcohol-dependent subjects within the frontal, parietal and temporal cortices, including regions in which grey matter atrophy was absent. CONCLUSIONS Alcohol dependency is associated with reduced GABA-benzodiazepine receptor levels in the absence of grey matter atrophy in some cortical regions, such as within the parietal lobe. Regional variability of reduction in GABA-benzodiazepine receptors demonstrates that alcohol does not have a global, toxic effect on the brain.
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195
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DI SCLAFANI VICTORIA, TRURAN DIANAL, BLOOMER COURTNAY, TOLOU-SHAMS MARINA, CLARK HWESTLEY, NORMAN DAVID, HANNAUER DAVID, FEIN GEORGE. Abstinent chronic crack-cocaine and crackcocaine/alcohol abusers evidence normal hippocampal volumes on MRI despite persistent cognitive impairments. Addict Biol 1998; 3:261-70. [PMID: 26734920 DOI: 10.1080/13556219872074] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
We measured hippocampal volumes and cognitive functioning in crack-cocaine and crack-cocaine/alcoholdependent subjects (abstinent approximately 10-12 weeks) compared to age-matched controls. Cognitive function was evaluated using the computerized MicroCog Assessment of Cognitive Functioning (which includes tests of explicit, declarative memory subserved by the hippocampus). The hippocampal volumes were quantified on T1-weighted MRIs and were expressed as a proportion of intracranial vault volume. Both subjects and controls showed the larger right versus left hippocampal volume expected in normal anatomy, but we found no differences in hippocampal volume between any of the groups. However, both abstinent cocaine-dependent subjects and abstinent cocaine/alcohol-dependent subjects showed persistent cognitive impairments, including deficits in explicit memory. Our results suggest that either: (1) the hippocampus is resistant to structural volume loss in young and middle-aged cocaine or cocaine/alcohol-dependent subjects, (2) the hippocampal volume loss suffered by young and middle-aged cocaine or cocaine/alcohol-dependent subjects resolves after approximately 3 months of abstinence, or (3) hippocampal atrophy is obscured by the process of gliosis. Further, the cognitive impairments persisting in these abstinent cocaine and cocaine/alcohol-dependent samples may (1) be unrelated to hippocampal function or (2) be associated with abnormal hippocampal function that is not reflected in MRI measures of overall hippocampal atrophy.
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196
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Bedell BJ, Narayana PA. Volumetric analysis of white matter, gray matter, and CSF using fractional volume analysis. Magn Reson Med 1998; 39:961-9. [PMID: 9621920 DOI: 10.1002/mrm.1910390614] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Quantitative cerebral tissue volumes may be useful for an objective assessment of pathological changes in brain. Accurate determination of tissue volumes is complicated, however, by the partial volume averaging (PVA) effect. We have, therefore, developed a new pulse sequence that minimizes the PVA through the use of inversion-recovery (IR) and double inversion-recovery (DIR) techniques. This pulse sequence simultaneously acquires four different sets of images to provide the necessary information for volumetric analysis and reduces potential spatial misregistration of images due to patient motion. The image sets acquired from the proposed pulse sequence are 1) gray matter visible, 2) white matter visible, 3) FLAIR, and 4) fast spin-echo proton-density weighted images. An algorithm has been implemented to correct for differential T1-weighting and for tissue quantitation.
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Affiliation(s)
- B J Bedell
- Department of Radiology, University of Texas Medical School at Houston, 77030, USA
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197
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Estruch R, Bono G, Laine P, Antunez E, Petrucci A, Morocutti C, Hillbom M. Brain imaging in alcoholism. Eur J Neurol 1998; 5:119-135. [PMID: 10210823 DOI: 10.1046/j.1468-1331.1998.520119.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Copyright Rapid Science Ltd
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Affiliation(s)
- R Estruch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain
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198
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Sullivan EV, Mathalon DH, Lim KO, Marsh L, Pfefferbaum A. Patterns of regional cortical dysmorphology distinguishing schizophrenia and chronic alcoholism. Biol Psychiatry 1998; 43:118-31. [PMID: 9474444 DOI: 10.1016/s0006-3223(97)00264-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study used magnetic resonance imaging (MRI) to compare the extent and pattern of tissue volume deficit and cerebrospinal fluid volume enlargement in chronic alcoholics and schizophrenics. METHODS The subjects included 62 detoxified chronic alcoholics (26-63 years), 71 schizophrenics (23-63 years), and 73 controls spanning the adult age range (21-70 years). MRI volumes were adjusted for normal variation in head size and age established from the control group. RESULTS Both patient groups showed widespread cortical gray matter volume deficits compared with controls, but only the alcoholics had white matter volume deficits. The schizophrenics had significantly greater volume deficits in the prefrontal and anterior superior temporal gray matter than in the more posterior cortical regions. By contrast, the deficits in the alcoholics were relatively homogeneous across the cortex. For white matter, the deficits in the alcoholics were greatest in the prefrontal and temporal-parietal regions. Although both patient groups had abnormally larger cortical sulci and lateral and third ventricles than the controls, the alcoholics had significantly larger sulcal volumes in the frontal, anterior, and posterior parietal-occipital regions than the schizophrenics. CONCLUSIONS This quantitative MRI study revealed different patterns of regional cortical volume abnormalities in schizophrenics and alcoholics. The schizophrenic group exhibited cortical gray matter volume deficits of modestly greater magnitude than that observed in the alcoholic group, and the alcoholics but not the schizophrenics exhibited cortical white matter volume deficits.
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Affiliation(s)
- E V Sullivan
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, CA 94305-5417, USA
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199
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Zhang XL, Begleiter H, Porjesz B. Do chronic alcoholics have intact implicit memory? An ERP study. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1997; 103:457-73. [PMID: 9368491 DOI: 10.1016/s0013-4694(97)00044-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In order to investigate whether visual object priming differs from visual word priming and whether the visual repetition priming in chronic alcoholic patients is impaired, we performed an ERP study on 27 male control and 67 male alcoholic subjects. Sixty-one electrodes were employed to record ERPs that were elicited by random presentations of object pictures, words, and scrambles for both pictures and words. We also used an implicit task that required subjects to identify whether each stimulus was recognizable. The current experiment revealed that (1) the reaction times to both recognizable picture and word stimuli were significantly shortened by the prior exposures of the same stimuli, (2) control subjects reflected visual object and word priming in different ERP components with different topographic patterns, (3) alcoholic subjects manifested visual word priming in the same ERP component as controls, and (4) the differences in ERP components, both in amplitude and topographic distribution, between the two groups occurred mainly in the different stimuli. These data suggest that the visual object and word priming have distinctive neural processes. The visual object priming in alcoholic subjects may be impaired while the visual word priming seemed to be intact.
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Affiliation(s)
- X L Zhang
- Department of Psychiatry, SUNY Health Science Center at Brooklyn 11203, USA
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Abstract
There is some controversy in the literature concerning whether chronic alcohol consumption damages the cerebral cortex. While decreased neuronal density in specific cortical regions is well described in chronic alcoholics, a recent study by Badsberg Jensen and Pakkenberg using unbiased stereological methods questions whether neurodegeneration occurs. In order to assess selective neurodegeneration in the cerebral cortex of chronic alcoholics, regional volumes and unbiased estimates of regional neuronal number (including neuronal identification with calcium-binding proteins) were calculated for 14 chronic alcoholics and 21 controls. Cases were carefully screened to exclude any interfering pathologies. Lifetime and maximum daily alcohol consumption was determined, and homogeneous groups were identified (four chronic alcoholics with Wernicke's encephalopathy and Korsakoff's psychosis, four chronic alcoholics with Wernicke's encephalopathy alone, six chronic alcoholics without Wernicke's encephalopathy or Korsakoff's psychosis, and 21 controls). Brain volume analysis revealed that discrete regions were significantly smaller in the chronic alcoholics compared to controls. As previously shown, white matter regions (particularly in the frontal lobe) were the most significantly reduced in volume. Alcoholics with Wernicke's encephalopathy (either alone or in combination with Korsakoff's psychosis) had significantly smaller white matter volumes than controls or alcoholics without these complications. Medial temporal lobe regions and the thalamus were also reduced in volume. Regression analyses revealed that the volume of both the white matter and thalamus negatively correlated with alcohol consumption. Consistent with the interpretation of previous neuronal density studies, selective neuronal loss was found in the superior frontal association cortex of chronic alcoholics, while no loss occurred from the motor cortex. The number of parvalbumin-, calbindin- and calretinin-immunoreactive neurons was found to be unaltered in chronic alcoholics, suggesting that the neurodegeneration is confined to the non-GABAergic pyramidal neurons. As neurodegeneration was observed in all alcoholic groups, damage to the frontal association cortex is not restricted to alcoholics with the amnesia of Korsakoff's psychosis. These results are consistent with the notion that chronic alcohol consumption is associated with selective neuronal vulnerability. The selective frontal neurodegeneration and the frontal focus of white matter atrophy are supported by neuropsychological, regional blood flow, and magnetic resonance imaging studies of frontal lobe dysfunction in chronic alcoholics and may correlate with abnormalities in working memory.
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Affiliation(s)
- J J Kril
- Department of Pathology, The University of Sydney, Australia
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