Computed Tomography Scans of Alcoholics: Cerebral Atrophy?

Reversibility of brain-stem evoked potential abnormalities in abstinent chronic alcoholics: one year follow-up

Brain-stem auditory evoked potentials (BAEPs) were studied in 34 chronic alcoholics who had been abstinent for 1 year, and in age- and sex-matched control subjects. The patients were examined 3 times, at 1 month, 5 months and 1 year after the start of the abstinence treatment. At 1 month of abstinence the alcoholics showed differences with respect to controls in the peak V latency (P < 0.01), and in the III-V (P < 0.01) and I-V (P < 0.01) intervals. After 1 year of abstinence a significant improvement in the V (P < 0.01), III-V (P < 0.01) and I-V (P < 0.01) parameters was recorded. The most notable development was in the 5-12 month period, with shortening in V latency (P < 0.01) and in the I-V interval (P < 0.01); in the first 5 months there was only shortening in the III-V interval (P < 0.01). This improvement was also indicated by a decrease in the number of patients with BAEP parameter abnormalities. The recovery of the functions impaired by chronic alcohol consumption after 1 year of abstinence was incomplete, although the tendency was towards normalization.

Computerized tomographic scan assessment of alcoholic brain damage and its potential reversibility

The assessment of alcoholic brain damage by computerized tomographic (CT) scanning is reviewed and discussed. Alcoholics showed greater cerebral atrophy than aged-matched neurological controls. Supratentorial atrophy measurements correlated significantly with some neurobehavioral assessment measures. The cerebral atrophy reversed in some subjects with maintained abstinence. Computerized assessment of cerebral spinal fluid volume (cerebral atrophy) and mean cerebral density showed decreased cerebral spinal fluid volume and increased cerebral density with maintained abstinence over 4 weeks in a group of 20 alcoholics. CT cerebellar measurements demonstrated atrophy in many subjects, but these measurements did not correlate with measures of ataxia, cognitive impairment, supratentorial atrophy measurements, or age. An example of a magnetic resonance imaging scan of an alcoholic is given. Its advantages in avoiding bony artifact for posterior fossa atrophy estimations and its potential for in vivo description and localization of central nervous system metabolic abnormalities in alcoholism are discussed.

Partially reversible cerebral atrophy and functional improvement in recently abstinent alcoholics

52 recently abstinent chronic alcoholics were given repeated psychological tests and 20 of these had repeated CT scans. The first scan was done within 5 weeks of the last drink. The degree of measurably reversible cerebral atrophy on CT scan correlated negatively with the interval between the last drink and the first CT scan. Significantly more reversibility of cerebral atrophy was noted in those subjects claiming interscan abstinence. There were positive correlations between functional improvement scores on neurological exam and reversible cerebral atrophy measurements. Significant improvement on psychological test performance was restricted to patients tested initially within 3 weeks of the last drink. Both the CT results and the psychological test results suggest that reversible changes occur soon after the cessation of drinking.