Alcohol and the brain

Cognitive impairment in Aboriginal people with heavy episodic patterns of alcohol use

BACKGROUND

With chronic alcohol abuse, cognitive studies suggest that progressive cognitive decline may precede more serious and irreversible neurological syndromes. The early detection of cognitive impairment may therefore aid in the prevention of permanent brain damage. Despite the devastating consequences of alcohol abuse among Aboriginal Australians, the effects on brain function have never been studied in this population and a lack of appropriate assessment tools has prevented the development of such research.

AIMS

To determine the impact of long-term and heavy episodic alcohol use on cognitive function in Aboriginal people.

DESIGN

Cross-sectional comparing heavy episodic alcohol users with non-alcohol users.

SETTING

Two remote Aboriginal communities in north-east Arnhem Land, northern Australia.

SUBJECTS

The control group consisted of 24 non-drinkers (15 males, nine female) and the heavy episodic group consisted of 20 people (19 males, one female) who had been drinking alcohol in a heavy episodic style (median 14 drinks per occasion) for a mean of 8.9 years (SD = 5.0).

MEASUREMENTS

Interview to obtain demographic information, substance abuse history and symptoms of mental health and wellbeing, together with a computerized cognitive assessment battery (CogState Ltd).

FINDINGS

Compared with non-drinkers, heavy episodic drinkers showed reduced psychomotor speed (P = 0.04) and reduced accuracy when performing tasks of attention (P = 0.045), working memory (P = 0.04), implicit memory (P = 0.03) and associate learning and memory (P = 0.001).

CONCLUSIONS

Specific cognitive abnormalities that suggest frontostriatal abnormalities and have been observed in association with chronic alcoholism in other populations were observed among Aboriginal Australians who were heavy episodic alcoholic users.

Neurological and cognitive recovery following abstinence from petrol sniffing

Anecdotal observations suggest that neurological impairments associated with petrol (gasoline) sniffing resolve with abstinence, although these effects have not been proven empirically. Severe exposure to leaded petrol may induce a lead encephalopathy that extends beyond any acute intoxication and requires emergency hospital treatment. Previously, in chronic petrol sniffers, we showed neurological, saccadic, and cognitive abnormalities that were more severe in petrol sniffers with a history of hospitalization for lead encephalopathy, and that correlated with blood lead levels and the length of time of sniffing petrol. Ex-petrol sniffers showed a qualitatively similar but quantitatively less severe pattern of impairment. Petrol sniffing was stopped completely in one of the study communities by modifying social, occupational, and recreational opportunities. After 2 years, we obtained biochemical and neurobehavioral (neurological, saccade, and cognitive) data from all available participants of the earlier study including 10 nonsniffers and 29 chronic petrol sniffers, with six of these individuals previously receiving hospital treatment for lead encephalopathy. Here, we report that blood lead was reduced and that neurobehavioral impairments improved, and in many cases normalized completely. The most severe petrol-related neurobehavioral impairment was observed among individuals who had longer histories of abuse and higher blood lead levels, and among petrol sniffers with a history of lead encephalopathy. Those with the greatest extent of neurobehavioral impairment showed the greatest degree of improvement with abstinence, but were less likely to recover completely. This is the first direct evidence that neurological and cognitive impairment from chronic petrol sniffing ameliorates with abstinence and may recover completely.

Acute ethanol alters calcium signals elicited by glutamate receptor agonists and K+ depolarization in cultured cerebellar Purkinje neurons

The effect of acute ethanol on Ca2+ signals evoked by ionotropic (iGluR) and metabotropic (mGluR) glutamate receptor (GluR) activation and K+ depolarization was examined in cultured rat cerebellar Purkinje neurons to assess the ethanol sensitivity of these Ca2+ signaling pathways. Mature Purkinje neurons approximately 3 weeks in vitro were studied. iGluRs were activated by (RS)-alpha-amino-3-hydroxyl-5 methyl-4-isoxazolepropionic acid (AMPA; 1 and 5 microM) and domoate (5 microM). mGluRs were activated by (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid (ACPD; 300 microM) and (R,S)-3,5-dihydroxyphenylglycine (DHPG; 200 microM). These agents and K+ (150 mM) were applied from micropipettes by brief (1 s) microperfusion pulses. Ca2+ levels were monitored at 2-3 s intervals during pre- and post-stimulus periods using microscopic digital imaging and the Ca2+ sensitive dye fura-2. iGluR and mGluR agonists and K+ produced abrupt increases in intracellular Ca2+ that slowly recovered to baseline resting levels. Acute exposure to ethanol at 33 mM (150 mg%) and 66 mM (300 mg%) significantly reduced the amplitude of the Ca2+ signals to iGluR agonists and K+ with little or no effect on Ca2+ signals to mGluR agonists. In contrast, acute ethanol at 10 mM (45 mg%) had no effect on the Ca2+ signals to the iGluR agonist AMPA but significantly enhanced the Ca2+ signals to the mGluR agonist DHPG. These results show that ethanol modulates Ca2+ signaling linked to GluR activation in a receptor subtype specific manner, and suggest that Ca2+ signaling pathways linked to GluR activation and membrane depolarization may be important mechanisms by which ethanol alters the transduction of excitatory synaptic signals at glutamatergic synapses and thereby affects intercellular and intracellular communication in the CNS.

Screening Cognitive Impairment in Alcohol Abusers

1. Studies have reported various neuropsychological abnormalities in people with excessive drinking patterns and associated problems with the assessment and treatment of this group. 2. The aim of this study was to assess the potential of a screening instrument to help detect the presence of cognitive impairment in excessive alcohol users undergoing detoxification. 3. The Memory Screening Test has potential as a screening instrument to assess clients' cognitive ability to benefit from psychoeducational material.

Calcium signals elicited by quisqualate in cultured Purkinje neurons show developmental changes in sensitivity to acute alcohol

The effect of acute alcohol (33 mM ethanol) on calcium signaling evoked by glutamate receptor activation was studied in cultured cerebellar Purkinje and granule neurons at different stages of development. Calcium signals were measured by microscopic imaging using the calcium sensitive dye fura-2. At an early stage in development (10 days in vitro), acute alcohol enhanced the calcium signals evoked in Purkinje neurons by exogenous application of quisqualate, an agonist at ionotropic and metabotropic glutamate receptors. In contrast, in mature cultured Purkinje neurons (21-24 days in vitro) the calcium signals produced by quisqualate were reduced by alcohol. At an intermediate stage of development (14 days in vitro) reflecting the main period of morphological and physiological maturation, alcohol had no significant effect on the response to quisqualate. Alcohol's actions were significantly altered by manipulation of the intracellular stores with caffeine, implicating intracellular stores in alcohol's actions. Calcium signals produced by quisqualate in the cultured granule neurons were also altered by acute alcohol, in a manner similar to that observed in the Purkinje neurons. These data demonstrate that calcium signaling pathways are a site of alcohol action in developing CNS neurons and that the cellular consequences of alcohol exposure can change with development. Such actions of alcohol could have significant effects on the immature nervous system, where the precise timing of appropriate signaling levels are important aspects of the maturation process.

Effect of ethanol on cytochrome P450 in the rat brain

After a single dose of ethanol (0.8 ml/kg) administered intraperitoneally, the P450 content of the rat brain increased from 62 +/- 19 to 230 +/- 97 pmol/g (wet weight) of tissue (mean +/- SD, n = 5). Most of this increase could be accounted for by a 10- to 20-fold increase in the olfactory lobes and hypothalamic preoptic area. The P450s were identified by Western blot analysis and by microsequencing of the N-terminal ends after resolution of the proteins on SDS gels. They were identified as P450 2C7, 2C11, 2E1, 4A3, 4A8, and a member of the P450 2D family. In P450 extracted from the brains of control rats, P450 2C and 4A were also detectable but at a much lower concentration. P450 1A1, 2A1, 2B1, or 3A was not detected in the brains of either control or ethanol-treated rats. Oral administration of the same dose of ethanol resulted in a similar increase in the whole brain but smaller effects in the olfactory lobes. This effect of ethanol on the P450 in the brain has implications for the mechanism of toxicity and the development of tolerance to ethanol and for the effects of other drugs and environmental pollutants that act on the central nervous system.