High alcohol consumption, liver toxic drugs and brain damage--a population study

Computed tomography (CT) of the brain was performed in a random sample of 195 men to investigate the relationship between alcohol drinking and brain damage. This sample from the general population was divided into subsamples on the basis of their self-reported loss of control over drinking, morning drinks and blackouts. Three groups with different degrees of alcohol consumption were distinguished and the only differences in CT findings were a significantly higher frequency of frontal lobe atrophy with increasing alcohol consumption. The consumption of hepatotoxic drugs was also investigated and the following were the types of drug used: antiarrhythmics, antiepileptics, antibiotics, antiphlogistics, mixed analgetics, sulphonamides, benzodiazepines and derivatives of phenothiazines, all of which are metabolized by way of the liver. The material was divided into four groups with regard to both alcohol consumption and use of hepatotoxic drugs: Group IA, low or moderate alcohol consumption and no use of such drugs; IB, low or moderate alcohol consumption with use of such drugs; IIA, high alcohol consumption with no use of such drugs; and IIB, high alcohol consumption with use of such drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. The results indicate that drug use influences the incidence of cortical and subcortical aberrations. It is concluded that there is a typical frontal lobe atrophy associated with alcohol abuse; thus with increasing alcohol ingestion there is accelerated shrinkage of the brain, the frontal lobe being the first part affected. The groups with alcohol abuse who used hepatotoxic drugs show a picture of cortical changes and also of subcortical aberrations, expressed as an increased anterior horn index and widening of the third ventricle.