Brain CT changes in alcoholics: effects of age and alcohol consumption

A computerized tomographic (CT) brain scan and assessments of lifetime alcohol consumption, body size, and cognitive performance were performed in 37 male alcoholics, aged 26-62 years. Hematocrit and mean corpuscular volume (MCV) were also measured. CT data were analyzed using a semiautomated scoring system yielding measures of percentage of fluid at the ventricles and cortical sulci. Normative brain CT data from 57 community controls spanning the adult age range allowed Z-score assessment of deviation from age norms for each alcoholic. Across the entire group, alcoholics had significantly enlarged ventricles and sulci for their age. Enlargement at both sites correlated significantly with lifetime alcohol consumption. Sulcal enlargement in alcoholics was found across all ages. In contrast, ventricular enlargement was apparent only in older alcoholics and became increasingly exaggerated with age. Measures of body size, hematocrit, and MCV correlated with ventricular but not sulcal enlargement, suggesting that nutritional factors play a role in ventricular enlargement. Associations between neuropsychological performance and CT changes or alcohol consumption were less pronounced and at times counterintuitive. The findings support a modest dose-effect relationship between ethanol exposure and changes in brain morphology, and suggest that ventricles and sulci show a different time course of response. The role of nutritional status needs to be more closely investigated.