Effects of white matter lesion grading on the cognitive function of patients with chronic alcohol dependence

Alcohol dependence has become a major problem that poses a serious threat to public health. Long-term heavy alcohol consumption can lead to brain functional disorders. This study aimed to investigate the relationship of the severity of cerebral white matter lesions (WMLs), serum neurofilament light (NfL) and inflammatory factors, tumour necrosis factor alpha (TNF-α) and Interleukin-1β (IL-1β), with the cognitive function of patients with alcohol dependence.

A total of 118 patients were enrolled in this prospective study, and divided into alcohol-dependent and non-alcohol-dependent groups. The severity of WMLs was assessed using the Fazekas scale based on magnetic resonance imaging analysis. The expression levels of NfL, TNF-α and IL-1β in the serum of the subjects were measured by enzyme-linked immunosorbent assay. The cognitive function and psychological status of the patients were assessed using the Minimum Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). The severity of WMLs and the expression levels of serum NfL, TNF-α and IL-1β in alcohol-dependent patients were analysed for their influence on cognitive function. This clinical trial was approved by China Clinical Trials Registry, and the trial number is ChiCTR2200066057 (http://www.chictr.org.cn/searchproj.aspx).

The score of Fazekas scale was higher, and the MMSE score and MoCA score were lower in the alcohol-dependent group than those in the non-alcohol-dependent group. Moreover, the Fazekas score of the alcohol-dependent group was negatively correlated with the MMSE and MoCA scores. The serum NfL, TNF-α and IL-1β levels were higher in the alcohol-dependent group than in the non-alcohol-dependent group, and the serum NfL, TNF-α and IL-1β levels in the alcohol-dependent group were negatively correlated with the MMSE and MoCA scores.

Alcohol-dependent patients have more severe cerebral WMLs and significant cognitive impairment, particularly in visuospatial and executive functions, attention, calculation, abstraction, delayed recall and orientation. Serum NfL, TNF-α and IL-1β may be used as biomarkers to assess alcohol related cognitive decline.