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Brain atrophy in chronic alcoholic patients: a quantitative pathological study.

C Harper, J Kril

    Journal of Neurology, Neurosurgery, and Psychiatry
    |March 1, 1985
    PubMed
    Summary

    Chronic alcohol use causes significant brain tissue loss, measurable by increased pericerebral space. This brain atrophy is more severe with thiamine deficiency or liver disease.

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    Area of Science:

    • Neuropathology
    • Neuroimaging
    • Addiction Medicine

    Background:

    • Neuroradiological studies suggest brain atrophy in chronic alcoholics, but objective neuropathological data are lacking.
    • Brain atrophy, or shrinkage, is a known consequence of chronic alcohol abuse.
    • Lack of quantitative neuropathological evidence necessitates direct measurement of brain volume changes.

    Purpose of the Study:

    • To objectively measure brain atrophy in chronic alcoholic patients using necropsy data.
    • To quantify the relationship between chronic alcoholism and brain volume loss.
    • To investigate if nutritional deficiencies or liver disease exacerbate alcohol-induced brain atrophy.

    Main Methods:

    • Necropsy study involving 25 chronic alcoholic patients and 44 controls.
    • Measurement of intracranial volume (ICV) and brain volume (BV).
    • Calculation of pericerebral space (PICS) as an indicator of brain atrophy.

    Main Results:

    • Chronic alcoholics showed a statistically significant increase in PICS (mean 11.3%) compared to controls (mean 8.3%).
    • Alcoholics with Wernicke's encephalopathy had a higher PICS (14.7%), and those with liver disease had the highest (16.2%).
    • Increased PICS indicates a loss of brain tissue in chronic alcoholics.

    Conclusions:

    • Objective neuropathological evidence confirms significant brain tissue loss in chronic alcoholic patients.
    • Alcohol-induced brain atrophy is exacerbated by associated thiamine deficiency (Wernicke's encephalopathy) and alcoholic liver disease.
    • Quantitative measurement of pericerebral space is a reliable indicator of brain atrophy in alcoholism.

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