Mann K, Ackermann K, Croissant B, Mundle G, Nakovics H, Diehl A
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Alcohol Clin Exp Res. 2005 May;29(5):896-901. doi: 10.1097/01.alc.0000164376.69978.6b.
Alcoholic brain damage has been demonstrated in numerous studies using neuropathology and brain imaging techniques. However, gender differences were addressed only in a few studies. Recent research has shown that development, course, and consequences of alcohol dependence may differ between female and male patients. Our investigation was built upon earlier research where we hypothesized that women develop alcoholic brain damage more readily than men do. To further compare the impact of alcohol dependence between men and women, we examined brain atrophy in female and male alcoholics by means of computed tomography (CT).
The study group consisted of a total of 158 subjects (76 women: 42 patients, 34 healthy controls; 82 age-matched men: 34 patients, 48 healthy controls). All patients had a DSM-IV and ICD-10 diagnosis of alcohol dependence. CT with digital volumetry was performed twice in patients (at the beginning and end of the 6-week inpatient treatment program) and once in controls.
Patients of both genders had consumed alcohol very heavily. Although the average alcohol consumption in the year before the study was significantly lower in female alcoholics, this gender difference disappeared when controlled for weight. However, women had a significantly shorter duration of alcohol dependence. Despite this fact, both genders developed brain atrophy to a comparable extent. Brain atrophy was reversible in part after 6 weeks of treatment; it did not reach the level in the control groups.
Gender-specific differences in the onset of alcohol dependence were confirmed. This is in line with the telescoping effect, where a later onset and a more rapid development of dependence in women were described. Under the assumption of a gradual development of consequential organ damage, brain atrophy seems to develop faster in women. As shown in other organs (i.e., heart, muscle, liver), this may confirm a higher vulnerability to alcohol among women.
众多使用神经病理学和脑成像技术的研究已证实酒精性脑损伤的存在。然而，仅有少数研究探讨了性别差异。近期研究表明，酒精依赖的发展、过程及后果在女性和男性患者中可能有所不同。我们的研究基于早期研究，在早期研究中我们假设女性比男性更容易发生酒精性脑损伤。为进一步比较男性和女性酒精依赖的影响，我们通过计算机断层扫描（CT）检查了女性和男性酗酒者的脑萎缩情况。
研究组共有158名受试者（76名女性：42名患者，34名健康对照；82名年龄匹配的男性：34名患者，48名健康对照）。所有患者均符合《精神疾病诊断与统计手册》第四版（DSM-IV）和《国际疾病分类》第十版（ICD-10）的酒精依赖诊断标准。对患者进行了两次带有数字容积测量的CT检查（在为期6周的住院治疗项目开始时和结束时），对对照组进行了一次CT检查。
两性患者饮酒量都非常大。尽管女性酗酒者在研究前一年的平均饮酒量显著低于男性，但在控制体重后，这种性别差异消失了。然而，女性的酒精依赖持续时间明显较短。尽管如此，两性脑萎缩的程度相当。治疗6周后脑萎缩部分可逆；但未恢复到对照组的水平。
证实了酒精依赖发病存在性别特异性差异。这与“ telescoping效应”相符，该效应描述了女性发病较晚但依赖发展更快的情况。在假定后果性器官损伤逐渐发展的情况下，女性的脑萎缩似乎发展得更快。正如在其他器官（如心脏、肌肉、肝脏）中所显示的那样，这可能证实女性对酒精的易感性更高。
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