De Bellis Michael D, Narasimhan Anandhi, Thatcher Dawn L, Keshavan Matcheri S, Soloff Paul, Clark Duncan B
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Alcohol Clin Exp Res. 2005 Sep;29(9):1590-600. doi: 10.1097/01.alc.0000179368.87886.76.
In adults, prefrontal, thalamic, and cerebellar brain injury is associated with excessive ethanol intake. As these brain structures are actively maturing during adolescence, we hypothesized that subjects with adolescent-onset alcohol use disorders, compared with control subjects, would have smaller brain volumes in these areas. Thus, we compared prefrontal-thalamic-cerebellar measures of adolescents and young adults with adolescent-onset alcohol use disorders (AUD, defined as DSM-IV alcohol dependence or abuse) with those of sociodemographically similar control subjects.
Magnetic resonance imaging was used to measure prefrontal cortex, thalamic, and cerebellar volumes in 14 subjects (eight males, six females) with an AUD (mean age, 17.0+/-2.1 years) and 28 control subjects (16 males, 12 females; 16.9+/-2.3 years). All AUD subjects were recruited from substance abuse treatment programs and had comorbid mental disorders.
Subjects with alcohol use disorders had smaller prefrontal cortex and prefrontal cortex white matter volumes compared with control subjects. Right, left, and total thalamic, pons/brainstem, right and left cerebellar hemispheric, total cerebellar, and cerebellar vermis volumes did not differ between groups. There was a significant sex-by-group effect, indicating that males with an adolescent-onset AUD compared with control males had smaller cerebellar volumes, whereas the two female groups did not differ in cerebellar volumes. Prefrontal cortex volume variables significantly correlated with measures of alcohol consumption.
These findings suggest that a smaller prefrontal cortex is associated with early-onset drinking in individuals with comorbid mental disorders. Further studies are warranted to examine if a smaller prefrontal cortex represents a vulnerability to, or a consequence of, early-onset drinking.
在成年人中，前额叶、丘脑和小脑的脑损伤与过量饮酒有关。由于这些脑结构在青春期时正处于活跃的发育阶段，我们推测，与对照受试者相比，患有青少年期酒精使用障碍的受试者在这些区域的脑容量会更小。因此，我们比较了患有青少年期酒精使用障碍（AUD，定义为符合《精神疾病诊断与统计手册》第四版的酒精依赖或滥用）的青少年和青年与社会人口统计学特征相似的对照受试者在前额叶 - 丘脑 - 小脑方面的测量结果。
使用磁共振成像测量了14名患有酒精使用障碍的受试者（8名男性，6名女性；平均年龄17.0±2.1岁）和28名对照受试者（16名男性，12名女性；16.9±2.3岁）的前额叶皮质、丘脑和小脑体积。所有患有酒精使用障碍的受试者均从药物滥用治疗项目中招募，且患有共病精神障碍。
与对照受试者相比，患有酒精使用障碍的受试者前额叶皮质和前额叶皮质白质体积更小。右、左和总的丘脑、脑桥/脑干、右和左小脑半球、总的小脑以及小脑蚓部体积在两组之间没有差异。存在显著的性别 - 组效应，表明患有青少年期酒精使用障碍的男性与对照男性相比，小脑体积更小，而两组女性在小脑体积上没有差异。前额叶皮质体积变量与酒精摄入量测量值显著相关。
这些发现表明，较小的前额叶皮质与患有共病精神障碍个体的早发性饮酒有关。有必要进一步研究以检验较小的前额叶皮质是早发性饮酒的易感性因素还是后果。
