Brain damage in alcoholics without neuropsychological impairment. A population study.

Computed tomography (CT) of the brain and neuropsychological assessment was performed in a random sample of 195 men to investigate the relationship between drinking of alcohol and brain damage. This sample from the general population was divided into subsamples on the basis of their self-reported loss of control over drinking, morning drinks and blackouts. The consumption of hepatotoxic drugs was also investigated. For this the material was divided into four groups with regard to both alcohol consumption and use of hepatotoxic drugs: Group IA, low or moderate alcohol consumption and no use of such drugs; IB, low or moderate alcohol consumption with use of such drugs; IIA, high alcohol consumption with no use of such drugs; and IIB, high alcohol consumption with use of such drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. Differences in CT variables were observed between the 4 groups IA-IIB, but there were no differences in the results of neuropsychological assessment. Thus, an alcoholic could have progressive cortical and subcortical changes without any neuropsychological impairment at all. Neither the duration of self-reported loss of control over drinking nor the amount of alcohol consumed per drinking occasion were found to be associated with cognitive impairment, but both showed a relationship to cortical and subcortical CT changes.