Seoul St. Mary's Hospital, Department of Psychiatry, Catholic University of Korea, Catholic Medical Center, Banpo-dong, Seocho-gu, Korea.
Int J Environ Res Public Health. 2009 Nov;6(11):2783-92. doi: 10.3390/ijerph6112783. Epub 2009 Nov 6.
For a long time, alcohol was thought to exert a general depressant effect on the central nervous system (CNS). However, currently the consensus is that specific regions of the brain are selectively vulnerable to the acute effects of alcohol. An alcohol-induced blackout is the classic example; the subject is temporarily unable to form new long-term memories while relatively maintaining other skills such as talking or even driving. A recent study showed that alcohol can cause retrograde memory impairment, that is, blackouts due to retrieval impairments as well as those due to deficits in encoding. Alcoholic blackouts may be complete (en bloc) or partial (fragmentary) depending on severity of memory impairment. In fragmentary blackouts, cueing often aids recall. Memory impairment during acute intoxication involves dysfunction of episodic memory, a type of memory encoded with spatial and social context. Recent studies have shown that there are multiple memory systems supported by discrete brain regions, and the acute effects of alcohol on learning and memory may result from alteration of the hippocampus and related structures on a cellular level. A rapid increase in blood alcohol concentration (BAC) is most consistently associated with the likelihood of a blackout. However, not all subjects experience blackouts, implying that genetic factors play a role in determining CNS vulnerability to the effects of alcohol. This factor may predispose an individual to alcoholism, as altered memory function during intoxication may affect an individual's alcohol expectancy; one may perceive positive aspects of intoxication while unintentionally ignoring the negative aspects. Extensive research on memory and learning as well as findings related to the acute effects of alcohol on the brain may elucidate the mechanisms and impact associated with the alcohol-induced blackout.
长期以来,人们一直认为酒精对中枢神经系统(CNS)有普遍的抑制作用。然而,目前的共识是,大脑的特定区域对酒精的急性作用特别敏感。酒精引起的断片性昏迷就是一个典型的例子;在相对保持其他技能(如说话甚至开车)的同时,受测者暂时无法形成新的长期记忆。最近的一项研究表明,酒精会导致逆行性记忆障碍,即由于检索障碍和编码缺陷而导致的断片性昏迷。根据记忆损伤的严重程度,酒精性断片性昏迷可能是完全的(整块的)或部分的(片段的)。在片段性昏迷中,提示通常有助于回忆。急性醉酒期间的记忆损伤涉及情景记忆功能障碍,情景记忆是一种带有空间和社会背景的记忆类型。最近的研究表明,有多个记忆系统由离散的大脑区域支持,酒精对学习和记忆的急性影响可能是由于海马体和相关结构在细胞水平上的功能障碍。血液酒精浓度(BAC)的快速增加与断片性昏迷的发生可能性最密切相关。然而,并非所有受测者都经历断片性昏迷,这意味着遗传因素在决定中枢神经系统对酒精作用的敏感性方面起着作用。这个因素可能使个体易患酒精中毒,因为醉酒期间记忆功能的改变可能会影响个体对酒精的预期;一个人可能会感知到醉酒的积极方面,而无意中忽略了消极方面。对记忆和学习的广泛研究以及与酒精对大脑的急性作用相关的发现,可以阐明与酒精引起的断片性昏迷相关的机制和影响。