Harper C G, Kril J J
Department of Pathology, University of Sydney, Australia.
Alcohol Alcohol. 1990;25(2-3):207-16. doi: 10.1093/oxfordjournals.alcalc.a044994.
There are wide ranging effects of alcohol on the nervous system. Some interfere with physiological and neurochemical functions but ultimately structural damage occurs. During life one of the most impressive changes is brain shrinkage which can be visualized using neuroradiological imaging techniques. This article reviews the pathological explanations for brain shrinkage and addresses the question of the pathogenesis of the reversible component of this damage in relation to prolonged abstinence from alcohol. This shrinkage seems to relate to a loss of white matter. However, the cortex is also abnormal in that there is a loss of neurones from the frontal region. In this and other regions of the cortex examined there is shrinkage of the neuronal soma. This is reflected in a retraction of the neuronal dendritic arbor which plays a crucial role in cell-to-cell communication. In addition, the cerebellum appears to be vulnerable in alcoholic patients although it may well be that associated nutritional deficiencies play an important role. The Wernicke-Korsakoff syndrome is another important deficiency disorder which is seen most frequently in alcoholic patients. Two important population groups which are considered in this review are females and moderate ('social') drinkers. Females are thought to be more susceptible to the damaging effects of alcohol than males and this is examined in the light of the scant data available. Similarly, there are few neuropathological data on people who drink 30-80 grams of alcohol per day. In order to assess so-called 'safe levels of drinking' this is an important group to study.
酒精对神经系统有广泛影响。有些影响会干扰生理和神经化学功能，但最终会导致结构损伤。在生命过程中，最显著的变化之一是脑萎缩，这可以通过神经放射成像技术观察到。本文回顾了脑萎缩的病理学解释，并探讨了与长期戒酒相关的这种损伤可逆部分的发病机制问题。这种萎缩似乎与白质丢失有关。然而，皮质也存在异常，额叶区域的神经元会丢失。在所检查的皮质的这个区域和其他区域，神经元胞体都有萎缩。这反映在神经元树突分支的回缩上，而树突分支在细胞间通讯中起着关键作用。此外尽管可能是相关的营养缺乏起了重要作用，但小脑在酒精中毒患者中似乎也很脆弱。韦尼克 - 科尔萨科夫综合征是另一种重要的缺乏症，在酒精中毒患者中最为常见。本文所考虑的两个重要人群是女性和适度（“社交性”）饮酒者。女性被认为比男性更容易受到酒精的损害作用，本文根据现有的少量数据对此进行了研究。同样，关于每天饮用30 - 80克酒精的人群，神经病理学数据很少。为了评估所谓的“安全饮酒水平”，这是一个需要研究的重要群体。
