Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Alcohol Alcohol. 2020 Jun 25;55(4):382-390. doi: 10.1093/alcalc/agaa034.
Magnetic resonance imaging (MRI) studies report widespread cortical thinning in individuals with alcohol use disorder (AUD), but did not consider potential effects of pro-atherogenic conditions such as hypertension, type 2 diabetes mellitus, hepatitis C seropositivity and hyperlipidemia on cortical thickness. The conditions are associated with regional cortical thinning in those without AUD. We predicted that individuals with concurrent AUD and pro-atherogenic conditions demonstrate the greatest regional cortical thinning in areas most vulnerable to decreased perfusion.
Treatment-seeking individuals with AUD (n = 126) and healthy controls (CON; n = 49) completed a 1.5 T MRI study. Regional cortical thickness was quantitated via FreeSurfer. Individuals with AUD and pro-atherogenic conditions (Atherogenic+), AUD without pro-atherogenic conditions (Atherogenic-) and CON were compared on regional cortical thickness.
Individuals with AUD showed significant bilateral cortical thinning compared to CON, but Atherogenic+ demonstrated the most widespread and greatest magnitude of regional thinning, while Atherogenic- had reduced thickness primarily in anterior frontal and posterior parietal lobes. Atherogenic+ also showed a thinner cortex than Atherogenic- in lateral orbitofrontal and dorso/dorsolateral frontal cortex, mesial and lateral temporal and inferior parietal regions.
Our results demonstrate significant bilateral cortical thinning in individuals with AUD relative to CON, but the distribution and magnitude were influenced by comorbid pro-atherogenic conditions. The magnitude of cortical thinning in Atherogenic+ strongly corresponded to cortical watershed areas susceptible to decreased perfusion, which may result in morphometric abnormalities. The findings indicate that pro-atherogenic conditions may contribute to cortical thinning in those seeking treatment for AUD.
磁共振成像（MRI）研究报告称，酒精使用障碍（AUD）患者的皮质广泛变薄，但并未考虑到动脉粥样硬化的潜在影响条件，如高血压、2 型糖尿病、丙型肝炎血清阳性和高脂血症对皮质厚度的影响。这些情况与没有 AUD 的人局部皮质变薄有关。我们预测，同时患有 AUD 和动脉粥样硬化的个体在最容易出现灌注减少的区域表现出最大的区域皮质变薄。
寻求治疗的 AUD 个体（n=126）和健康对照（CON；n=49）完成了 1.5T MRI 研究。通过 FreeSurfer 定量分析区域皮质厚度。比较 AUD 伴动脉粥样硬化条件（Atherogenic+）、AUD 无动脉粥样硬化条件（Atherogenic-）和 CON 个体的区域皮质厚度。
与 CON 相比，AUD 个体表现出明显的双侧皮质变薄，但 Atherogenic+表现出最广泛和最大程度的区域变薄，而 Atherogenic-主要在前额和后顶叶表现出皮质变薄。Atherogenic+在外侧眶额和背侧/背外侧额叶皮质、内侧和外侧颞叶以及下顶叶区域的皮质也比 Atherogenic-薄。
我们的结果表明，与 CON 相比，AUD 个体存在明显的双侧皮质变薄，但分布和程度受共病动脉粥样硬化条件的影响。Atherogenic+的皮质变薄程度与易发生灌注减少的皮质分水岭区域强烈对应，这可能导致形态异常。这些发现表明，动脉粥样硬化条件可能导致寻求 AUD 治疗的个体皮质变薄。
