Nicolás J M, Catafau A M, Estruch R, Lomeña F J, Salamero M, Herranz R, Monforte R, Cardenal C, Urbano-Marquez A
Department of Internal Medicine, Hospital Clínic, University of Barcelona, Spain.
J Nucl Med. 1993 Sep;34(9):1452-9.
To determine the prevalence of central nervous system damage due to ethanol, we evaluated 40 asymptomatic chronic alcoholics and 20 age-matched controls. Studies included neuropsychological testing, brain 99mTc-HMPAO SPECT, and morphometric analysis by CT scan. In the qualitative analysis, 30 of the 40 alcoholics showed hypoperfused areas on SPECT scan. In the semiquantitative analysis, alcoholics exhibited significant reduction in regional cerebral blood flow (rCBF) ratio of all brain lobes compared to controls (p < 0.001). The rCBF ratio was mainly reduced in frontal lobes (65%). Only 11 alcoholics showed significant frontal lobe atrophy in the morphometric analysis; most also had abnormalities on SPECT scan. Alcoholics exhibited significant impairment of frontal tasks and visuospatial skills. Frontal test impairment was independently related to both frontal atrophy and hypoperfusion. In a group of ten alcoholics in whom another SPECT scan was performed after 2 mo of ethanol abstinence, rCBF ratio of the frontal lobes normalized in eight, without frontal atrophy. In patients without frontal atrophy, reduced rCBF ratio of the anterior portion of the frontal lobes correlated negatively with frontal test results (r = -0.6535, p < 0.001). A significant negative correlation between cerebral perfusion and the amount of ethanol consumed in the month prior to study was observed (r = -0.6289, p < 0.001). In conclusion, asymptomatic chronic alcoholics frequently showed reversible frontal lobe hypoperfusion, which is related to recent ethanol intake, reflects brain function impairment and is independent of brain atrophy.
为了确定乙醇所致中枢神经系统损害的患病率，我们评估了40名无症状慢性酒精中毒者和20名年龄匹配的对照者。研究包括神经心理学测试、脑99mTc - HMPAO单光子发射计算机断层扫描（SPECT）以及CT扫描形态学分析。在定性分析中，40名酒精中毒者中有30名在SPECT扫描中显示灌注不足区域。在半定量分析中，与对照组相比，酒精中毒者所有脑叶的局部脑血流量（rCBF）比值显著降低（p < 0.001）。rCBF比值主要在额叶降低（65%）。在形态学分析中，只有11名酒精中毒者显示出明显的额叶萎缩；大多数在SPECT扫描中也有异常。酒精中毒者在额叶任务和视觉空间技能方面表现出显著损害。额叶测试损害与额叶萎缩和灌注不足均独立相关。在一组10名酒精中毒者中，在戒酒2个月后进行了另一次SPECT扫描，其中8名额叶的rCBF比值恢复正常，且无额叶萎缩。在没有额叶萎缩的患者中，额叶前部rCBF比值降低与额叶测试结果呈负相关（r = -0.6535，p < 0.001）。观察到脑灌注与研究前一个月乙醇摄入量之间存在显著负相关（r = -0.6289，p < 0.001）。总之，无症状慢性酒精中毒者经常出现可逆性额叶灌注不足，这与近期乙醇摄入有关，反映了脑功能损害且与脑萎缩无关。
