Pfefferbaum A, Sullivan E V, Rosenbloom M J, Mathalon D H, Lim K O
Neuropsychiatry Program, Center for Health Sciences, SRI International, Menlo Park, Calif 94025, USA.
Arch Gen Psychiatry. 1998 Oct;55(10):905-12. doi: 10.1001/archpsyc.55.10.905.
We report on structural brain changes during a 5-year period in healthy control and alcoholic men.
Alcoholic patients (n = 16), from an initial group of 58 who underwent brain magnetic resonance imaging scanning while in treatment, were rescanned with the same acquisition sequence approximately 5 years later. Control subjects (n = 28) spanning the same age range also were scanned twice at a comparable interval. Changes in brain volume were corrected for error due to differences in head placement between scans and expressed as slopes (cubic centimeters per year), percentage of change over baseline for the control subjects, and standardized change for the alcoholic patients. The alcoholic patients varied considerably in the percentage of time that symptoms of alcohol dependence were present and in the amount of alcohol consumed during follow-up.
The cortical gray matter diminished in volume over time in the control subjects, most prominently in the prefrontal cortex, while the lateral and third ventricles enlarged. The alcoholic patients showed similar age-related changes with a greater rate of gray matter volume loss than the control subjects in the anterior superior temporal lobe. The amount of alcohol consumed during follow-up predicted the rate of cortical gray matter volume loss, as well as sulcal expansion. The rate of ventricular enlargement in alcoholic patients who maintained virtual sobriety was comparable to that in the control subjects.
During a 5-year period, brain volume shrinkage is exaggerated in the prefrontal cortex in normal aging with additional loss in the anterior superior temporal cortex in alcoholism. The association of cortical gray matter volume reduction with alcohol consumption over time suggests that continued alcohol abuse results in progressive brain tissue volume shrinkage.
我们报告了健康对照者和酗酒男性在5年期间大脑结构的变化。
在最初的58名接受治疗时进行脑磁共振成像扫描的酗酒患者中，选取16名患者，约5年后用相同的采集序列进行重新扫描。年龄范围相同的对照者（n = 28）也在类似的间隔时间进行了两次扫描。对扫描之间头部位置差异导致的误差进行校正后，得出脑容量变化，并表示为斜率（每年立方厘米）、对照者相对于基线的变化百分比以及酗酒患者的标准化变化。酗酒患者在随访期间酒精依赖症状出现的时间百分比以及饮酒量差异很大。
随着时间的推移，对照者的皮质灰质体积减小，最明显的是前额叶皮质，而侧脑室和第三脑室扩大。酗酒患者表现出类似的与年龄相关的变化，在前颞上叶灰质体积损失率高于对照者。随访期间的饮酒量可预测皮质灰质体积损失率以及脑沟扩张。保持几乎戒酒的酗酒患者的脑室扩大率与对照者相当。
在5年期间，正常衰老过程中前额叶皮质的脑容量缩小加剧，而酗酒会导致前颞上叶额外的脑容量损失。随着时间的推移，皮质灰质体积减少与饮酒之间的关联表明，持续酗酒会导致脑组织体积逐渐缩小。
