Longitudinal brain metabolic characterization of chronic alcoholics with proton magnetic resonance spectroscopy.

Parks MH, Dawant BM, Riddle WR, Hartmann SL, Dietrich MS, Nickel MK, Price RR, Martin PR
Alcohol Clin Exp Res. 2002 26 (9): 1368-80

PMID: 12351932 · DOI:10.1097/01.ALC.0000029598.07833.2D

BACKGROUND - Proton magnetic resonance spectroscopy may elucidate the molecular underpinnings of alcoholism-associated brain shrinkage and the progression of alcohol dependence.

METHODS - Using proton magnetic resonance spectroscopy, we determined absolute concentrations of -acetylaspartate (NAA), creatine/phosphocreatine (Cr), and choline (Cho)-containing compounds and -inositol (mI) in the anterior superior cerebellar vermis and frontal lobe white matter in 31 alcoholics and 12 normal controls. All patients were examined within 3 to 5 days of their last drink. Patients who did not relapse were again studied after 3 weeks and 3 months of abstinence by using an on-line repositioning technique that allows reliable localization of volumes of interest (VOIs).

RESULTS - At 3 to 5 days after the last drink, frontal white matter metabolite concentrations were not significantly different from those of normal controls, whereas brain tissue in the VOI was reduced. Cerebellar [NAA] and [Cho] and brain and cerebellar volumes were decreased, but [Cr], [mI], and VOI brain tissue volume were not significantly different. Eight patients relapsed before 3 weeks (ER), 12 relapsed between 3 weeks and 3 months (LR), and 11 did not relapse (NR) during 3 months. Cerebellar [NAA] was reduced only in ER patients, despite the fact that ER patients drank for significantly fewer years and earlier in life than LR or NR patients. After 3 months, in the 11 continuously abstinent patients, cerebellar [NAA] and brain and cerebellar volumes increased; cerebellar [Cho], [Cr], and [mI] and VOI brain tissue did not change significantly.

CONCLUSIONS - Decreased [NAA] and [Cho] in cerebellar vermis indicate a unique sensitivity to alcohol-induced brain injury. Cerebellar [NAA] increased with abstinence, but reduced [Cho] persisted beyond 3 months. Further studies are needed to determine whether low cerebellar [NAA] is a risk factor for, or consequence of, malignant, early-onset alcoholism.

MeSH Terms (17)

Adult Aged Alcoholism Brain Cerebellum Female Frontal Lobe Humans Longitudinal Studies Magnetic Resonance Spectroscopy Male Middle Aged Neuropsychological Tests Recurrence Retrospective Studies Statistics, Nonparametric Temperance

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