title: High ethanol intake and malnutrition in alcoholic cerebellar shrinkage.
abstract: To determine the influence of chronic ethanol intake and nutritional status on cerebellar shrinkage in alcoholism, we studied 12 undernourished patients with acute Wernicke's encephalopathy (WE), 12 undernourished and 24 well-nourished asymptomatic chronic alcoholics, and 24 age-matched well-nourished controls, using morphometric analysis of MRI scans with volumetry of the cerebellum. Alcoholics reported a mean daily intake of ethanol of 177+/-8 g over a period of 27+/-1 years. Most undernourished alcoholics and half of the well-nourished alcoholics, compared to one-tenth of the controls, showed a significant reduction in cerebellar volume (p< or =0.01, both). Alcoholics with cerebellar shrinkage (n=33) were older (p=0.05) and tended to report greater daily ethanol intake than alcoholics without cerebellar shrinkage (n=15), although not significantly so (p=0.09). Cerebellar volume correlated negatively with age in controls and asymptomatic alcoholics (r> or =0.52, p< or =0.01, both), with a significantly greater shrinkage for age in the latter (p=0.003). Logistic regression analysis showed that malnutrition (OR 6.6 [95%CI 1.7-25.6], p=0.005) and a daily ethanol intake of more than 140 g over ten years (OR 6.1 [95%CI 1.8-20.5], p=0.003) were independently associated with the development of cerebellar shrinkage.
authors.affiliation: Department of Internal Medicine, Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain. nicolas@medicina.ub.es
authors.forename: J M
authors.initials: JM
authors.lastname: Nicolás
authors.forename: J
authors.initials: J
authors.lastname: Fernández-Solà
authors.forename: J
authors.initials: J
authors.lastname: Robert
authors.forename: E
authors.initials: E
authors.lastname: Antúnez
authors.forename: M
authors.initials: M
authors.lastname: Cofán
authors.forename: C
authors.initials: C
authors.lastname: Cardenal
authors.forename: E
authors.initials: E
authors.lastname: Sacanella
authors.forename: R
authors.initials: R
authors.lastname: Estruch
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Márquez
mesh_terms: D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D000704:Analysis of Variance; D016022:Case-Control Studies; D002531:Cerebellum / Q000187:drug effects / Q000473:pathology*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications* / Q000175:diagnosis; D012044:Regression Analysis; D014899:Wernicke Encephalopathy / Q000175:diagnosis / Q000209:etiology*