Brain atrophy in alcoholics: relationship with alcohol intake; liver disease; nutritional status, and inflammation.
OBJECTIVE
Brain atrophy is a common finding in alcoholics. Several mechanisms may be involved, including ethanol itself, malnutrition, liver failure, and, possibly, ethanol-induced hormone and cytokine changes. The aim of this study was to analyse the relation of brain atrophy-assessed by computerized tomography (CT) scan-and the aforementioned alterations.


METHODS
Serum insulin-like growth factor 1 (IGF-1), interleukin (IL)-6, IL-8, IL-10, TNF alpha, PTH, estradiol, free testosterone, and corticosterone were measured in 36 alcoholics, ten of them cirrhotics, who also underwent brain CT, which recorded the presence of cortical atrophy or cerebellar atrophy, Evan's, Huckmann's, cella media, bicaudate, cortical atrophy, bifrontal, and ventricular indices, and diameter of the third ventricle; subjective nutritional assessment, midarm anthropometry, and evaluation of liver function.


RESULTS
Patients showed marked alterations of all the CT indices compared with 12 controls, but poor relations between these indices and the other parameters analysed (IGF-1, handgrip strength and years of addiction with bifrontal index (P < 0.025 in all cases); PTH and Evan's index (r = 0.36, P = 0.032); mean corpuscular volume with cella index and cortical atrophy (P < 0.05). Cerebellar atrophy was associated with a greater daily ethanol consumption (t = 2.19, P = 0.034).


CONCLUSIONS
Brain atrophy is frequently observed in alcoholics, but relationships with liver function, cytokines, nutritional status, and hormone levels are poor.
García-Valdecasas-Campelo
Elena
E
Servicio de Medicina Interna, Hospital Universitario.Ofra s/n, Tenerife, Canary Islands Spain.
González-Reimers
Emilio
E
Santolaria-Fernández
Francisco
F
De La Vega-Prieto
María José
MJ
Milena-Abril
Antonio
A
Sánchez-Pérez
María José
MJ
Martínez-Riera
Antonio
A
Rodríguez-Rodríguez
Eva
E
D000328:Adult; D000428:Alcohol Drinking / Q000378:metabolism / Q000473:pathology; D000437:Alcoholism / Q000378:metabolism / Q000473:pathology*; D001284:Atrophy; D001927:Brain Diseases / Q000378:metabolism* / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology; D054022:Cerebrum / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D011859:Radiography