title: Readiness to change and brain damage in patients with chronic alcoholism.
abstract: High motivation to change is a crucial triggering factor to patients' engagement in clinical treatment. This study investigates whether the low readiness to change observed in some alcoholic inpatients at treatment entry could, at least partially, be linked with macrostructural gray matter abnormalities in critical brain regions. Participants comprised 31 alcoholic patients and 27 controls, who underwent 1.5-T magnetic resonance imaging. The Readiness to Change Questionnaire, designed to assess three stages of motivation to change (precontemplation, contemplation and action stages), was completed by all patients, who were then divided into "Action" (i.e., patients in action stage) and "PreAction" (i.e., patients in precontemplation or in contemplation stage) subgroups. The PreAction subgroup, but not the Action subgroup, had gray matter volume deficits compared with controls. Unlike the patients in the Action subgroup, the PreAction patients had gray matter abnormalities in the cerebellum (Crus I), fusiform gyri and frontal cortex. The low level of motivation to modify drinking behavior observed in some alcoholic patients at treatment entry may be related to macrostructural brain abnormalities in regions subtending cognitive, emotional and social abilities. These brain volume deficits may result in impairment of critical abilities such as decision making, executive functions and social cognition skills. Those abilities may be needed to resolve ambivalence toward alcohol addiction and to apply "processes of change", which are essential for activating the desire to change problematic behavior.
authors.affiliation: INSERM, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France.
authors.forename: Anne-Pascale
authors.initials: AP
authors.lastname: Le Berre
authors.forename: Géraldine
authors.initials: G
authors.lastname: Rauchs
authors.forename: Renaud
authors.initials: R
authors.lastname: La Joie
authors.forename: Shailendra
authors.initials: S
authors.lastname: Segobin
authors.forename: Florence
authors.initials: F
authors.lastname: Mézenge
authors.forename: Céline
authors.initials: C
authors.lastname: Boudehent
authors.forename: François
authors.initials: F
authors.lastname: Vabret
authors.forename: Fausto
authors.initials: F
authors.lastname: Viader
authors.forename: Francis
authors.initials: F
authors.lastname: Eustache
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Pitel
authors.forename: Hélène
authors.initials: H
authors.lastname: Beaunieux
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D002908:Chronic Disease; D004410:Dyslexia / Q000209:etiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: Alcoholism; Brain morphology; Frontal cortex; Motivation