Abstinence and Relapse

MR Imaging

While most studies of chronic alcoholics have been conducted during the postalcohol period (e.g. during detoxification or abstinence), few studies have employed repeated MR measurements to document brain changes associated with prolonged abstinence or relapse. Several of these studies reported reversibilty of alcohol-induced ventricular enlargements (Schroth et al., 1988; Mann et al., 1989; Zipursky et al., 1989). The Zipursky study also demonstrated ventricular volume stability over time in controls, suggesting that ventricular volume normalization in abstinent alcoholics is associated with abstinence (Zipursky et al., 1989). A study of alcoholic women repeatedly scanned over a 6-week interval noted no ventricular volume changes; however, baseline ventricular volumes in those women were nearly normal and abstinence-associated changes may have been too small to detect (Kroft et al., 1991). Subsequent longitudinal studies of abstinent alcoholics reported improved brain white matter, ventricular, sulcal, and anterior gray matter cortical volumes (Shear et al., 1994; Pfefferbaum et al., 1995). By contrast, studies of relapsed alcoholics noted persistent white matter and ventricular abnormalities (Shear et al., 1994) and white matter volume reductions (Pfefferbaum et al., 1995). In a long-term (5-yr) longitudinal study, Pfefferbaum (1998) noted a correlation between alcohol consumption and cortical gray matter volume changes in relapsed alcoholics, and also found that abstinent alcoholics experienced ventricular volume rates of change comparable to those found in controls (Pfefferbaum et al., 1998).

MR Spectroscopy

Martin and colleagues (1995) first used 1H MRS to study neurochemical changes in alcoholics during prolonged abstinence. Elevated cerebellar vermis choline/ N-acetylaspartate (Cho/NAA) ratios were noted, along with a correlation between Cho/NAA ratios and neuropsychological test performance (Martin et al., 1995). The findings were interpreted to suggest remyelination or reversal of cholinergic deafferentation, although the authors pointed out that the Cho/NAA ratio might also have reflected NAA abnormalities (Martin et al., 1995). Elevated Cho/NAA ratios were subsequently detected in the cerebellum, frontal lobe, and thalamus in abstinent alcoholics (Jagannathan et al., 1996). That study also reported decreased NAA levels in all three brain regions, suggestive of neuronal loss (Jagannathan et al., 1996). The presence of NAA abnormalities suggests that metabolite ratios using NAA in the denominator might not provide stable measures in alcoholics. Seitz and colleagues (1999) reported both reduced cerebellar volumes and reduced NAA/Cr ratios in recently abstinent alcoholics, consistent with neuronal loss. Phosphorus (31P) MRS has also been used to evaluate the neurochemical effects of chonic alcohol abuse. White matter phosphocreatine (PCr) and phosphodiester (PDE) levels were reduced in alcoholics, and correlations between white matter PDE levels and both age and ventricular volumes were found (Meyerhoff et al., 1995). PCr abnormalities implied bioenergetic dysfunction while abnormal PDE levels were interpreted to reflect either altered phospholipid concentration or phospholipid relaxation rates (Meyerhoff et al., 1995).

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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