Cross-sectional volumetric analysis of brain atrophy in alcohol dependence: Effects of drinking history and comorbid substance use disorder
Cross-sectional volumetric analysis of brain atrophy in alcohol dependence: Effects of drinking history and comorbid substance use disorder
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DOI：
10.1176/appi.ajp.160.11.2038
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发表时间：
2003-11-01
影响因子：
17.7
通讯作者：
Hommer, DW
中科院分区：
文献类型：
--
作者：
Bjork, JM;Grant, SJ;Hommer, DW
目的：作者评估了饮酒史的个体差异以及共病可卡因或大麻使用障碍的终生发生率是否是酒精依赖受试者脑萎缩差异模式的基础。采用分段磁共振图像对134例30-50岁男性酒精依赖者的全脑灰质和白色物质进行比较，结果：在所有受试者中，饮酒史变量与年龄控制后的灰质和白色物质呈负相关。与终生患有可卡因使用障碍诊断的酒精依赖受试者（N = 50）相比，没有合并药物使用障碍的酒精依赖受试者（N=51）显示出年龄与灰质/白色比值之间更陡峭的负相关性。与无药物使用障碍共病的酒精依赖受试者相比，有可卡因使用障碍共病的酒精依赖受试者的年龄与白色物质（经颅内体积校正）之间的负相关性更陡。年龄和更大的估计累积酒精消费量的酒精依赖受试者与共病可卡因使用障碍的控制在多元回归分析，但是，共病可卡因使用障碍并没有解释任何独立的变量在任何体积的措施。酒精依赖受试者的脑萎缩反映了酒精暴露的个体差异，这些数据提供了混合的证据表明，共病可卡因使用障碍可能会加剧酒精中毒的白色萎缩。
Objective: The authors assessed whether individual differences in drinking history as well as lifetime incidence of comorbid cocaine or marijuana use disorder underlie differential patterns of brain atrophy in subjects with alcohol dependence.Method: Segmented magnetic resonance images were used to compare whole brain cerebral gray matter and white matter in 134 male subjects age 30-50 with alcohol dependence, either alone or with comorbid cocaine or marijuana use disorder.Results: Across all subjects, drinking history variables correlated negatively with both gray matter and white matter after age was controlled. Alcohol-dependent subjects with no comorbid substance use disorder (N=51) showed a steeper negative correlation between age and the gray matter/white matter ratio than did alcohol-dependent subjects with a comorbid lifetime cocaine use disorder diagnosis (N=50). Alcohol-dependent subjects with comorbid cocaine use disorder tended to have a steeper negative correlation between age and white matter (adjusted for intracranial volume) than did alcohol-dependent subjects with no comorbid substance use disorder. After age and the greater estimated cumulative alcohol consumption of alcohol-dependent subjects with comorbid cocaine use disorder were controlled in a multiple regression analysis, however, comorbid cocaine use disorder did not account for any independent variance in any volumetric measure.Conclusions: Brain atrophy among subjects with alcohol dependence reflects individual differences in exposure to alcohol, and the data provide mixed evidence that comorbid cocaine use disorder may exacerbate white matter atrophy in alcoholism.