Cortical gray matter loss in treatment-naive alcohol dependent individuals
Cortical gray matter loss in treatment-naive alcohol dependent individuals
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DOI：
10.1097/00000374-200204000-00017
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发表时间：
2002-04-01
影响因子：
3.2
通讯作者：
Meyerhoff, DJ
中科院分区：
文献类型：
--
作者：
Fein, G;Di Sclafani, V;Meyerhoff, DJ
背景：大多数关于酒精依赖对大脑影响的研究都是针对个体的，治疗这些样本代表了一般人群中酗酒者的一小部分。如果变量（例如，酗酒和皮质灰质损失）之间的关联在接受治疗的酗酒者群体和普通人群中的酗酒者群体之间存在差异，则此类样本可能体现出偏见（Berkson谬误）。我们的目的是确定是否治疗初治酗酒者显示结构性脑变化与对照组相比，并比较我们的研究结果与报告评估酒精样本从治疗population.Methods：结构MRI被用来评估全脑和区域体积的皮质灰质和白色物质在24个年轻到中年治疗初治酒精依赖男性与17个对照组。酒精依赖个体的皮质灰质体积与年龄和酒精使用的寿命呈负相关（这是高度混淆的）。与对照组相比，这些受试者的全脑（p < 0.05）、前额叶（p < 0.01）和顶叶（p < 0.05）皮质灰质减少。白色物质和颞叶皮质，通常显示从治疗中提取的样本体积减少的组织，在治疗初治的酗酒者和对照组之间没有差异（所有p > 0.40）。我们的研究结果与以下假设相一致，即未经治疗的酗酒者的大脑结构变化不如临床酗酒者样本中报告的严重，这可能是由于在未接受过治疗的酗酒者中伴随的精神病理学较少和酗酒严重程度降低。然而，在将我们的研究结果与临床样本的结果进行比较时必须谨慎，因为我们没有直接比较未经治疗的酗酒者与经治疗的酗酒者，并且我们的未经治疗的样本往往比文献中报道的（临床）样本更年轻。然而，我们认为，大多数关于酒精中毒对中枢神经系统影响的报道可能并不能准确地描述大多数酒精依赖者。
Background: Most studies of the impact of alcohol dependence on the brain have examined individuals it., treatment. Such samples represent a small proportion of alcoholics in the general population. Such samples may embody a bias (Berkson's fallacy) if the association between variables (for example, alcoholism and cortical gray matter loss) differs between the population of alcoholics in treatment and alcoholics in the general population. Our objective was to determine if treatment-naive alcoholics show structural brain changes versus controls and to compare our findings with reports evaluating alcoholic samples drawn from treatment populations.Methods: Structural MRI was used to assess whole brain and regional volumes of cortical gray matter and white matter in 24 young to middle-aged treatment-naive alcohol-dependent males versus 17 controls.Results: Cortical gray matter volumes in alcohol-dependent individuals were negatively associated with age and lifetime duration of alcohol use (which were highly confounded). These subjects showed reduced whole brain (p < 0.05), prefrontal (p < 0.01), and parietal (p < 0.05) cortical gray matter compared with controls. White matter and temporal cortex, tissues that usually show volume reductions in samples drawn from treatment, did not differ between treatment-naive alcoholics and controls (all p > 0.40).Conclusions: Our findings are consistent with the hypothesis that structural brain changes in treatment-naive alcoholics are less severe than those reported in clinical samples of alcoholics, perhaps due to less concomitant psychopathology and a reduced severity of alcoholism in treatment-naive alcoholics. However, caution must be taken when comparing our findings with results from clinical samples, as we did not directly compare treatment-naive alcoholics with treated alcoholics and our treatment-naive sample tended to be younger than the (clinical) samples reported in the literature. Nevertheless, we suggest that most of the reports of the central nervous system consequences of alcoholism may not accurately describe the majority of alcoholic-dependent individuals.