Brain Morbidity in Treatment-Naive Alcoholics

描述(由申请人提供)：关于酒精影响的大多数研究 对大脑的依赖已经检查了接受治疗的个体。它们可能体现了 如果变量之间的关联(例如， 酒精中毒和脑萎缩或脑功能)在不同人群之间存在差异 正在接受治疗的酗酒者和普通人群中的酗酒者。我们 假设未接受治疗的酗酒者的精神共病较少 与治疗样本相比，这种减少的精神疾病发病率是 与大脑结构损伤的严重程度和 功能。 拟议研究的主要目标是确定：1) 治疗--天真的酗酒者在大脑结构和功能上与 从戒酒中心招募的酗酒者，2)是否接受治疗-幼稚 酗酒者不同于从戒酒中心招募的酗酒者 共病情绪和外化障碍症状的存在和严重程度 特征，3)哪些因素与大脑结构和 在治疗中的作用--幼稚的酗酒者和从治疗中抽出的酗酒者 中枢(包括存在和严重的共病情绪、焦虑和 外在性障碍症状和特征，APOE-4等位基因的存在， 发病前头部大小作为功能储备的衡量标准(由 MRI上的颅内脑室体积)，以及脑出血的频率(和严重程度) 戒断症状)，4)男性和女性在这些比较中是否不同， 5)遵循治疗--未来的纵向治疗--单纯酗酒者 对预测其酗酒过程的因素进行评估(特别是 寻求治疗，以及大脑结构和功能的变化)。 我们将在五年内研究380名受试者：220种治疗方法--幼稚 酒精依赖者：门诊80例 治疗，以及80名终生轻度/非饮酒者对照。治疗样本 将从门诊治疗中心抽签。治疗--幼稚的样本 将从马林县第一罪犯酒后驾车(Fodd)招募 程序。轻度/非饮酒者控制组将从社区招募。 大脑结构将使用核磁共振检查，并将包括分割 把大脑放进它的？组分组织分类，特定的描述 结构(例如，海马体、小脑和胼胝体)，以及 将图像转换为标准坐标系(以便于 分析区域皮质体积差异)。功能评估将 包括神经心理和行为测试以及电生理 录音，专注于抑制/去抑制过程，执行 功能，视觉空间能力，步态和平衡，以及处理和记忆 情感刺激。

DESCRIPTION (provided by applicant): Most studies of the impact of alcohol dependence on the brain have examined individuals in treatment. They may embody a bias, called "Berkson?s fallacy", if the association between variables (e.g., alcoholism and brain atrophy or brain function) differ between the population of alcoholics in treatment and alcoholics in the general population. We hypothesize that treatment-naive alcoholics have less psychiatric comorbidity compared to treatment samples, and that this reduced psychiatric morbidity is associated with a lessened severity of impairments in brain structure and function. The major goals of the proposed research are to determine: 1) whether treatment-naive alcoholics differ in brain structure and function from alcoholics recruited from treatment centers, 2) whether treatment-naive alcoholics differ from alcoholics recruited from treatment centers in the presence and severity of comorbid mood and externalizing disorder symptoms and traits, 3) what factors are associated with impairments in brain structure and function in treatment-naive alcoholics and in alcoholics drawn from treatment centers (including presence and severity of comorbid mood, anxiety, and externalizing disorder symptoms and traits, presence of the APOE-4 allele, premorbid headsize as a measure of functional reserve (as indexed by intracranial vault volume on MRI), and the frequency (and severity) of withdrawal symptoms), 4) whether males and females differ in these comparisons, and 5) to follow the treatment-naive alcoholics for future longitudinal assessment of factors that predict the course of their alcoholism (especially the seeking of treatment, and changes in brain structure and function). We will study 380 subjects over five years: 220 treatment-naive alcohol-dependent subjects, 80 alcohol-dependent subjects in outpatient treatment, and 80 lifetime light/non-drinker controls. The treatment sample will be drawn from outpatient treatment centers. The treatment-naive sample will be recruited from the Marin County First Offender Drinking Driver (FODD) program. The light/non-drinker controls will be recruited from the community. Brain structure will be examined using MRI, and will include segmentation of the brain into its? component tissue classes, delineation of specific structures (e.g., the hippocampus, cerebellum, and corpus callosum), and transformation of the images into a standard coordinate system (to facilitate analysis of regional cortical volume differences). Functional assessment will include neuropsychological and behavioral testing and electrophysiological recordings, focusing on inhibitory/disinhibitory processes, executive functions, visuospatial abilities, gait and balance, and processing and memory of emotional stimuli.