IN VIVO DIFFUSION AND SPECTROSCOPIC BRAIN IMAGING IN ALCOHOLISM

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目的：应用弥散张量成像(DTI)和常规MRI检查戒酒和/或复吸慢性酒精中毒患者的脑功能。 方法：对57例酗酒者(身高40米，体重17周)和74名对照组(身高32米，体重42周)治疗3个月后进行研究。两年后，19名酗酒者和37名对照组回归。在酗酒者中，12人在随访前至少保持了一年的戒酒，7人已经恢复饮酒。单次激发自旋回波平面冠状DTI序列结合快速自旋回波(FSE)、破坏梯度回波(SPGR)和1.5T液体衰减反转恢复(FLAIR)结构序列，评估衰老和酒精中毒对显微白质和宏观变化的交互作用。我们对SPGR数据进行分割，以评估皮质和皮质下灰质、白质和脑脊液的整体体积，以及在正中矢状面上测量的穹隆体区面积。根据DTI，我们计算了FA，计算了从几何学上定义的胼胝体区域，以及手动识别的全容量、局灶性5mm3样本。 结果：对照组男性和女性均表现出与年龄相关的脑脊液增加和组织体积减少，尤其是灰质。对照组和酗酒者的体积根据对照组中测量的ICV和年龄的变化进行了统计调整。与性别匹配的对照组相比，酗酒的男性和女性的灰质和白质体积、组织缺失和脑脊液增大。酗酒的男性和女性表现出相似的膝盖骨萎缩模式和程度，膝盖骨和躯干的萎缩最严重，压部的萎缩较小。这种萎缩伴随着FA的异常，且膝部比压部更明显。老年酗酒者的膝部和压部较小，在这些区域的扩散率比年轻酗酒者高。区域MRI和DTI测量与工作记忆、视觉空间能力、步态和平衡的表现之间的显著相关性为膝盖骨异常的功能分支提供了证据。 在随访中，与膝部戒毒者相比，复发者的患病率显著增加，但压部并非如此。使用非刚性配准算法比较入院扫描和后续扫描，我们观察到对照组有适度的脑室扩张，而复发组有更明显的脑室和裂隙扩张。戒毒者要么表现出控制性的脑室扩张(女性)，要么表现出适度的收缩迹象(男性)。 结论：在戒酒3个月后的基线，酒精中毒与年龄相互作用，以额部分布和功能分支的形式对骨痂的宏观结构和微观结构产生复杂的不良影响。随访时的清醒与白质微观结构和大体结构状况的适度改善有关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Aims: Use DTI and conventional MRI to examine the brain of chronic alcoholics through abstinence and/or relapse. Methods: We studied 57 alcoholics (40 m, 17 w) and 74 controls (32 m, 42 w) 3 months post-treatment. 19 alcoholics and 37 controls returned 2 years later. Of the alcoholics, 12 had maintained sobriety for at least one year prior to follow-up and 7 had resumed drinking. A single shot spin-echo echo-planar coronal DTI sequence, combined with fast spin-echo (FSE), SPoiled Gradient Recalled Echo (SPGR), and Fluid Attenuated Inversion Recovery (FLAIR) structural sequences at 1.5T assessed the interaction of aging and alcoholism on microscopic white matter and macroscopic changes. We segmented SPGR data to assess global volumes of cortical and subcortical gray matter, white matter and CSF and measured area of corpus callosum on a midsagittal slice. From the DTI we computed FA and from geometrically defined regions of corpus callosum as well as manually identified fully-volumed, focal 5 mm3 samples. Results: Control men and women both exhibited age-related increases in CSF and decreases in tissue volumes, especially for gray matter. Volumes for controls and alcoholics were statistically adjusted for the variance associated with ICV and age measured in the controls. Alcoholic men and women had gray and white matter volume tissue deficits and CSF enlargement compared with sex-matched controls. Alcoholic men and women showed similar patterns and extents of callosal shrinkage, which was greatest in the genu and body and less prominent in the splenium. This shrinkage was accompanied by abnormalities in FA and more prominent in the genu than the splenium. Older alcoholics had smaller genu and splenium and higher diffusivity in these regions than younger alcoholics. Significant correlations between regional MRI and DTI measures and performance on working memory, visuospatial ability, and gait and balance provided evidence for the functional ramifications of the callosal abnormalities. On follow-up, there was a significant increase in for relapsers compared to abstainers in the genu, but not the splenium. Using a nonrigid registration algorithm to compare entry and follow-up scans, we observed modest ventricular expansion in controls, more prominent ventricular and fissure expansion in the relapsers. Abstainers showed either conrol-like ventricular expansion (women) or modest evidence for contraction (men). Conclusions: At baseline after three months abstinence, alcoholism interacted with age to exerted a compounded untoward effect on callosal macrostructure and microstructure with frontal distribution and functional ramifications. Sobriety at follow-up was associated with modest improvements in the condition of white matter microstructure and macrostructure.