( reverse these effects. Key presenta...)Investigating 'brain shrinkage' in alcoholics

Key presentation highlights were:

- A number of toxic, metabolic, and nutritional factors interact in a complex way to cause brain damage in those individuals who abuse or are dependent on alcohol.

"The exact ways in which alcohol damages the brain are uncertain," said Harper. "It might be that alcohol, or a metabolic byproduct of alcohol such as acetaldehyde, are toxic. Research on malnutrition, a common consequence of poor dietary habits in some alcoholics, indicates that thiamine deficiency can contribute to impaired cognition. Cirrhosis of the liver, also common in alcoholics, is known to cause clinical and structural changes in the brain. In addition, head injury and sleep apnoea are more common in alcoholics and can contribute to brain damage. All of these factors ?particularly the alcohol, thiamine deficiency and cirrhosis ?are linked and probably contribute in a complex way to cause brain damage."

- Both permanent and transient changes may occur in the alcoholic brain.

"The most important permanent structural change is nerve cell loss," said Harper. "Some nerve cells cannot be replaced, those in the frontal cortex, cerebellum and several regions deep in the brain."

However, he added, some changes can be transient, such as the shrinkage of dendrites, those fibers that allow neurons to "talk" with neighbouring neurons. "In experimental animals," he said, "these have been shown to grow and spread again after periods of abstinence ?weeks to months ?and have been accompanied by improved brain function. Structural and functional changes seen in cirrhosis of the liver are also potentially reversible if treated. Furthermore, thiamine deficiency can be treated easily with oral or injected thiamine. Patients with acute deficiency respond very quickly but some permanent damage can occur if patients are not treated and particularly if they suffer repeated episodes of the deficiency."

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Source:Alcoholism: Clinical & Experimental Research