Longitudinal brain metabolic characterization of chronic alcoholics with proton magnetic resonance spectroscopy

Alcohol Clin Exp Res. 2002 Sep;26(9):1368-80. doi: 10.1097/01.ALC.0000029598.07833.2D.


Background: Proton magnetic resonance spectroscopy may elucidate the molecular underpinnings of alcoholism-associated brain shrinkage and the progression of alcohol dependence.

Methods: Using proton magnetic resonance spectroscopy, we determined absolute concentrations of -acetylaspartate (NAA), creatine/phosphocreatine (Cr), and choline (Cho)-containing compounds and -inositol (mI) in the anterior superior cerebellar vermis and frontal lobe white matter in 31 alcoholics and 12 normal controls. All patients were examined within 3 to 5 days of their last drink. Patients who did not relapse were again studied after 3 weeks and 3 months of abstinence by using an on-line repositioning technique that allows reliable localization of volumes of interest (VOIs).

Results: At 3 to 5 days after the last drink, frontal white matter metabolite concentrations were not significantly different from those of normal controls, whereas brain tissue in the VOI was reduced. Cerebellar [NAA] and [Cho] and brain and cerebellar volumes were decreased, but [Cr], [mI], and VOI brain tissue volume were not significantly different. Eight patients relapsed before 3 weeks (ER), 12 relapsed between 3 weeks and 3 months (LR), and 11 did not relapse (NR) during 3 months. Cerebellar [NAA] was reduced only in ER patients, despite the fact that ER patients drank for significantly fewer years and earlier in life than LR or NR patients. After 3 months, in the 11 continuously abstinent patients, cerebellar [NAA] and brain and cerebellar volumes increased; cerebellar [Cho], [Cr], and [mI] and VOI brain tissue did not change significantly.

Conclusions: Decreased [NAA] and [Cho] in cerebellar vermis indicate a unique sensitivity to alcohol-induced brain injury. Cerebellar [NAA] increased with abstinence, but reduced [Cho] persisted beyond 3 months. Further studies are needed to determine whether low cerebellar [NAA] is a risk factor for, or consequence of, malignant, early-onset alcoholism.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Alcoholism / metabolism*
  • Alcoholism / psychology
  • Brain / metabolism*
  • Cerebellum / metabolism
  • Female
  • Frontal Lobe / metabolism
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Spectroscopy* / methods
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Recurrence
  • Retrospective Studies
  • Statistics, Nonparametric
  • Temperance / psychology
  • Temperance / statistics & numerical data