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Alcohol and the Brain

Published online by Cambridge University Press:  02 January 2018

W. A. Lishman
W. A. Lishman*
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
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Abstract

Some of the major effects of alcohol, and alcoholism, on the brain are reviewed, with reappraisal of evidence drawn from brain imaging, neuropathology, clinical psychology, and laboratory experimental work. A hypothesis is developed which may help to account for the wide variability encountered in individual susceptibility to alcoholic brain damage and its varied manifestations. Therapeutic implications are considered.

Type
Lecture
Information
The British Journal of Psychiatry , Volume 156 , Issue 5 , May 1990 , pp. 635 - 644
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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References

Acker, C., Jacobson, R. R. & Lishman, W. A. (1987) Memory and ventricular size in alcoholics. Psychological Medicine, 17, 343–348.Google Scholar
Acker, W., Ron, M. A., Lishman, W. A., et al (1984) A multivariate analysis of psychological, clinical and CT scanning measures in detoxified chronic alcoholics. British Journal of Addiction, 79, 293–301.Google Scholar
Akai, J. & Akai, (1989) Neuropathological study of the nucleus basalis of Meynert in alcoholic dementia. Japanese Journal of Alcohol and Drug Dependence, 24, 80–88.Google Scholar
Arendt, T., Bigl, V., Arendt, A., et al (1983) Loss of neurons in the nucleus basalis of Meynert in Alzheimer's disease, paralysis agitans and Korsakoff's disease. Acta Neuropathologica (Berlin), 61, 101–108.Google Scholar
Arendt, T., Bigl, V., Arendt, A., Allen, Y., Sinden, J., et al (1988) Cholinergic-rich brain transplants reverse alcohol-induced memory deficits. Nature, 332, 448–450.CrossRefGoogle ScholarPubMed
Baldy, T. E., Brindley, G. S., Ewusi-Mensah, I., et al (1986) A fully-automated computer-assisted method of CT brain scan analysis for the measurement of cerebrospinal fluid spaces and brain absorption density. Neuroradiology, 28, 109–117.Google Scholar
Bergman, H., Borg, S., Hindmarsh, T., et al (1980) Computed tomography of the brain and neuropsychological assessment of male alcoholic patients and a random sample from the general male population. Acta Psychiatrica Scandinavica, 62 (suppl. 286), 47–56.Google Scholar
Blass, J. P. & Gibson, G. E. (1975) Abnormality of a thiamine-requiring enzyme in patients with Wernicke-Korsakoff syndrome. New England Journal of Medicine, 297, 1367–1370.CrossRefGoogle Scholar
Cala, L. A., Jones, B., Wiley, B., et al (1980) A computerised axial tomography (CAT) study of alcohol induced cerebral atrophy in conjunction with other correlates. Acta Psychiatrica Scandinavica, 62 (suppl. 286), 31–40.Google Scholar
Carlen, P. L., Wortzman, G., Holgate, R. C., et al (1978) Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomographic scans. Science, 200, 1076–1078.Google Scholar
Carlen, P. L., Wortzman, G., Holgate, R. C. & Wilkinson, D. A. (1980) Alcoholic brain damage and reversible deficits. Acta Psychiatrica Scandinavica, 62 (suppl. 286), 103–118.Google Scholar
Courville, C. B. (1955) The Effects of Alcohol on the Nervous System of Man. Los Angeles: San Lucas Press.Google Scholar
Edwards, J. G. (1989) As the years go rolling by: drinking problems in the time dimension. British Journal of Psychiatry, 154, 18–26.Google Scholar
Finlay-Jones, R. (1986) Should thiamine be added to beer? Australian and New Zealand Journal of Psychiatry, 20, 3–6.Google Scholar
Gebhardt, C. A., Naeser, M. A. & Butters, N. (1984) Computerised measures of CT scans of alcoholics: thalamic region related to memory. Alcohol, 1, 133–140.Google Scholar
Greenwood, J., Jeyasingham, M., Pratt, O. E., et al (1984) Heterogeneity of human erythrocyte transketolase: a preliminary report. Alcohol and Alcoholism, 19, 123–129.Google Scholar
Gurling, h. M. O., Murray, R. M. & Ron, M. A. (1986) Increased brain radiodensity in alcoholism. A co-twin control study. Archives of General Psychiatry, 43, 764–767.CrossRefGoogle ScholarPubMed
Harper, C. (1979) Wernicke's encephalopathy: a more common disease than realised. A neuropathological study of 51 cases. Journal of Neurology, Neurosurgery and Psychiatry, 42, 226–231.Google Scholar
Harper, C. (1983) The incidence of Wernicke's encephalopathy in Australia - a neuropathological study of 131 cases. Journal of Neurology, Neurosurgery and Psychiatry, 46, 593–598.Google Scholar
Harper, C. & Blumbergs, P. C. (1982) Brain weights in alcoholics. Journal of Neurology, Neurosurgery and Psychiatry, 45, 838–840.Google Scholar
Harper, C. & Kril, J. (1985) Brain atrophy in chronic alcoholic patients: a quantitative pathological study. Journal of Neurology, Neurosurgery and Psychiatry, 48, 211–217.Google Scholar
Harper, C. & Holloway, R. L. (1985) Brain shrinkage in chronic alcoholics: a pathological study. British Medical Journal, 290, 501–504.Google Scholar
Harper, C. & Daly, J. (1987) Are we drinking our neurones away? British Medical Journal, 294, 534–536.Google Scholar
Hata, T., Meyer, J. S., Tanahashi, N., et al (1987) Three-dimensional mapping of local cerebral perfusion in alcoholic encephalopathy with and without Wernicke-Korsakoff syndrome. Journal of Cerebral Blood Flow and Metabolism, 7, 35–44.CrossRefGoogle ScholarPubMed
Jacobson, R. (1986) The contributions of sex and drinking history to the CT brain scan changes in alcoholics. Psychological Medicine, 16, 547–559.Google Scholar
Jacobson, R. (1987) CT Scan, Psychometric and Clinical Studies of the Wernicke-Korsakoff Syndrome. MD thesis: University of Cambridge.Google Scholar
Jacobson, R. (1989) Alcoholism, Korsakoff's syndrome and the frontal lobes. Behavioural Neurology, 2, 25–38.Google Scholar
Jacobson, R., Turner, S. W., Baldy, R. E., et al (1985) Densitometrie analysis of scans: important sources of artefact. Psychological Medicine, 15, 879–889.Google Scholar
Jacobson, R. & Lishman, W. A. (1990) Cortical and diencephalic lesions in Korsakoff's syndrome: a clinical and CT scan study. Psychological Medicine (in press).Google Scholar
Kaczmarek, M. J. & Nixon, P. F. (1983) Variants of transketolase from human erythrocytes. Clinica Chimica Acta, 130, 349–356.Google Scholar
Kendell, R. E. (1987) Drinking sensibly. The first Benno Pollak Lecture. British Journal of Addiction, 82, 1279–1288.Google Scholar
Kopelman, M. D. (1985) Multiple memory deficits in Alzheimertype dementia: implications for pharmacotherapy. Psychological Medicine, 15 527–541.Google Scholar
Jacobson, R. & Corn, T. (1988) Cholinergic ‘blockade’ as a model for cholinergic depletion. A comparison of the memory deficits with those of Alzheimer-type dementia and the alcoholic Korsakoff syndrome. Brain, 111, 1079–1110.Google Scholar
Lesch, P., Schmidt, E. & Schmidt, F. W. (1972) Effects of chronic alcohol abuse on the structural lipids in the human brain. Journal of Clinical Chemistry and Clinical Biochemistry (Berlin), 10, 410–415.Google Scholar
Lesch, P., Schmidt, E. & Schmidt, F. W. (1973) Effects of chronic alcohol abuse on the fatty acid composition of major lipids in the human brain hepatocerebral degeneration II. Journal of Clinical Chemistry and Clinical Biochemistry (Berlin), 11, 159–166.Google Scholar
Lishman, W. A. (1981) Cerebral disorder in alcoholism. Syndromes of impairment. Brain, 104, 1–20.Google Scholar
Lishman, W. A. (1986) Alcoholic dementia: a hypothesis. Lancet, i, 1184–1186.Google Scholar
Lishman, W. A., Jacobson, R. R. & Acker, C. (1987) Brain damage in alcoholism: current concepts. Acta Medica Scandinavica (suppl. 717), 5–17.CrossRefGoogle Scholar
Martin, P. R., Adinoff, B., Eckardt, M. J., et al (1989) Effective pharmacotherapy of alcoholic amnesic disorder with fluvoxamine: preliminary findings. Archives of General Psychiatry, 46, 617–621.Google Scholar
McEntee, W. J. & Mair, R. G. (1980) Memory enhancement in Korsakoff's psychosis by Clonidine: further evidence for a noradrenergic deficit. Annals of Neurology, 7, 466–470.Google Scholar
McEntee, W. J. & Langlais, P. J. (1984) Neurochemical pathology in Korsakoff's psychosis: implications for other cognitive disorders. Neurology, 34, 648–652.Google Scholar
McMullen, P. A., Saint-Cyr, J. A. & Carlen, P. L. (1984) Morphological alterations in rat CAI hippocampal pyramid cell dendrites resulting from chronic ethanol consumption and withdrawal. Journal of Comparative Neurology, 225, 111–118.Google Scholar
Moscovitch, M. (1982) Multiple dissociations of function in amnesia. In Human Memory and Amnesia (ed. Cermak, L. S.), pp. 337–370. New Jersey: Lawrence Erlbaum Associates.Google Scholar
Nixon, P. F. (1984) Is there a genetic component to the pathogenesis of the Wernicke-Korsakoff syndrome? Alcohol and Alcoholism, 19, 219–221.Google Scholar
Parsons, O. A. (1987) Intellectual impairment in alcoholics: persistent issues. Acta Medica Scandinavica (suppl. 717), 33–46.Google Scholar
Pratt, O. E., Jeyasingham, M., Shaw, G. K., et al (1985) Transketolase variant enzymes and brain damage. Alcohol and Alcoholism, 20, 223–232.Google ScholarPubMed
Price, J. & Kerr, R. (1985) Some observations on the Wernicke-Korsakoff syndrome in Australia. British Journal of Addiction, 80, 69–76.Google Scholar
Ron, M. A. (1977) Brain damage in chronic alcoholism: a neuropathological, neuroradiological and psychological review. Psychological Medicine, 7, 103–112.Google Scholar
Ron, M. A. (1983) The alcoholic brain: CT scan and psychological findings. Psychological Medicine (monograph suppl. 3).Google Scholar
Ron, M. A., Acker, W. & Lishman, W. A. (1979) Dementia in chronic alcoholism. A clinical, psychological and computerised axial tomographic study. In Biological Psychiatry Today (eds J. Obiols, C. Ballus, E. Gonzales Monclus, et al). Amsterdam: Elsevier/North Holland Biomedical Press.Google Scholar
Ron, M. A., Acker, W. & Lishman, W. A. (1980) Morphological abnormalities in the brains of chronic alcoholics. A clinical, psychological and computerised axial tomographic study. Acta Psychiatrica Scandinavica, 62 (suppl. 286), 41–46.Google Scholar
Ron, M. A., Acker, W. & Lishman, W. A. Shaw, G. K., et al (1982) Computerised tomography of the brain in chronic alcoholism. A survey and follow-up study. Brain, 105, 497–514.Google Scholar
Torvik, A., Lindboe, C. F. & Rogde, S. (1982) Brain lesions in alcoholics. A neuropathological study with clinical correlations. Journal of the Neurological Sciences, 56, 233–248.Google Scholar
Turner, S., Daniels, L. & Greer, S. (1989) Wernicke's encephalopathy in an 18-year-old woman. British Journal of Psychiatry, 154, 261–262.CrossRefGoogle Scholar
Victor, M. & Adams, R. D. (1985) The alcoholic dementias. In Handbook of Clinical Neurology, 2 (46) Neurobehavioural Disorders (eds P. J. Vinken, G. W. Bruyn & H. L. Klawans). Amsterdam: Elsevier Science Publishers.Google Scholar
Walker, D. W., Barnes, D. E., Riley, J. M., et al (1980a) Neurotoxicity of chronic alcohol consumption: an animal model. In Psychopharmacology of Alcohol (ed. Sandler, M.). New York: Raven Press.Google Scholar
Walker, D. W., Barnes, D. E., Riley, J. M., Zornetzer, S. F., et al (1980b) Neuronal loss in hippocampus induced by prolonged ethanol consumption in rats. Science, 209, 711–713.Google Scholar
West, J. R., Lind, M. S., Demuth, R. M., et al (1982) Lesion-induced sprouting in the rat dentate gyrus is inhibited by repeated ethanol administration. Science, 218, 808–810.Google Scholar
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