Alcohol Effect

difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory: clearly, alcohol affects the brain. a number of factors influence how and to what extent alcohol affects the brain (1), including

this alcohol alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. blackouts and memory lapses

alcohol can produce detectable impairments in memory after only a few drinks and, as the amount of alcohol increases, so does the degree of impairment. a woman’s tendency to black out more easily probably results from differences in how men and women metabolize alcohol. females also may be more susceptible than males to milder forms of alcohol–induced memory impairments, even when men and women consume comparable amounts of alcohol (4).

are women more vulnerable to alcohol’s effects on the brain?

for example, alcoholic women develop cirrhosis (5), alcohol–induced damage of the heart muscle (i.e., cardiomyopathy) (6), and nerve damage (i.e., peripheral neuropathy) (7) after fewer years of heavy drinking than do alcoholic men. studies comparing men and women’s sensitivity to alcohol–induced brain damage, however, have not been as conclusive.

using imaging with computerized tomography, two studies (8,9) compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects. studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking (10). brain damage from other causes

people who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease.

up to 80 percent of alcoholics, however, have a deficiency in thiamine (15), and some of these people will go on to develop serious brain disorders such as wernicke–korsakoff syndrome (wks) (16). administering thiamine helps to improve brain function, especially in patients in the early stages of wks. custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills (19).

liver disease

new imaging techniques have enabled researchers to study specific brain regions in patients with alcoholic liver disease, giving them a better understanding of how hepatic encephalopathy develops. alcohol–damaged liver cells allow excess amounts of these harmful byproducts to enter the brain, thus harming brain cells.

alcohol and the developing brain

drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain, the most serious of which is a collection of symptoms known as fetal alcohol syndrome (fas). treatment

scientists are investigating the use of complex motor training and medications to prevent or reverse the alcohol–related brain damage found in people prenatally exposed to alcohol (24). other preventive therapies showing promise in animal studies include 1–octanol, which ironically is an alcohol itself. treatment with l–octanol significantly reduced the severity of alcohol’s effects on developing mouse embryos (26). mk–801 reversed a specific learning impairment that resulted from early postnatal alcohol exposure (28).

growing new brain cells

the discovery of brain stem cells and adult neurogenesis provides a new way of approaching the problem of alcohol–related changes in the brain and may lead to a clearer understanding of how best to treat and cure alcoholism (30).

characterizing what makes some alcoholics vulnerable to brain damage whereas others are not remains the subject of active research (34).

clinicians must consider a variety of treatment methods to help people stop drinking and to recover from alcohol–related brain impairments, and tailor these treatments to the individual patient.