摘要:

AbstractCurrent views concerning the brain damage occasioned by alcohol abuse are reviewed. Diffuse cerebral changes appear to be common and partially reversible with prolonged abstinence. The possible determinants of such changes, and their relevance to functional deficits are discussed, with illustrations from work currently proceeding at the Institute of Psychiatry. Possible interactions between cortical and subcortical pathologies in contributing to the cognitive deficits shown by alcoholic patients are emphasised.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13037.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractChronic alcoholics who maintain abstinence often demonstrate remarkable improvement of neurological and mental dysfunction. This paper presents an overview of the clinical and laboratory work of our group. Reversible clinical manifestations include psychometric scores, ataxia, tremor, Parkinsonism, dyskinesia, cerebral atrophy, EEG parameters, and a CSF acidosis. Electrophysiological investigations showed that in the in vitro hippocampus of rats fed ethanol for several months there was evidence for diminished long‐term potentiation, impaired neuronal inhibitory mechanisms (diminished inhibitory postsynaptic potentials and post‐spike after hyperpolarisations), decreased neuronal specific membrane capacitance and increased specific membrane resistance. Golgi stains sho wed attenuation of hippocampal CA1neuronal dendrites in rats fed ethanol for five months, which reverted to control size in rats permitted two months of alcohol withdra

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13038.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe effect of ingesting varying quantities of alcohol upon the structure and function of the brain was studied using CT scan and psychometric testing. Nutritional status was also assessed. Alcoholics, heavy, moderate and light social drinkers were examined and their results compared with a normal control series. It was concluded that a daily consumption of more than 40 grams alcohol per day, “the safe level” results in brain damage. The latter may partially reverse with abstinence and having reversed maintain improvement, even though patients then resume drinking at the “safe level”. The role of thiamin in brain function is still

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13039.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractIntellectual impairment in sober intermediate stage alcoholics has been well established. However, a number of persistent issues remain to be explored. Three of the most important concern 1) variability in cognitive‐perceptual functioning in samples of alcoholics, 2) differential vulnerability of cognitive‐perceptual functions to alcohol abuse and 3) the relationship of cognitive‐perceptual impairment to treatment behaviour and benefit. Consideration of these issues resulted in the following conclusions. There is a substantial minority of alcoholics who do not manifest impairment on any given cognitive test. Variability of findings with different samples of alcoholics may be, in part, a function of family history of alcoholism and/or severity of alcoholism. Verbal and rote learning functions are less sensitive to alcohol abuse than non‐verbal, or complex verbal, abstracting/problem‐solving skills. Alcoholics' impersonal and interpersonal problem‐solving abilities are both impaired but appear to be uncorrelated. Impairment in cognitive‐perceptual functioning in alcoholics does predict therapists' ratings of treatment behaviou

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13040.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractExamination of the autopsy material from a city hospital in Oslo gave the following results:1The brain weight of male alcoholics was significantly lower than that of age‐matched controls in all 10‐year age groups from 40 to 69 years. The mean weight reduction was 31 g.2Combined morphometric and histologic studies demonstrated atrophy of the anterior vermis in 42 per cent of all male alcoholics under 70 years of age. In cases over 70 years, 33 per cent of the non‐alcoholic controls showed atrophy of the anterior vermis. This is assumed to be a consequence of physiologic ageing. The prevalence of alcoholic cerebellar atrophy could therefore not be determined in this age group.3Wernicke's encephalopathy was found in 12.5 per cent of all alcoholics and in 0.8 per cent of all autopsies. One third of the Wernicke cases had acute and subacute lesions while two thirds were chronic. Most of the acute lesions were widespread and severe. The chronic lesions were more restricted but showed great variations in extent and severity within the affected areas. There were corresponding variations in the severity of the clinical sym

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13041.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractAn assessment has been made of metabolic factors possibly causing or contributing to the brain damage associated with chronic alcoholism, especially thiamin lack or disturbance of amino acid metabolism. Abnormalities in the thiamin‐dependent enzyme, transketolase, provide evidence of a high incidence of thiamin deficiency as well as of disturbed thiamin metabolism in chronic alcoholics, which are likely to be caused by reduced vitamin intake as well as impaired absorption. A grossly disturbed pattern of amino acids in the blood of patients undergoing treatment for alcohol withdrawal syndromes is likely to be caused by loss of hepatic function and may well aggravate brain damage caused by B group vitamin deficiency. A hypothesis is proposed of how chronic thiamin lack can lead to brain damag

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13042.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractIn a series of experimental studies involving ethanol vapour administration to rats, sustained blood alcohol levels in the range 89–115 mM for nine hours of each day over a two week period did not lead to neural degeneration detactable with either light or electron microscopy. A single nine hours exposure to ethanol and disulfiram giving rise to 20–41 mM alcohol and 52–76 μM acetaldehyde in the blood did lead to degeneration; and that with repeated exposures of this later type, the damage was found to be accumulative. The lowest levels of blood acetaldehyde which led to neural degeneration in the present study were not distant from clinically observed

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13043.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractAlcohol, both alone and in concert with deficiencies or excesses of other substances, can produce cardiomyopathy. In addition, alcohol can directly affect the cardiac‐conduction system and produce arrhythmias. A Icohol also affects kno wn risk factors for stroke and coronary heart disease (CHD). Alcohol increases blood pressure, which may lead to hypertension and thus increase the risk of stroke. HDL cholesterol, which is inversely related to CHD risk, increases with alcohol, and LDL cholesterol, which is positively related to CHD risk, may decrease with alcohol, a potentially dually protective effect. However, both case‐control and population based studies indicate only moderate levels of consumption, defined as two drinks per day or less, may be of benefit.Preliminary data from the Lipid Research Clinics Follow‐up Study suggest that the beneficial effect of moderate amounts of alcohol may be mediated in part by increased HDL cholesterol and in part by another factor, possibly reduced coagulation. Clinical and laboratory data, in addition to epidemiologic data, suggest alcohol intake above two drinks per day leads to excess cardiovascular disease (CVD), probably reflecting hypercoagulability as well as hypertension at higher levels of intake.Because alcohol can lead to excess morbidity and mortality from CVD as well as several other diseases and conditions, public health policy should continue to discourage the drinking of alcohol, especially non‐moderate cons

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13044.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe consequences of alcoholic intemperance and economic problems on CHD mortality and morbidity were studied among the participants in a large primary preventive trial. Official register data were used. Subjects registered with the Board of Social Welfare were categorised with respect to increasing load of alcoholic intemperance. Non‐fatal CHD was not related to alcoholic problems. Fatal CHD, on the other hand, was strongly associated with registration for intemperance. This was especially pronounced for cases dying suddenly from CHD. A multivariate analysis was performed, controlling for smoking, systolic blood pressure and scrum cholesterol, which showed that the association between intemperance and fatal CHD was independent of these factor

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13045.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractFor more than 30 years, clinical observations to link alcohol abuse and stroke have accumulated in several countries. Studies of general populations have indicated that the risk for stroke increases with increasing alcohol consumption. Studies of young victims of stroke where the classical risk factors of stroke are uncommon, have demonstrated that even occasional heavy drinking carries an increased risk for stroke. In particular, the increased occurrence of strokes during weekends, the very time of heavy alcohol consumption in non‐alcoholics, supports this notion. Alcoholics seem to get their strokes at an earlier age than non‐alcoholics. Paradoxically, the published evidence has implicated drinking in both ischemic and hemorrhagic strokes, which suggests that there may be more than one mechanism by which alcohol can increase the risk. Strokes seem to be precipitated during the alcohol intoxication itself rather than the following withdra wal syndrome, but the contributing mechanisms, except for bleedings caused by external violence, are unknown. Alcohol can produce fluctuations in platelet reactivity and untoward interactions with certain drugs, but it remains to be demonstrated that such effects are temporally related to the onset of ischemic and hemorrhagic stro

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb13046.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY