Brain Damage and Dysfunction in Alcoholism
Brain damage is a serious and common consequence of continued heavy drinking. Brain examinations in individuals with a history of continued drinking show that alcohol causes physical and neurological damage to the brain.
Evidence of this damage includes structural changes in the brain. Individuals with a history of chronic alcohol abuse have been found to have smaller, lighter and more shrunken brains as compared to normal individuals of the same age and sex. Additionally, continued drinking studied over a five year period shows brain shrinkage greater than that associated with normal ageing, correlating roughly with the amount of alcohol consumed. Some researchers have also established a link between low to moderate alcohol consumption and brain shrinkage in middle-aged adults.
Changes observed in brain structure are accompanied by functional abnormalities in the brain. These include reduced cerebral blood flowand metabolic rates – even altered electrical activity. Additionally, 10% of severe alcoholics show serious organic cerebral impairment.
Brain shrinkage and altered activity has been noticed mostly in two areas in the front and back of the brain:
- The Cortex – i.e. the outer layer of the frontal lobe, considered a major center of higher cognitive functions, and
- The Cerebellum (back of the brain), responsible largely for gait and balance, along with some aspects of learning.
Some damage, be it brain shrinkage, metabolic rate or blood flow, together with cognitive functioning, can reverse, over time, with abstinence from alcohol (if caught in time). However, reverting back to drinking restarts the progressive deterioration process. When heavy drinking and brain damage go unchecked and untreated, the damage can become permanent and irreversible.
One of the most devastating effects of continued heavy drinking is brain dysfunction or the development of alcohol induced brain syndromes, which have been found to occur in a small but significant percentage of heavy drinkers. The various signs and symptoms of brain dysfunction have been categorized into two organic mental disorders/syndromes:
- Alcohol amnestic disorder (memory disorder) and
- Dementia associated with alcoholism
Recent research indicates that these two disorders are not mutually exclusive and that some elements of both can, and often do exist in the same patient.
Alcohol amnestic disorder, involves a general loss of memory as a result of chronic long term alcohol abuse. It is primarily a memory disorder and occurs without loss of intellectual abilities. Nutritional deficiency (Thiamine or Vitamin B1) has been implicated in this disorder.
It is commonly called Korsakoff’s psychosis or Wernicke-Korsakoff syndrome and involves two phases – Wernicke encephalopathy, followed by Korsakoff’s psychosis – each characterized by its set of signs and symptoms.
Dementia associated with alcoholism involves a progressive loss of mental functions due to continued drinking:
- Global loss of intellectual abilities
- Impairment in memory function
- Disturbance(s) of abstract thinking, judgment, other higher cortical functions
- Personality change
This disorder is associated with cortical changes (changes in the front part of the brain – the cortex, affecting higher level functioning) that take place because of alcoholism.
Brain disorders caused by alcoholism need to be diagnosed and treated as, in time, they cause progressive debilitation and may ultimately even cause death. Diagnosis of brain disorders is not easy and requires a detailed and thorough medical assessment, including cognitive testing. Also, once brain disorders develop, the chance of complete recovery is rare. Thus, drinking moderately and eating healthily is recommended, in order to keep risks of incurring brain damage and developing alcohol induced brain disorders to the minimum.
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