SINGLE-PHOTON EMISSION COMPUTERIZED-TOMOGRAPHY IN CHRONIC-ALCOHOLISM - ANTISOCIAL PERSONALITY-DISORDER MAY BE ASSOCIATED WITH DECREASED FRONTAL PERFUSION

Background. We examined the functional and structural cerebral changes in chronic alcoholics. analysing their association with personality f eatures and alcohol drinking habits. Method. Forty patients with alcoh ol dependency including 15 with antisocial personality disorder (ASP) as defined in DSM-III-R and 10 age and sex matched healthy controls we re studied after termination of withdrawal symptoms, using high resolu tion single photon emission tomography (SPECT) cranial computerised to mography (CT) and brainstem auditory evoked potentials (BAEP). Results . We found significant reductions in regional cerebral blood flow (rCB F) measurements of alcoholic patients. Low flow in frontal regions enc ountered in 67.5% of the patients was associated with the duration of alcohol consumption, while no such relation existed with the amount of daily intake. Patients with ASP exhibited more marked frontal hypoper fusion. Significant brain atrophy detected by CT was present in 40% of the patients and did not correlate with frontal hypoperfusion. Conclu sions. Patients with ASP are more sensitive to toxic effects of alcoho l. Alternatively chronic alcoholism leads to frontal robe dysfunction recognised as ASP in the clinical setting.