BRAIN PROTON MAGNETIC-RESONANCE SPECTROSCOPY STUDIES IN RECENTLY ABSTINENT ALCOHOLICS

Chronic alcohol-dependent patients have reduced brain volumes and conc omitant neurobehavioral deficits that may recover during abstinence. I n 10 chronic alcoholic patients, using localized proton magnetic reson ance spectroscopy, we found reliable increases during the first 3-4 we eks of abstinence in the concentrations within the superior cerebellar vermis of choline (Cho)-containing compounds relative to the neuronal marker, N-acetylaspartate (NAA). Lesser changes were observed followi ng 1 month of abstinence, and in one of the patients studied longitudi nally over 3 months, a marked reduction in the Cho/NAA ratio was assoc iated with relapse. After detoxification, the Cho/NAA ratio correlated with a composite clinical impression of brain functions. The lowest C ho/NAA was observed in a patient with persisting alcoholic dementia, i n striking contrast to reduced relative concentrations of NAA reported in dementia of the Alzheimer's type. Possible molecular explanations for these brain metabolic changes are discussed.