LONGITUDINAL CHANGES IN MAGNETIC-RESONANCE-IMAGING BRAIN VOLUMES IN ABSTINENT AND RELAPSED ALCOHOLICS

Chronic alcoholism is associated with smaller volumes of cortical gray matter and white matter and a complementary increase in brain cerebro spinal fluid (CSF) volumes, relative to age norms. This longitudinal s tudy quantified the extent of brain volume changes associated with abs tinence and drinking at three time points in chronic alcoholics. We ob tained magnetic resonance imaging (MRI) on 58 alcoholic men after an a verage of 12 days (MRI-1) and 32 days (MRI-2) of sobriety. In addition , 58 healthy control subjects were scanned at a comparable interval. A t MRI-3, 11 controls and 39 alcoholics were rescanned, 2-12 months aft er MRI-2; 19 alcoholics had abstained, and 20 had resumed drinking. Ax ial MRI slices were segmented into cortical gray matter, white matter, and CSF and summed over seven slices; lateral and third ventricular v olumes were also estimated. MRI volume changes were corrected using an estimate of interscan measurement error caused by head positioning di fferences, and then divided by the interval to yield rates of change ( slopes). From MRI-1 to MRI-2, the alcoholic group showed declines in C SF volumes of the lateral ventricles and posterior cortical sulci, and a trend toward an increase in anterior cortical gray matter volume re lative to the control group. From MRI-2 to MRI-3, third ventricular vo lumes decreased in the abstainers relative to the relapsers and contro ls; cortical white matter volume decreased in the relapsers. In the re lapsers, lifetime consumption of alcohol (as of MRI-1) predicted later vulnerability to white matter volume decline and third ventricular en largement with resumption of drinking. These data suggest that improve ment in cortical gray matter, sulcal, and lateral ventricular volumes occur early in the course of abstinence, and that improvement in third ventricular volume appears later with continued abstinence. Resumptio n of drinking after a short period of abstinence arrests third ventric ular volume improvement and produces white matter volume loss.