MODERATE ALCOHOL-CONSUMPTION AND LOSS OF CEREBELLAR PURKINJE-CELLS

Objective-To examine the dose-response effect of alcohol consumption o n the number of cerebellar Purkinje cells. Design-A prospective necrop sy study combined with detailed reports on use of alcohol from a relat ive or friend. The number of Purkinje cells was counted in the anterio r midsagittal section of the cerebellar vermis, the area of which was measured by computer assisted morphometry. Setting-Department of foren sic medicine, University of Helsinki. Subjects-66 men, aged 35 to 69 y ears, subjected to medicolegal necropsy because of sudden or violent d eath. The average all year daily alcohol consumption over the year was 0 to 10 g in 17 men, 11 to 80 g in 24 men, and more than 80 g in 25 m en. Main outcome measures-Number of Purkinje cells, alcohol consumptio n. Results-The numbers and density of Purkinje cells in the cross sect ion of vermis showed a consistent but weak decrease with increasing da ily alcohol intake but not with age. A wide variation in the cell coun ts was observed, especially in men drinking more than 80 g, suggesting differences in the susceptibility to effects of alcohol. Compared wit h men drinking 40 g or less, a long term moderate consumption of an av erage of 41 to 80 g daily was associated with a significant average lo ss of 242 (95% confidence interval 45 to 439) Purkinje cells (15.2%) f rom a mean of 1583 to 1341 cells. In those drinking 81 to 180 g the av erage loss was 535 (259 to 811) cells (33.4%) to a mean of 1048 cells. The density of cells in the cross section of vermis also fell signifi cantly by 0.9 cell/mm (0.1 to 1.7) when the daily consumption exceeded 40 g and by 1.4 cell/mm (0.3 to 2.5) when the intake was 81 to 180 g. Only three cases (4.5%); in the series showed macroscopical cerebella r atrophy. Conclusion-Long term intake of moderate doses of alcohol da ily for 20-30 years may damage the cerebellum before the onset of macr oscopical atrophy. Despite distinct individual differences an all year average daily alcohol intake of 41-80 g results in a risk of signific ant loss of Purkinje cells.