REGIONAL CEREBRAL BLOOD FLOW-SPECT IN CHRONIC-ALCOHOLISM - RELATION TO NEUROPSYCHOLOGICAL TESTING

To determine the prevalence of central nervous system damage due to et hanol, we evaluated 40 asymptomatic chronic alcoholics and 20 age-matc hed controls. Studies included neuropsychological testing, brain Tc-99 m-HMPAO SPECT, and morphometric analysis by CT scan. In the qualitativ e analysis, 30 of the 40 alcoholics showed hypoperfused areas on SPECT scan. In the semiquantitative analysis, alcoholics exhibited signific ant reduction in regional cerebral blood flow (rCBF) ratio of all brai n lobes compared to controls (p < 0.001). The rCBF ratio was mainly re duced in frontal lobes (65%). Only 11 alcoholics showed significant fr ontal lobe atrophy in the morphometric analysis; most also had abnorma lities on SPECT scan. Alcoholics exhibited significant impairment of f rontal tasks and visuospatial skills. Frontal test impairment was inde pendently related to both frontal atrophy and hypoperfusion. In a grou p of ten alcoholics in whom another SPECT scan was performed after 2 m o of ethanol abstinence, rCBF ratio of the frontal lobes normalized in eight, without frontal atrophy. In patients without frontal atrophy, reduced rCBF ratio of the anterior portion of the frontal lobes correl ated negatively with frontal test results (r = -0.6535, p < 0.001). A significant negative correlation between cerebral perfusion and the am ount of ethanol consumed in the month prior to study was observed (r = -0.6289, p < 0.001). In conclusion, asymptomatic chronic alcoholics f requently show reversible frontal lobe hypoperfusion, which is related to recent ethanol intake, reflects brain function impairment and is i ndependent of brain atrophy.