Alcoholism, peripheral neuropathy (PNP) and cardiovascular autonomic neuropathy (CAN)

In contrast to diabetic autonomic neuropathy, cardiovascular autonomic neur opathy (CAN) in long-term alcoholics has been studied rarely. Using both st andardized bedside tests and computer-assisted analysis of heart rate varia bility (HRV), we prospectively compared autonomic neurocardial function bet ween 35 strictly selected, detoxified alcoholics (DSM-III-R), and 80 well m atched healthy controls. Evidence for a potential CAN was found in 25.7% of all the alcoholics studied and in 41% of those with clinically manifest PN P (n=22). Overall, our results demonstrated a significant association betwe en the presence of a CAN and peripheral neuropathy (PNP) amongst chronic al coholics (chi-square test P<0.05); there was no evidence of a CAN in any of the alcoholics without a clinically manifest PNP. The CAN was characterize d by a dissociated appearance of parasympathetic and sympathetic disorders. Our findings provide reason to suspect that the total lifetime dose of alc ohol and the duration of alcohol dependence are the most important factors contributing to the pathogenesis of both PNP and sympathetic dysfunction. A s is the case with diabetics, computer-assisted measurements of HRV includi ng spectral analysis appear to be far superior to conventional bedside test s for detecting evidence of cardiovagal dysfunction in long-term alcoholics . (C) 1998 Elsevier Science B.V. All rights reserved.