Localized proton magnetic resonance spectroscopy of the cerebellum in detoxifying alcoholics

An increased daily alcohol consumption results in neurological symptoms and morphological central nervous system changes, e.g. shrinkage of the fronta l lobes and the cerebellar vermis. Brain shrinkage can be due to neuronal l oss, gliosis, or alterations of (cell) membrane constitutes/myelin. Neurona l, glial, and metabolic changes can be measured in vivo with proton magneti c resonance spectroscopy. A total of 11 alcoholics and 10 age-matched volun teers were examined by magnetic resonance imaging and localized magnetic re sonance spectroscopy at an echo time of 135 and 5 msec. Peak integral value s were calculated for N-acetylaspartate(NAA), choline (Cho), myo-inositol ( ml), glutamate/glutamine (Glx), and normalized to phosphocreatine/creatine (Cr). Patients had a significant shrinkage of the cerebellar vermis. NAA/Cr and Cho/Cr ratios were reduced in both sequences, but the NAA/Cr reduction was only significant in long echo time, although the Cho/Cr reduction was significant in short echo time. The ml/Cr and Glx/Cr ratios did not show an y significant difference between volunteers and patients. The decrease of N AA/Cr in alcohol dependent patients is consistent with neuronal loss. The C ho/Cr decrease and an unchanged ml/Cr may reflect cell membrane modificatio n or myelin alterations in alcohol-dependent patients. These changes lead t o brain shrinkage, although hydration effects and gliosis are less likely.