FRONTAL-LOBE VOLUME LOSS OBSERVED WITH MAGNETIC-RESONANCE-IMAGING IN OLDER CHRONIC-ALCOHOLICS

This study used magnetic resonance imaging to quantify the extent and pattern of tissue volume deficit and cerebrospinal fluid volume enlarg ement in younger versus older chronic alcoholics relative to normal co ntrols. In the present analysis, we divided our previously reported gr oup of 62 alcoholic men into a younger group (n = 33, age mean = 37.5 +/- 4.5, and range = 26 to 44 years) and an older group (n = 29, age m ean = 52.7 +/- 6.0, and range = 45 to 63 years) to examine whether, in addition to extent, the two age groups differed in pattern of tissue type and regional brain volume abnormalities quantified with magnetic resonance imaging, Brain volumes were adjusted for normal variation in head size and age established from a group of healthy controls and we re expressed as Z-scores. The younger group had significant cortical g ray, but not white, matter volume deficits and sulcal and ventricular enlargement relative to age-matched controls. The older group had volu me deficits in both cortical gray and white matter and sulcal and vent ricular enlargement that significantly exceeded the younger alcoholic group. An analysis of six cortical regions revealed that, although bot h age groups had gray matter volume deficits throughout the cortex, th e older alcoholic group had a selectively more severe deficit in prefr ontal gray matter relative to the younger alcoholic group. Similarly, the cortical white matter volume deficit in the older alcoholics was e specially severe in the prefrontal and frontal regions. The difference s in brain dysmorphology between the two alcoholic groups cannot easil y be attributed to potential alcohol history differences typically rel ated to age because the two groups had similar disease durations and a mounts of lifetime alcohol consumption. These results provide in vivo evidence that the frontal lobes are especially vulnerable to chronic a lcoholism in older men.