Sex differences in the effects of alcohol on brain structure

Objective: This study investigated whether alcoholic women manifest deficit s in cortical gray and white matter volumes and ventricular enlargement sim ilar to those seen in alcoholic men. Method: Volumetric measures of intracranium, cortical gray matter, white ma tter and sulci, and lateral and third ventricles were obtained from magneti c resonance images of 42 women and 44 men with DSM-III-R alcoholism and age -matched healthy comparison groups (37 women and 48 men). Groups of alcohol ic men and women were matched on age and length of sobriety, but men had a 2.5 times higher lifetime alcohol consumption than women. Results: Women, regardless of diagnosis, had less cortical gray and white m atter and smaller third ventricles than men, consistent with sex-related di fferences in intracranial volume. Alcoholics had larger volumes of cortical sulci and lateral and third ventricles than comparison subjects. Diagnosis -by-sex interactions for cortical white matter and sulcal volumes were due to abnormalities in alcoholic men but not alcoholic women, relative to same -sex comparison subjects. This interaction persisted for cortical sulci aft er covarying for lifetime alcohol consumption. Slopes relating cortical gra y matter and sulcal volumes to age were steeper in alcoholic than in compar ison men. Slopes relating lateral ventricle volume to age were steeper in a lcoholic than in comparison women. In alcoholic women, longer sobriety was associated with larger white matter volumes. Conclusions: Alcoholic men and women show different brain morphological def icits, relative to same-sex comparison subjects. However, age and alcoholis m interact in both sexes, which puts all older alcoholics at particular ris k for the negative sequelae of alcoholism.