EFFECTS OF ABSTINENCE AND RELAPSE UPON NEUROPSYCHOLOGICAL FUNCTION AND CEREBRAL GLUCOSE-METABOLISM IN SEVERE CHRONIC-ALCOHOLISM

Prolonged excessive consumption of alcohol has been associated with a variety of cognitive disorders accompanied by neuropathological and ne urochemical abnormalities of the brain, particularly in the frontal lo bes. Studies with positron emission tomography (PET) have shown decrea sed local cerebral metabolic rates for glucose (ICMRglc) in frontal re gions, with correlated abnormalities an neuropsychological tests sensi tive to executive functioning. This investigation was designed as a pi lot study to examine the effects of abstinence and relapse in patients with severe chronic alcoholism studied longitudinally with PET and wi th neuropsychological evaluation to assess both general and executive functioning. Six patients, including 4 who remained relatively abstine nt and 2 who relapsed following their initial evaluation, were studied twice, with inter-evaluation intervals ranging from 10 to 32 months. The patients who remained abstinent or who had minimal alcohol use sho wed partial recovery of ICMRglc in two of three divisions of the front al lobes and improvement on neuropsychological tests of general cognit ive and executive functioning, whereas the patients who relapsed had f urther declines in these areas. These results. although based upon a r elatively small number of subjects, provide preliminary support for at least partial recovery of metabolic and cognitive functioning in indi vidual patients who abstain from alcohol.