Brain proton magnetic resonance spectroscopy studies in recently abstinent alcoholics.

Chronic alcohol-dependent patients have reduced brain volumes and concomitant neurobehavioral deficits that may recover during abstinence. In 10 chronic alcoholic patients, using localized proton magnetic resonance spectroscopy, we found reliable increases during the first 3-4 weeks of abstinence in the concentrations within the superior cerebellar vermis of choline (Cho)-containing compounds relative to the neuronal marker, N-acetylaspartate (NAA). Lesser changes were observed following 1 month of abstinence, and in one of the patients studied longitudinally over 3 months, a marked reduction in the Cho/NAA ratio was associated with relapse. After detoxification, the Cho/NAA ratio correlated with a composite clinical impression of brain functions. The lowest Cho/NAA was observed in a patient with persisting alcoholic dementia, in striking contrast to reduced relative concentrations of NAA reported in dementia of the Alzheimer's type. Possible molecular explanations for these brain metabolic changes are discussed.

[1]  J. Pettegrew,et al.  L‐Phosphoserine, a Metabolite Elevated in Alzheimer's Disease, Interacts with Specific L‐Glutamate Receptor Subtypes , 1991, Journal of Neurochemistry.

[2]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[3]  O Henriksen,et al.  In vivo quantification of brain metabolites by 1H-MRS using water as an internal standard. , 1993, Magnetic resonance imaging.

[4]  George Fein,et al.  Proton magnetic resonance spectroscopy of human brain: Applications to normal white matter, chronic infarction, and MRI white matter signal hyperintensities , 1992, Magnetic resonance in medicine.

[5]  J. Coyle,et al.  N‐Acetyl‐Aspartyl‐Glutamate: Regional Levels in Rat Brain and the Effects of Brain Lesions as Determined by a New HPLC Method , 1984, Journal of neurochemistry.

[6]  P A Bottomley,et al.  Human in vivo NMR spectroscopy in diagnostic medicine: clinical tool or research probe? , 1989, Radiology.

[7]  K O Lim,et al.  Brain gray and white matter volume loss accelerates with aging in chronic alcoholics: a quantitative MRI study. , 1992, Alcoholism, clinical and experimental research.

[8]  J. Kril,et al.  Neuropathology of alcoholism. , 1990, Alcohol and alcoholism.

[9]  J. Gray,et al.  Cholinergic-rich brain transplants reverse alcohol-induced memory deficits , 1988, Nature.

[10]  P. Carlen,et al.  Alcohol-related dementia in the institutionalized elderly. , 1994, Alcoholism, clinical and experimental research.

[11]  A. Pfefferbaum,et al.  MRI study of brain changes with short-term abstinence from alcohol. , 1989, Alcoholism, clinical and experimental research.

[12]  B D Ross,et al.  Metabolic disorders of the brain in chronic hepatic encephalopathy detected with H-1 MR spectroscopy. , 1992, Radiology.

[13]  B. Cragg,et al.  Alcohol withdrawal causes a loss of cerebellar Purkinje cells in mice. , 1984, Journal of studies on alcohol.

[14]  L. Bauer,et al.  Motoric signs of CNS dysfunction associated with alcohol and cocaine withdrawal , 1993, Psychiatry Research.

[15]  R. Shulman,et al.  Effects of Acute Hyperammonemia on Cerebral Amino Acid Metabolism and pHi In Vivo, Measured by 1H and 31P Nuclear Magnetic Resonance , 1989, Journal of neurochemistry.

[16]  J. Rohrbaugh,et al.  Regional cerebral glucose utilization in chronic organic mental disorders associated with alcoholism. , 1992, The Journal of neuropsychiatry and clinical neurosciences.

[17]  A. Brancati,et al.  Distribution of N-acetylaspartate, N-acetylaspartylglutamate, free glutamate and aspartate following complete mesencephalic transection in rat neuraxis , 1990, Neuroscience Letters.

[18]  P. Strick,et al.  Activation of a cerebellar output nucleus during cognitive processing. , 1994, Science.

[19]  B. Pakkenberg,et al.  Do alcoholics drink their neurons away? , 1993, The Lancet.

[20]  S R Vrbaski,et al.  Cerebellum Lipids in Rats After Chronic Ethanol Treatment , 1985, Journal of neurochemistry.

[21]  J. Blass,et al.  Impairment of behavior and acetylcholine metabolism in thiamine deficiency. , 1981, The Journal of pharmacology and experimental therapeutics.

[22]  G. Shulman,et al.  Cerebral Lactate Turnover after Electroshock: In vivo Measurements by 1H/13C Magnetic Resonance Spectroscopy , 1992, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[23]  T. Telakivi,et al.  Influence of improved drinking habits on brain atrophy and cognitive performance in alcoholic patients: a 5-year follow-up study. , 1989, Alcoholism, clinical and experimental research.

[24]  R C Holgate,et al.  Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. , 1978, Science.

[25]  P. Carlen,et al.  Partially Reversible Cerebral Atrophy and Functional Improvement in Recently Abstinent Alcoholics , 1984, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[26]  R A Koeppe,et al.  Cerebellar and frontal hypometabolism in alcoholic cerebellar degeneration studied with positron emission tomography , 1990, Annals of neurology.

[27]  J Hennig,et al.  Coupling effects in volume selective 1H spectroscopy of major brain metabolites , 1991, Magnetic resonance in medicine.

[28]  M. E. Charness,et al.  Ethanol and the nervous system. , 1989, The New England journal of medicine.

[29]  K. Mann,et al.  The reversibility of alcoholic brain damage is not due to rehydration: a CT study. , 1993, Addiction.

[30]  N Butters,et al.  Volumetric magnetic resonance imaging quantification of longitudinal brain changes in abstinent alcoholics. , 1994, Alcoholism, clinical and experimental research.

[31]  S. Torp,et al.  The prevalence of alcoholic cerebellar atrophy A morphometric and histological study of an autopsy material , 1986, Journal of the Neurological Sciences.

[32]  B D Ross,et al.  Alzheimer disease: depiction of increased cerebral myo-inositol with proton MR spectroscopy. , 1993, Radiology.

[33]  G. Freund,et al.  Loss of cholinergic muscarinic receptors in the frontal cortex of alcohol abusers. , 1988, Alcoholism, clinical and experimental research.

[34]  R. Kauppinen,et al.  Observation of Cerebral Metabolites in an Animal Model of Acute Liver Failure In Vivo: A 1H and 31P Nuclear Magnetic Resonance Study , 1989, Journal of neurochemistry.

[35]  G. Fein,et al.  Reduced brain N‐acetylaspartate suggests neuronal loss in cognitively impaired human immunodeficiency virus‐seropositive individuals , 1993, Neurology.

[36]  P. Bottomley.  Spatial Localization in NMR Spectroscopy in Vivo , 1987, Annals of the New York Academy of Sciences.

[37]  M. Hillbom,et al.  The clinical versus radiological diagnosis of alcoholic cerebellar degeneration , 1986, Journal of the Neurological Sciences.

[38]  M. Eckardt,et al.  Clinical assessment of cognition in alcoholism. , 1986, Alcoholism, clinical and experimental research.

[39]  J. Alger,et al.  High‐Resolution Proton Magnetic Resonance Spectroscopy of Rabbit Brain: Regional Metabolite Levels and Postmortem Changes , 1988, Journal of neurochemistry.

[40]  M. Eckardt,et al.  Alcoholic organic brain disease: Nosology and pathophysiologic mechanisms , 1986, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[41]  D. Gadian,et al.  Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types , 1993, The Journal of neuroscience : the official journal of the Society for Neuroscience.