Am J Psychiatry 1992; 149:1016-1022
Copyright © 1992 by American Psychiatric Association
Decreased brain metabolism in neurologically intact healthy alcoholics
ND Volkow, R Hitzemann, GJ Wang, JS Fowler, G Burr, K Pascani, SL Dewey and AP Wolf
Medical Department, Brookhaven National Laboratory, Upton, NY 11973.
OBJECTIVE: The extent to which cerebral dysfunction in alcoholics is
related to the direct effects of alcohol in the brain rather than to
indirect mechanisms and/or alcohol withdrawal remains unclear. The purpose
of this study was to evaluate whether healthy alcoholics with no evidence
of alcohol-associated complications showed changes in brain glucose
metabolism. METHOD: Positron emission tomography and [18F]-
fluorodeoxyglucose were used to measure regional brain metabolism. The
study group consisted of 22 normal, healthy, right-handed volunteers and 22
neurologically intact, healthy, right-handed alcoholics tested 6 to 32 days
after alcohol discontinuation. RESULTS: Alcoholics showed significantly
lower whole brain metabolism than normal control subjects. Normalization of
regional metabolic values to the whole brain metabolic rate revealed that
the left parietal and right frontal cortices were the most affected
regions. Although the whole brain metabolic rate was correlated with the
amount of time since alcohol discontinuation, the "normalized" decreases in
left parietal and right frontal glucose metabolism were not. CONCLUSIONS:
These findings support the contribution of the direct effect of alcohol as
well as alcohol withdrawal on the changes in regional brain metabolism seen
in alcoholics. They also provide evidence of cerebral changes in
neurologically intact healthy alcoholics.
