Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T06:12:02.416Z Has data issue: false hasContentIssue false
  • English
  • Français

Cerebral blood flow in alcohol withdrawal: relation to severity of dependence and cognitive impairment

Published online by Cambridge University Press:  24 June 2014

E. Hamdi ,
A. Al-Suhaili ,
M. T. Abou-Saleh ,
Y. Amin  and
V. Prais
E. Hamdi*
Affiliation:
Pembury Hospital, Tunbridge Wells, UK and King's College, London, UK
A. Al-Suhaili
Affiliation:
Department of Nuclear Medicine, Tawan Hospital, Al-Ain, UAE
M. T. Abou-Saleh
Affiliation:
St George's Hospital Medical School, London, UK
Y. Amin
Affiliation:
West Kent NHS and Social Care Trust, The Pagoda, Maidstone, UK
V. Prais
Affiliation:
Department of Nuclear Medicine, Tawan Hospital, Al-Ain, UAE
*
Consultant Psychiatrist, 12 Havering Close, Tunbridge Wells, Kent TN2 4XW, UK. Tel: 0044 1892823535 ext 3621, 01892 518091; Fax: 0044 1892825557.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Alcohol dependence affects cerebral function in complex, still unsettled ways.

Methods:

Thirty exclusively alcohol-dependent patients in various stages of withdrawal and 25 matched controls were examined for regional uptake of 99mTc-HMPAO in nine homologous regions of the cerebral cortex by single photon emission tomography (SPET). Image analysis reports regional uptake/uptake in homologous hemisphere.

Results:

Alcohol dependence is associated with diminished perfusion in the anterior, and middle frontal regions, and increased perfusion in the posterior temporal regions. Frontal hypoperfusion is related to alcohol withdrawal because it disappears with longer time between imaging, last intake and correlates with a composite index of cognitive impairment at the time. Temporal hyperperfusion persists for longer periods. Severe dependence correlates with both frontal, and temporal altered perfusion.

Discussion:

Alcohol withdrawal leads to redistribution of blood flow favouring the temporal, and more posterior regions of the cortex at the expense of frontal flow.

Keywords

alcohol withdrawalsingle photon emission tomography (SPET)cognitive impairmentcerebral blood flow
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 2 , April 2003 , pp. 55 - 62
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mathew, RJ, Wilson, WH. Substance abuse and cerebral blood flow. Am J Psychiatry 1991;148: 292–305.Google ScholarPubMed
Devous, M. Imaging brain function by single photon emission computer tomography. In: Andreasen, N, ed. Brain imaging: applications in psychiatry. Washington, DC: American Psychiatric Press Inc., 1989;75–91. Google Scholar
Wang, GJ, Volkow, ND, Roque, CTet al. Functional importance of ventricular enlargement and cortical atrophy in healthy subjects and alcoholics as assessed with PET, MR imaging, and neuropsychologic testing. Radiology 1993;186: 59–65.CrossRefGoogle ScholarPubMed
Erbas, B, Bekdik, C, Erbengi, Get al. Regional cerebral blood flow changes in chronic alcoholism using Tc-99m HMPAO SPECT. Comparison with CT parameters. Clin Nucl Med 1992;17: 123–127.CrossRefGoogle ScholarPubMed
Neulin, DB, Golden, CJ, Quaife, M, Graber, B. Effect of alcohol ingestion on cerebral blood flow. Int J Neurosci 1982;17: 145–150.CrossRefGoogle Scholar
de Wit, H, Metz, J, Wagner, N, Cooper, M. Behavioral and subjective effects of ethanol: relationship to cerebral metabolism using PET. Alcoholism 1990;14: 482–489.CrossRefGoogle ScholarPubMed
Wang, GJ, Volkow, ND, Hizemann, R, Oster, ZH, Roque, C, Cestaro, V. Brain imaging of an alcoholic with MRI, SPECT, and PET. Am J Physiologic Imaging 1992;7: 194–198. Google ScholarPubMed
Nicholas, JM, Catafau, AM, Estruch, Ret al. Regional cerebral blood flow-SPECT in chronic alcoholism: relation to cognitive testing. J Nucl Med 1993;34: 1452–1459.Google Scholar
Melgaard, B, Henriksen, L, Ahlgren, P, Danielsen, UT, Paulson, OB, Sorensen, H. Regional cerebral blood flow in chronic alcoholics measured by single photon emission computerized tomography. Acta Psychiatr Scand 1990;82: 87–93. Google ScholarPubMed
Caspari, D, Trabert, W, Heinz, G, Lion, N, Henkes, H, Huber, G. The pattern of regional cerebral blood flow during alcohol withdrawal — a single photon emission tomography study with 99mTc-HMPAO. Acta Psychiatr Scand 1993;87: 414–417.CrossRefGoogle ScholarPubMed
Berglund, M, Risberg, J. Regional cerebral blood flow during alcohol withdrawal. Arch General Psychiatry 1981;38: 351–355. CrossRefGoogle ScholarPubMed
Hemmingsen, R, Vorstrup, S, Clemmesen, Let al. Cerebral blood flow during delirium tremens and related clinical states studied with xenon-133 inhalation tomogrpahy. Am J Psychiatry 1988;145: 1384–1390.Google Scholar
Mampunza, S, Verbanck, P, Verhas, Met al. Cerebral blood flow in just detoxified alcohol dependent patients. A 99mTc-HMPAO-SPECT study. Acta Neurol Belg 1995;95: 164–169.Google Scholar
Rogers, RL, Meyer, JS, Shaw, TG, Mortel, KF. Reductions in regional cerebral blood flow associated with chronic consumption of alcohol. J Am Geriatr Soc 1983;31: 540–543.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn, DSM-IV. Washington, DC: American Psychiatric Press, Inc., 1994. Google ScholarPubMed
Stockwell, TR, Hodgson, RJ, Edwards, G, Taylor, C, Raukin, HJ. Development of a questionnaire for measuring severity of alcohol dependence. Br J Addict 1979;74: 85–87. CrossRefGoogle Scholar
Ghodse, H. Drugs and addictive behaviour: a guide to treatment. Oxford: Blackwell, 1989. Google Scholar
Annett, M. Classification of hand preference by association analysis. Br J Psychol 1970;61: 303–321.CrossRefGoogle ScholarPubMed
Lezak, M. Neuropsychological assessment. New York: Oxford University Press, 1983. Google ScholarPubMed
Wechsler, D. Weschsler memory scale. New York: Psychological Corporation, 1972. Google Scholar
Abou-Saleh, MT, Al-Suhaili, AR, Karim, L, Prais, V, Hamoi, E. Single photon emission tomography with 99mTc-labelled hexamethyl propylene amine oxime in Arab patients with depression. J Affective Dis 1999;55: 115–123. CrossRefGoogle Scholar
Lamoureux, G, Dupont, RM, Ashburn, WL, Halpern, SE. ‘COR-TEX’: a program for quantitative analysis of brain SPECT data. J Nucl Med 1990;31: 1862–1871.Google Scholar
Mathew, RJ, Marglin, RA, Kessler, RM. Cerebral function, blood flow and metabolism: a new vista in psychiatric research. Integrative Psychiatry 1985;3: 214–225. Google Scholar
Buchsbaum, MS, Wu, J, Haier, Ret al. Positron emission tomography assessment of effects of benzodiazepines on regional glucose metabolic rate in patients with anxiety disorder. Life Sci 1987;40: 2393–2400.CrossRefGoogle ScholarPubMed
Heaton, RK. Wisconsin card sorting test manual. Odessa, FL: Psychological Assessment Resources, 1981. Google Scholar
Sullivan, EV, Mathalon, DH, Zipursky, RBHet al. Factors of the Wisconsin card sorting test as measures of frontal-lobe function in schizophrenia and in chronic alcoholism. Psychiatr Res 1993;46: 175–199. CrossRefGoogle ScholarPubMed