Sex Differences in the Effects of Alcohol on Brain Structure

• Published in: The American journal of psychiatry Vol. 158; no. 2; pp. 188 - 197
• Main Authors: Pfefferbaum, Adolf, Rosenbloom, Margaret, Deshmukh, Anjali, Sullivan, Edith V.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.02.2001; American Psychiatric Association
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Age Factors; Aged; Alcohol Drinking - adverse effects; Alcoholism; Alcoholism - complications; Alcoholism - diagnosis; Biological and medical sciences; Brain; Brain - anatomy & histology; Brain - drug effects; Brain structure; Cerebral Ventricles - anatomy & histology; Cerebral Ventricles - drug effects; Differences; Effects; Ethanol - adverse effects; Ethanol - pharmacology; Female; Gender differences; Heavy drinking; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - statistics & numerical data; Male; Medical sciences; Middle Aged; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Factors; Sexes; Skull - anatomy & histology; Temperance; Time Factors; Human; Intracranial; Volumetric analysis; Cerebral cortex; Senescence; Alcoholism; Grey matter; Sex; Central nervous system; Nuclear magnetic resonance imaging; White matter; Alcoholic beverage; Third cerebral ventricle; Cerebral sulcus; Dependence; Medical imagery; Severity score; Lateral cerebral ventricle; Age; Comparative study; Brain (vertebrata)
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.158.2.188

OBJECTIVE: This study investigated whether alcoholic women manifest deficits in cortical gray and white matter volumes and ventricular enlargement similar to those seen in alcoholic men. METHOD: Volumetric measures of intracranium, cortical gray matter, white matter and sulci, and lateral and third ventricles were obtained from magnetic 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 alcoholic 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 matter and smaller third ventricles than men, consistent with sex-related differences 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 after covarying for lifetime alcohol consumption. Slopes relating cortical gray matter and sulcal volumes to age were steeper in alcoholic than in comparison men. Slopes relating lateral ventricle volume to age were steeper in alcoholic 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 deficits, relative to same-sex comparison subjects. However, age and alcoholism interact in both sexes, which puts all older alcoholics at particular risk for the negative sequelae of alcoholism.