CT exposes women’s vulnerability to alcoholism

Findings from CT imaging show greater brain atrophy in alcoholic women than in men, confirming the hypothesis that women's brains are more vulnerable to alcohol.

Most previous studies of alcoholics' brains involved only men. Researchers assumed they could apply the results to both sexes, but that is no longer the case, according to Dr. Karl F. Mann, lead author of a study on the subject in the May issue of Alcoholism: Clinical & Experimental Research.

"Gender differences in the development, course, and consequences of alcohol dependence have to be considered in early diagnosis, as this probably will lead to different therapeutic strategies," Mann said.

Mann and colleagues at the University of Heidelburg in Germany examined 158 subjects:

• 76 women (42 alcoholic patients, 34 healthy controls)

• 82 age-matched men (34 alcoholic patients, 48 healthy controls)

Patients received two CT scans, one at the beginning and another at the end of a six-week inpatient rehabilitation program. Controls received one scan.

Imaging at week one revealed that both men and women alcoholics had smaller brain volumes, larger cerebrospinal fluid volumes, and lower global atrophy index (ratio of brain volume over intracranial volume) compared with controls.

Despite shorter durations of addiction, however, women suffered the same rate of brain damage as men with longer histories of alcohol dependence.

Previous studies had found that different milestones in the developmental course toward dependence occurred more rapidly in women. Mann had found in two earlier studies indications that brain atrophy is accelerated in alcoholic women. He designed the current study to test this hypothesis in a larger sample of patients and controls.

The results confirmed gender-specific differences in the onset of alcohol dependence, as well as faster atrophy rates for women, said Mann, a professor in the department for addictive behavior and addiction medicine.

The good news is that abstinence reversed atrophy for both sexes. A comparison of patient images from week one and week six showed an increase in brain volume and in the global atrophy index and a decrease of all CSF volumes.

"At the end of the six-week treatment program, with complete sobriety, we found an increase in brain volume in both genders, but significance of this reversibility of brain atrophy was higher in women than in men," the study said.

In the future, researchers plan to use functional imaging such as fMRI to find out whether the differences in brain structure also translate into functions such as cue-induced brain activity in the reward pathways.

For more information from the Diagnostic Imaging archives:

Imaging shows effects of alcohol use on brain

Obesity as disease touches a nerve

Supertensor imaging locates complex fibers