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Alcoholic brain damage and dementia viewed by MRI, with special consideration on frontal atrophy and white matter damage in dyslipidemic patients
Author(s) -
NAMURA Ikuro
Publication year - 2006
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/j.1479-8301.2006.00169.x
Subject(s) - atrophy , white matter , magnetic resonance imaging , dementia , medicine , hyperintensity , myelin , brain damage , cerebral atrophy , pathology , psychology , neuroimaging , cardiology , neuroscience , radiology , central nervous system , disease
Abstract Long‐term intake of excessive alcohol causes various forms of brain damage, most of which are now visualized by magnetic resonance imaging (MRI) and proved to be contributing to the early onset of dementia. Bi‐frontal atrophy has a unique position among these various forms of damage because of its lobar conformation localized only to the higher cortex, and because the same kind of atrophy is also seen in dyslipidemic patients like hypercholesterolemia. Multiple logistic regression analysis of 3100 subjects with MRI revealed no other significant group for this finding. Morphological features of this type of atrophy and its rate of progression are described in this paper, and computerized image analysis showed that this atrophy seems to depend mainly on the decrease of white matter. However, a common biochemical factor underlying the frontal atrophy in these two groups has not yet been identified. Importantly, dyslipidemic patients also show some type of T2 high white matter changes, which are not seen in ‘pure’ alcoholics. For dyslipidemic patients, this white matter change, which seems to be the degradation of myelin sheath, is another basis for early dementia. Although the author can propose a new concept of ‘dyslipidemic dementia’ due to frontal atrophy and white matter damage, details of its mechanism and its relation to alcoholism are left to future investigations.