Alcohol consumption is a leading contributor to the global burden of disease and to healthcare and economic costs. Alcohol use disorder is one of the most prevalent mental health conditions worldwide, with deleterious effects on physical, cognitive, and social functioning(1).
Chronic excessive alcohol consumption is associated with direct and
indirect adverse effects, including
cardiovascular disease, nutritional deficiency, cancer, and accelerated aging(2).
There are changes in brain structure and connectivity from chronic alcohol use(3).
Heavy alcohol consumption (3 or more drinks for women and 4 or more drinks for men on any day) is associated with widespread patterns of macrostructural and microstructural changes within the brain. Lower gray matter volume is associated with lifetime alcohol consumption.
In addition, research indicates that the effects of alcohol consumption on brain volume interact with the effects of aging(4).
Although there is extensive research and peer-reviewed publications on the association of alcohol consumption with brain structure and microstructure in individuals with alcohol use disorder, there is limited research exploring these associations in people who consume alcohol but are not considered to have alcohol use disorder.
A recent study examined the associations between alcohol intake and measures of grey matter structure and white matter microstructure in the brain of a large population sample from the UK Biobank. The UK Biobank is a prospective cohort study representative of the United Kingdom population aged 40-69 years and is the largest available collection of high-quality MRI brain scans, alcohol-related behavioral phenotypes, and measurements of the socioeconomic environment.
Negative relationships were observed between alcohol intake and global gray and white matter measures, regional grey matter volume and white matter microstructure indices. The associations identified are widespread across the brain, and their magnitude increases with the average absolute number of daily alcohol units consumed. Units are a simple way of expressing the quantity of pure alcohol in a drink. One unit equals 10ml or 8g of pure alcohol, which is around the amount of alcohol the average adult can process in an hour.
Negative associations are detectable in individuals who consume between 1 and 2 alcohol units daily. Thus, consuming just one alcoholic drink daily could be associated with changes in grey matter volume and white matter volume in the brain.
Like individuals with alcohol use disorder, alcohol intake in this healthy population sample is associated with microstructural differences in superficial white systems functionally related to grey matter networks.
Other
brain systems thought to be involved in cognitive functioning are also associated with alcohol intake. This pattern of alcohol associated white matter microstructural disruption supports previous research showing excessive intracellular and extracellular fluid in individuals with alcohol use disorder(5).
As mentioned previously, the effects of alcohol consumption on brain volume interact with the effects of aging. There is evidence that the frontal lobes are particularly vulnerable to alcoholism-related damage, and the brain changes in these areas are most prominent as alcoholics age(6).
Figure: Brain MRI scans of age-equivalent men with different histories of alcohol use. The image shows clear evidence of brain shrinkage in the alcoholic compared with the control subject. The graph on the right shows that older alcoholics have less cortical tissue than younger alcoholics, and that the prefrontal cortex is especially vulnerable to alcohol’s effects(7).
Other studies of frontal lobe function in older alcoholics have confirmed reports of a correlation between impaired neuropsychological performance (e.g., executive control skills, as noted above) and decreased blood flow or metabolism (energy use) in the frontal lobes, as seen using neuroimaging techniques(8).
It is evident that there is a negative association between alcohol intake and brain macrostructure and microstructure in a general population sample of middle-aged and older adults.
Alcohol intake is negatively associated with global brain volume measures, regional grey matter volume and white matter microstructure. The associations between alcohol intake and regional grey matter volume are evident across the entire brain.
Most of these negative associations are apparent in individuals consuming an average of only one to two daily alcohol units (i.e.10-20ml or 8-16g of pure alcohol).
I think the most relevant finding is the potential for even moderate drinking to be associated with changes in brain volume in middle-aged and older adults.
Your brain is a delicate and extremely valuable resource, so do everything you can to take care of it. That means staying hydrated, keeping alcohol consumption to a minimum, getting plenty of sleep, and exercising every day.
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References:
1. Zahr NM, Pfefferbaum A: Alcohol's Effects on the Brain: Neuroimaging Results in Humans and Animal Models. Alcohol Res 38:183-206, 2017
2. Daviet R, Aydogan G, Jagannathan K, et al: Associations between alcohol consumption and gray and white matter volumes in the UK Biobank. Nat Commun 13:1175, 2022
3. Sullivan EV, Pfefferbaum A: Brain-behavior relations and effects of aging and common comorbidities in alcohol use disorder: A review. Neuropsychology 33:760-780, 2019
4. Fein G, Shimotsu R, Barakos J: Age-related gray matter shrinkage in a treatment naïve actively drinking alcohol-dependent sample. Alcohol Clin Exp Res 34:175-82, 2010
5. Pfefferbaum A, Sullivan EV: Disruption of brain white matter microstructure by excessive intracellular and extracellular fluid in alcoholism: evidence from diffusion tensor imaging. Neuropsychopharmacology 30:423-32, 2005
6. Pfefferbaum A, Sullivan EV, Mathalon DH, et al: Frontal lobe volume loss observed with magnetic resonance imaging in older chronic alcoholics. Alcohol Clin Exp Res 21:521-9, 1997
7. Oscar-Berman M, Marinkovic K: Alcoholism and the brain: an overview. Alcohol Res Health 27:125-33, 2003
8. Adams KM, Gilman S, Johnson-Greene D, et al: The significance of family history status in relation to neuropsychological test performance and cerebral glucose metabolism studied with positron emission tomography in older alcoholic patients. Alcohol Clin Exp Res 22:105-10, 1998
