Item Information
- Author, Montserrat Corral Varela*
- role, the conversation**
- March 23, 2023
Updated 2 hours ago
A person lying on cardboard with a bottle of wine by his side is a naked eye warning to us of alcohol’s physical and social harm.
Much more difficult, however, is to discover the invisible damage that is part of the causal chain that leads to this situation: the damage that alcohol does to the brain.
Most people could quickly describe the acute effects of alcohol: incoordination, disinhibition, impulsiveness… But few are aware of the chronic consequences of this consumption, which react to the neurotoxic effects of alcohol on the brain.
Neuropsychological and imaging studies show that three neural networks are particularly vulnerable: the frontocerebellar network, which controls balance; the frontolimbics involved in memory, motivation, and selfesteem; and the frontostriatum, responsible for emotional regulation, inhibition, cognitive flexibility, and reward management.
Watch out for these symptoms
But how do we know if an alcohol drinker has brain damage? People around you will notice that you are slower, more distractible, more rigid, have a poor memory, make decisions without weighing risks, have trouble regulating emotions, and are less able to interpret the emotions of others. And all of this affects family, work and social life.
Furthermore, like a dog biting its own tail, the cognitive and emotional deficits caused by alcohol consumption will undermine efforts to initiate and maintain abstinence.
Healthcare professionals should consider that brain injuries can be a barrier to undertaking clinical management because they limit emotional selfregulation, motivation for change, interaction with other people, emotional cognition, and awareness of social dysfunction.
But even when these difficulties are overcome and abstinence is maintained, it may be too late for the brain.
Honest Lies and Alcohol: The Korsakoff Syndrome
Damage that is difficult to repair occurs in patients with Korsakoff syndrome.
This permanent and largely irreversible condition occurs in one in two cases of Wernicke’s encephalopathy, a condition caused by severe vitamin B1 deficiency and more common in malnourished people who abuse alcohol.
A prevalence of between 25 and 50 cases per 100,000 population is estimated. But studies on cadavers show that this condition is underdiagnosed.
In this syndrome, damage affects an area of the brain called the diencephalon, particularly the mammary bodies and nuclei of the thalamus. The deterioration is mainly reflected in the memory: the patients suffer from an amnestic syndrome, which is accompanied by fables, especially in the initial phase.
That is, the affected person has false memories and is convinced that they are real. These imaginative memories, referred to as “honest lies,” arise from a deficit in memory access.
caption,
Volume differences in the white and gray matter of the brain were also observed.
Adolescents and Overuse
And the youngsters? Does brain damage cause years of alcohol consumption? If they only drink on the weekends, are they okay?
No, drinking five or more units in a few hours at least once a month is associated with memory and leadership issues that allow us to plan, monitor, and regulate behavior according to our goals and standards.
These difficulties respond to structural and functional changes in the brain. Neuroimaging studies reveal neurofunctional abnormalities, such as B. excessive activation of neural networks when the response to an alcoholic drink should be inhibited.
Volume differences in the brain’s white and gray matter have also been observed in different regions associated with impulse control.
It must be borne in mind that adolescence is a period of brain vulnerability in which important changes in the structure and functional connectivity of neural networks occur.
We should be concerned that alcohol is still seen as a less dangerous drug among 1418 year olds.
The first involuntary drunkenness: fetal alcohol syndrome
But brain damage associated with alcohol use can begin long before puberty—even before birth. Consumption during pregnancy is the cause of fetal alcohol syndrome spectrum disorders, a completely preventable neurodevelopmental problem.
There is no safe alcohol consumption during pregnancy. Alcoholic beverage consumption during the nine months is associated with central nervous system disorders such as reduced head circumference, structural brain abnormalities, and neurobehavioral deficits.
All this affects the development of intellectual capacity, cognitive function and selfregulation of behavior.
Among the most vulnerable groups that require special attention are children from intercountry adoptions, especially if they come from countries with high alcohol consumption.
A recent study shows that up to 50% of them meet diagnostic criteria for the disorder. And one in five sufferers has the most severe form: fetal alcohol syndrome.
It is necessary to make the entire population aware of the risks to the fetus and to support pregnant women who decide to stop drinking alcohol. And don’t forget to identify and intervene early to ensure the appropriate academic, psychological and social development of all these children.
In short, no matter your age, the less alcohol the better if you want to take care of your brain health.
*Montserrat Corral Varela is Professor of Neuropsychology at the University of Santiago de Compostela, Spain.