Of those who reported drinking in the 2 weeks before the survey, 9. The students reported learning later that they had participated in a wide range of potentially dangerous events they could not remember, including vandalism, unprotected sex, and driving. College students may be at particular risk for experiencing a blackout, as an alarming number of college students engage in binge drinking.
Binge drinking, for a typical adult, is defined as consuming five or more drinks in about 2 hours for men, or four or more drinks for women. Equal numbers of men and women reported experiencing blackouts, despite the fact that the men drank significantly more often and more heavily than the women.
This outcome suggests that regardless of the amount of alcohol consumption, females—a group infrequently studied in the literature on blackouts—are at greater risk than males for experiencing blackouts. Females also may be more susceptible than males to milder forms of alcohol—induced memory impairments, even when men and women consume comparable amounts of alcohol 4.
Women are more vulnerable than men to many of the medical consequences of alcohol use. For example, alcoholic women develop cirrhosis 5 , alcohol—induced damage of the heart muscle i.
Using imaging with computerized tomography, two studies 8,9 compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects.
Studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking The difference is that alcoholic women reported that they had been drinking excessively for only about half as long as the alcoholic men in these studies.
Yet other studies have not shown such definitive findings. In fact, two reports appearing side by side in the American Journal of Psychiatry contradicted each other on the question of gender—related vulnerability to brain shrinkage in alcoholism 12, People who have been drinking large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain.
Damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or from severe liver disease. For example, thiamine deficiency is a common occurrence in people with alcoholism and results from poor overall nutrition. Thiamine, also known as vitamin B1, is an essential nutrient required by all tissues, including the brain. Thiamine is found in foods such as meat and poultry; whole grain cereals; nuts; and dried beans, peas, and soybeans.
Many foods in the United States commonly are fortified with thiamine, including breads and cereals. As a result, most people consume sufficient amounts of thiamine in their diets. Up to 80 percent of alcoholics, however, have a deficiency in thiamine 15 , and some of these people will go on to develop serious brain disorders such as Wernicke—Korsakoff syndrome WKS Schematic drawing of the human brain, showing regions vulnerable to alcoholism-related abnormalities.
Although these patients have problems remembering old information i. For example, these patients can discuss in detail an event in their lives, but an hour later might not remember ever having the conversation. Treatment The cerebellum, an area of the brain responsible for coordinating movement and perhaps even some forms of learning, appears to be particularly sensitive to the effects of thiamine deficiency and is the region most frequently damaged in association with chronic alcohol consumption.
Administering thiamine helps to improve brain function, especially in patients in the early stages of WKS. When damage to the brain is more severe, the course of care shifts from treatment to providing support to the patient and his or her family Custodial care may be necessary for the 25 percent of patients who have permanent brain damage and significant loss of cognitive skills Scientists believe that a genetic variation could be one explanation for why only some alcoholics with thiamine deficiency go on to develop severe conditions such as WKS, but additional studies are necessary to clarify how genetic variants might cause some people to be more vulnerable to WKS than others.
Most people realize that heavy, long—term drinking can damage the liver, the organ chiefly responsible for breaking down alcohol into harmless byproducts and clearing it from the body. But people may not be aware that prolonged liver dysfunction, such as liver cirrhosis resulting from excessive alcohol consumption, can harm the brain, leading to a serious and potentially fatal brain disorder known as hepatic encephalopathy Hepatic encephalopathy can cause changes in sleep patterns, mood, and personality; psychiatric conditions such as anxiety and depression; severe cognitive effects such as shortened attention span; and problems with coordination such as a flapping or shaking of the hands called asterixis.
In the most serious cases, patients may slip into a coma i. New imaging techniques have enabled researchers to study specific brain regions in patients with alcoholic liver disease, giving them a better understanding of how hepatic encephalopathy develops.
These studies have confirmed that at least two toxic substances, ammonia and manganese, have a role in the development of hepatic encephalopathy. Alcohol—damaged liver cells allow excess amounts of these harmful byproducts to enter the brain, thus harming brain cells. Treatment Physicians typically use the following strategies to prevent or treat the development of hepatic encephalopathy.
Treatment that lowers blood ammonia concentrations, such as administering L—ornithine L—aspartate. In initial studies, patients using these devices showed lower amounts of ammonia circulating in their blood, and their encephalopathy became less severe Liver transplantation, an approach that is widely used in alcoholic cirrhotic patients with severe i.
In general, implantation of a new liver results in significant improvements in cognitive function in these patients 22 and lowers their levels of ammonia and manganese Drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain, the most serious of which is a collection of symptoms known as fetal alcohol syndrome FAS. Children with FAS may have distinct facial features see illustration.
FAS infants also are markedly smaller than average. Their brains may have less volume i. And they may have fewer numbers of brain cells i. Children with fetal alcohol syndrome FAS may have distinct facial features. Treatment Scientists are investigating the use of complex motor training and medications to prevent or reverse the alcohol—related brain damage found in people prenatally exposed to alcohol These findings have important therapeutic implications, suggesting that complex rehabilitative motor training can improve motor performance of children, or even adults, with FAS.
Scientists also are looking at the possibility of developing medications that can help alleviate or prevent brain damage, such as that associated with FAS. Studies using animals have yielded encouraging results for treatments using antioxidant therapy and vitamin E. Other preventive therapies showing promise in animal studies include 1—octanol, which ironically is an alcohol itself.
Two molecules associated with normal development i. And a compound MK— that blocks a key brain chemical associated with alcohol withdrawal i. MK— reversed a specific learning impairment that resulted from early postnatal alcohol exposure Though these compounds were effective in animals, the positive results cited here may or may not translate to humans. Not drinking during pregnancy is the best form of prevention; FAS remains the leading preventable birth defect in the United States today.
For decades scientists believed that the number of nerve cells in the adult brain was fixed early in life. If brain damage occurred, then, the best way to treat it was by strengthening the existing neurons, as new ones could not be added.
In the s, however, researchers found that new neurons are indeed generated in adulthood—a process called neurogenesis These new cells originate from stem cells, which are cells that can divide indefinitely, renew themselves, and give rise to a variety of cell types.
Figure 2. One of the first areas affected as intoxication develops is the frontal cortex—leading to loss of judgement. Please read the Duke Wordpress Policies. Contact the Duke WordPress team. The Alcohol Pharmacology Education Partnership. Schwartz-Bloom, Ph. Fulton T.
Crews, Ph. Linda J. Porrino, Ph. David P. Friedman, Ph. Long-term abstinence over many years can allow the brain to heal enough to recover most cognitive function, but there are still some lasting effects on certain areas, such as spatial processing.
Clinicians: Monitor patients' cognitive performance levels and be wary of persistent problems with memory or executive function. Tailor interventions to consider cognitive deficits and avoid reliance on educational methods early in treatment, as patients will require time to return to normal learning ability.
Newly Recovering People: If you feel you are having difficulty remembering, learning, or understanding, ask for help. This is a normal part of early recovery and nothing to be ashamed of. Early treatment yields the best results. Remain abstinent and give yourself plenty of time in recovery to heal. The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs.
As the nation's leading nonprofit provider of comprehensive inpatient and outpatient treatment for adults and youth, the Foundation has 17 locations nationwide and collaborates with an expansive network throughout health care. With a legacy that began in and includes the founding of the Betty Ford Center, the Foundation today also encompasses a graduate school of addiction studies, a publishing division, an addiction research center, recovery advocacy and thought leadership, professional and medical education programs, school-based prevention resources and a specialized program for children who grow up in families with addiction.
Facebook Twitter Linkd In. Cognitive Improvement and Alcohol Recovery. How Does Alcohol Affect the Brain? The Hazelden Betty Ford Experience Patients are screened for cognitive deficits after admittance to treatment at the Hazelden Betty Ford Foundation and, when necessary, referred for further testing. Controversies and Questions Are there gender differences in how the brain recovers from alcohol abuse?
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