Elsevier

Biological Psychiatry

Volume 65, Issue 8, 15 April 2009, Pages 680-690
Biological Psychiatry

Archival Report
Degradation of Association and Projection White Matter Systems in Alcoholism Detected with Quantitative Fiber Tracking

https://doi.org/10.1016/j.biopsych.2008.10.039Get rights and content

Background

Excessive alcohol use can cause macrostructural tissue shrinkage with regional preference for frontal systems. The extent and locus of alcoholism's effect on white matter microstructure is less known.

Methods

Quantitative fiber tracking derived from diffusion tensor imaging (DTI) assessed the integrity of samples of 11 major white matter bundles in 87 alcoholics (59 men, 28 women) and 88 healthy control subjects (42 men, 46 women). Fiber integrity was expressed as fractional anisotropy (FA) and apparent diffusion coefficient (ADC), quantified separately for longitudinal diffusivity (λL), a putative index of axonal integrity, and transverse diffusivity (λT), a putative index of myelin integrity.

Results

Alcoholism affected FA and diffusivity, particularly λT, of several fiber bundles. Frontal and superior sites (frontal forceps, internal and external capsules, fornix, and superior cingulate and longitudinal fasciculi) showed greatest abnormalities in alcoholics relative to control subjects. More posterior and inferior bundles were relatively spared. Lifetime alcohol consumption correlated with regional DTI measures in alcoholic men but not women. When matched for alcohol exposure, alcoholic women showed more DTI signs of white matter degradation than alcoholic men in several fiber bundles. Among all alcoholics, poorer performance on speeded tests correlated with DTI signs of regional white matter degradation.

Conclusions

This survey of multiple brain fiber systems revealed a differential pattern of alcoholism's effect on regional FA and diffusivity with functional consequences attributable in part to compromised fiber microstructure with prominence in signs of myelin degradation. Sex-based differences suggest that women are at enhanced risk for alcoholism-related degradation in selective white matter systems.

Section snippets

Participants

Data were combined from two studies on alcoholism (13, 20, 33, 34, 35, 36). Extensive clinical and demographic descriptions and analysis appear elsewhere (37, 38). Control data were from men and women who matched the alcoholic groups herein in age range (39). Demographic data of the 175 men and women in the current analysis appear in Table 1.

Participants with alcoholism were recruited by referral from outpatient substance abuse treatment centers. Informed consent followed procedures approved by

Laterality Effects and Alcoholism

Analysis of variance tested group-by-hemisphere interactions in each bilateral fiber bundle. Significant group effects and hemisphere effects were found for 8 of 10 bundles (Tables 1 and 2 in Supplement 1), but in no case was the group-by-hemisphere interaction significant with family-wise Bonferroni correction for significance. Thus, we found no evidence that alcoholism significantly altered any normal left-right asymmetry for a given bundle. Subsequent analyses combined values for FA or

Discussion

Diffusion tensor imaging anisotropy and diffusivity measures derived from quantitative fiber tracking of selective fiber bundles enabled in vivo examination of the effect of chronic excessive alcohol consumption on the microstructural integrity of major fiber bundles. These data extend earlier reports of macrostructural and microstructural vulnerability of frontal regions to alcohol dependence by assessing FA of specific white matter tracts and bundles and three measures of diffusivity: ADC and

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