MRI EVALUATION OF BRAIN MORPHOMETRIC CHANGES AND ALCOHOL-RELATED ENCEPHALOPATHIES IN PATIENTS WITH ALCOHOL USE DISORDER: A CASE CONTROL STUDY

Abstract

Aim: The present study was undertaken to evaluate brain morphometric changes detected on magnetic resonance imaging in patients with alcohol use disorder and to compare these findings with age-matched controls. The study also aimed to determine whether the extent of morphometric abnormalities was related to the duration of alcohol consumption. Materials and Methods: This observational case-control study was carried out in the Department of Radiodiagnosis, SreeBalaji Medical College and Hospital, Chennai. The study population consisted of 80 adult males, including 40 patients with alcohol use disorder and 40 age-matched controls. Alcohol use disorder was diagnosed according to DSM-5 criteria. Participants between 21 and 60 years of age were included. Patients with a history of traumatic brain injury, epilepsy, delirium tremens, dementia, other organic neurological or psychiatric disorders, and claustrophobia were excluded. MRI of the brain was performed using a 1.5-Tesla MRI system. T1-weighted, T2-weighted, FLAIR, diffusion-weighted and ADC sequences were obtained as appropriate. Morphometric assessment included measurements of the ventricles, interhemispheric fissure, cerebral peduncles, pons, medulla, fourth ventricle, cerebellum and different parts of the corpus callosum. Results: Quantitative comparison of brain morphometric parameters showed differences between patients with alcohol use disorder and the control group. The thesis-derived findings showed enlargement of ventricular spaces and widening of the interhemispheric fissure, along with reduction in selected measurements of the brainstem and corpus callosum among alcohol-dependent individuals. Several of these abnormalities became more prominent with increasing duration of alcohol consumption. MRI also demonstrated characteristic patterns associated with alcohol-related neurological complications, including hepatic encephalopathy, Wernicke encephalopathy, Marchiafava-Bignami disease and osmotic demyelination. The exact means, standard deviations and p values for the revised cohort of 40 cases and 40 controls should be recalculated from the original individual-level dataset before submission to a journal. Conclusion: MRI is a useful non-invasive imaging modality for demonstrating structural brain changes associated with chronic alcohol consumption. Quantitative morphometry can demonstrate abnormalities involving the cerebral and cerebellar structures, ventricular system, brainstem and corpus callosum. In addition, conventional MRI with FLAIR and diffusion-weighted sequences can help identify characteristic patterns of alcohol-related encephalopathies.