Effects of abstinence and chronic cigarette smoking on white matter microstructure in alcohol dependence: Diffusion tensor imaging at 4 T

Abstract

Background We previously reported widespread microstructural deficits of brain white matter in alcohol-dependent individuals (ALC) compared to light drinkers in a small 1.5 Tesla diffusion tensor imaging study employing tract-based spatial statistics. Using a larger dataset acquired at 4 Tesla, the present study is an extension that investigated the effects of alcohol consumption, abstinence from alcohol, and comorbid cigarette smoking on white matter microstructure. Methods Tract-based spatial statistics were performed on 20 1-week-abstinent ALC, 52 1-month-abstinent ALC, and 30 controls. Regional measures of fractional anisotropy (FA) and mean diffusivity (MD) in the significant clusters were compared by Analysis of Covariance. The metrics were correlated with substance use history and behavioral measures. Results 1-week-abstinent ALC showed lower FA than controls in the corpus callosum, right cingulum, external capsule, and hippocampus. At 1 month of abstinence, only the FA in the body of the corpus callosum of ALC remained significantly different from controls. Some regional FA deficits correlated with more severe measures of drinking and smoking histories but only weakly with mood and impulsivity measures.. <ABS-P> Conclusion White matter microstructure is abnormal during early abstinence in alcohol dependent treatment seekers and recovers into the normal range within about four weeks. The compromised white matter was related to substance use severity, mood, and impulsivity. Our findings suggest that ALC may benefit from interventions that facilitate normalization of DTI metrics to maintain abstinence, via smoking cessation, cognitive-based therapy, and perhaps pharmacology to support remyelination.

Sexually dimorphic structural abnormalities in major connections of the medial forebrain bundle in alcoholism

“…However, when we analyzed FA and RD differences in a subset of ALC women ( n = 9) with drinking patterns comparable to the ALC men, the pattern of findings remained the same. Third, there is a strong comorbidity between cigarette smoking and alcohol abuse ( Durazzo et al, 2013 ; Luhar et al, 2013 ), and cigarette smoking has been also associated with brain white matter abnormalities ( Savjani et al, 2014 ; Zou et al, 2017 ). However, in this study, there were not sufficient data regarding smoking for additional analyses.…”

Differences in White Matter Microstructure and Connectivity in Nontreatment‐Seeking Individuals with Alcohol Use Disorder

“…However, this established body of research typically does not address the potential confound of cigarette smoking in abnormalities of brain structure in AUD. There is also a body of literature that indicates cigarette smoking has detrimental effects on WM (Zhang et al, 2011, Savjani et al, 2014, Baeza-Loya et al, 2016, Zou et al, 2017). However, given that up to 85% of alcoholics are also smokers (Durazzo et al, 2007b, Romberger and Grant, 2004), it is still unclear what the relative contribution of chronic alcohol misuse is to deficits in WM.…”

White matter microstructural correlates of relapse in alcohol dependence

“…One DTI metric commonly computed is fractional anisotropy (FA), a sensitive marker of white matter organization or fiber coherence at the microstructural level, reflecting axonal organization and membrane integrity. White matter FA has been generally found to be lower in corpus callosum, major frontocortico-striatal tracts and limbic pathways of individuals with AUD compared to healthy controls (Yeh et al, 2008; Gazdzinski et al, 2010; Kuceyeski et al, 2013; Monnig et al, 2015; Sorg et al, 2015; Zou et al, 2017). Lower FA in AUD is interpreted to reflect primarily axonal dystrophy or loss and demyelination or myelin loss (Beaulieu, 2002; Zahr, 2014), which is also associated with natural processes of white matter aging (Peters, 2002).…”