White matter microstructural recovery with abstinence and decline with relapse in alcohol dependence interacts with normal ageing: a controlled longitudinal DTI study.
Level 3 - non-randomized controlled study
Non-randomized controlled longitudinal cohort study with repeated neuroimaging measures
PubMed 26360732 · doi:10.1016/S2215-0366(14)70301-3
What was done
A longitudinal DTI (1.5T) and structural MRI study compared 47 individuals with DSM-IV alcohol dependence to 56 healthy controls scanned 2 to 5 times over 1–8-year intervals between 2000 and 2011. Tract-based spatial statistics (TBSS) assessed whole-brain white matter microstructural metrics (fractional anisotropy [FA] and axial diffusivity [AD]), alongside macrostructural volumetric assessments of the corpus callosum and centrum semiovale. Trajectories were compared across controls and three alcohol subgroups: sustained abstainers, light relapsers, and heavy relapsers (>5 kg alcohol/year).
What was found
Alcohol-dependent participants had significantly lower FA than controls across a large TBSS cluster (p < 0.001). Over follow-up, 27 alcohol-dependent participants (57%) remained abstinent, 10 (21%) relapsed into light drinking, and 10 (21%) relapsed into heavy drinking. Abstainers exhibited positive FA trajectories moving toward normal levels, contrasting with negative age-related trajectories in controls and relapsers. Elevated AD in the alcohol group tracked normal aging slopes in abstainers but showed accelerated aging in heavy relapsers. Microstructural deficits predominated in anterior and superior association/projection tracts and the callosal genu and body, in the absence of macrostructural volumetric differences.
Why it matters
This study provides in vivo neuroimaging evidence that alcohol-related white matter microstructural damage can undergo restorative remodeling with sustained sobriety, whereas continued heavy drinking accelerates age-related white matter deterioration.
Limits
Subgroup sample sizes for relapsed drinking were small (n = 10 in each relapse category). Imaging was performed at 1.5T rather than higher field strengths. The abstract does not report functional or neurocognitive correlates corresponding to microstructural recovery.
Cited by
- supports Former heavy alcohol users can experience a partial recovery of brain white matter after a period of abstinence.