Alcohol: learn how drinking harms the brain – 03/24/2023 – Equilíbrio

A person lying on cardboard with a bottle of wine at his side warns us, with the naked eye, about the physical and social damages of alcohol.

However, it is much more difficult to discover the invisible damage that, however, is part of the causal chain that leads to this situation: the damage that alcohol inflicts on the brain.

Most people could quickly describe the acute effects of alcohol: lack of coordination, disinhibition, impulsivity… But few know about the chronic consequences of this consumption, which respond to the neurotoxic effect of alcohol on the brain.

Neuropsychological and neuroimaging studies show that three neural networks are particularly vulnerable: the frontocerebellar network, which controls balance; the frontolimbic, involved in memory, motivation and self-awareness; and the frontostriatum, responsible for emotional regulation, inhibition, cognitive flexibility and reward management.

Watch out for these symptoms

But how do we know if an alcohol drinker has brain damage? The people around you will notice that you are slower, easily distracted, more rigid, have a poor memory, make decisions without evaluating risks, have difficulty regulating emotions and interpret the emotions of others worse. And all this affects the family, work and social life.

The good news is that if you stop drinking, your brain will show improvement in both structure and function. On the other hand, as long as you continue to consume alcoholic beverages, your brain will age faster than normal.

Furthermore, like a dog biting its own tail, the cognitive and emotional deficits caused by alcohol consumption will undermine efforts to initiate and maintain abstinence.

Health professionals should take into account that brain injuries can be an obstacle to following clinical treatment, as they limit emotional self-regulation, motivation for change, interaction with other people, emotional perception and awareness of social dysfunctions.

However, even when these difficulties are overcome and abstinence is maintained, it may be too late for the brain.

Honest Lies and Alcohol: The Korsakoff Syndrome

Damages that are difficult to recover appear in patients with Korsakoff’s syndrome.

This residual and largely irreversible disorder occurs in one out of every two cases of Wernicke’s encephalopathy, a condition caused by a severe vitamin B1 deficiency that is more frequent among malnourished people who abuse alcohol.

It is estimated a prevalence between 25 and 50 cases per 100,000 inhabitants. But studies on cadavers indicate that this condition is underdiagnosed.

In this syndrome, damage affects a region of the brain called the diencephalon, particularly the mammillary bodies and thalamic nuclei. The deterioration manifests itself above all in the memory: the patients suffer from an amnesic syndrome that is accompanied, mainly in the initial phases, by fables.

That is, the affected person has false memories and is convinced that they are real. Called “honest lies,” these fanciful memories arise from a deficit in memory access.

Teenagers and overuse

And the young people? Does brain damage need years of alcohol consumption? If they only drink on the weekend, will nothing happen to them?

No, drinking five or more units in a few hours at least once a month is associated with problems with memory and executive skills, which allow us to plan, monitor and regulate behavior according to our goals and standards.

These difficulties respond to structural and functional changes in the brain. Neuroimaging studies show neurofunctional abnormalities, such as excessive activation of neural networks when the response to an alcoholic beverage should be inhibited.

Volume differences in the white and gray matter of the brain were also observed in different regions related to impulse control.

It is necessary to take into account that adolescence is a period of brain vulnerability, during which important changes occur in the structure and functional connectivity of neural networks.

We should be concerned that alcohol is still seen as a less dangerous drug among 14- to 18-year-olds.

The first involuntary drunkenness: fetal alcohol syndrome

But brain damage associated with alcohol consumption can begin long before adolescence – even before birth. Consuming it during pregnancy is the cause of fetal alcohol syndrome spectrum disorders, a completely preventable neurological development problem.

There is no safe drinking of alcohol during pregnancy. Consumption of alcoholic beverages during the nine months is linked to central nervous system disorders such as decreased head circumference, structural brain abnormalities, and neuropsychological deficits.

All this will affect the development of intellectual capacity, cognitive functioning and self-regulation of behavior.

Among the particularly vulnerable groups that require special attention are children from international adoptions, especially when they come from countries with high alcohol consumption.

A recent study indicates that up to 50% of them meet diagnostic criteria for the disorder. And one in five affected has the most serious form: fetal alcohol syndrome.

It is necessary to make the entire population aware of the risks to the fetus and support pregnant women who decide to stop consuming alcohol. And don’t forget to detect and intervene early to ensure the proper academic, psychological and social development of all these children.

In short: whatever your age, if you want to take care of your brain health, the less alcohol, the better.

This article was originally published on the academic news site The Conversation and republished here under a Creative Commons license. Read the original version here (in Spanish). ANDwritten with the advice of Spanish Society of Epidemiology.

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