What Causes Brain Shrinkage in People Who Abuse Alcohol?

Chronic alcohol abuse causes significant brain damage, much of which can be reversed with abstinence and sobriety. The brains of people with severe alcohol abuse disorders are smaller and more light than brains of people who are not alcoholics. The brains of those people have ‘shrunken’ compared to nonalcoholic brains. The brain shrinkage affects the ‘wiring’ of the brain used by regions of the brain to communicate with other regions and affects parts of the brain that allow neurons to communicate with other neurons.

Hard Wiring

The cerebral cortex controls most of the brain’s complex mental functions. The cortex is filled with neurons that connect by fibers to different areas of the brain and to other neurons inside the brain and spinal cord. The nerve fibers are white matter parts of the brain or the ‘hard-wiring.’ nerve fibers have shorter, more numerous fibers called dendrites that branch out like roots of a tree to speak with other neurons. They communicate as few as five or as many as 10,000 neurons at a time. Brain shrinkage is not only damage alcohol abuse can do, it also causes chemical changes in the brain that impact function of neurotransmitters.

Complex Brain Issues

Research studies, with animals, and human subjects, show that chronic alcohol abuse produces toxic, metabolic, and nutritional factors that interact to cause mental deficits in people with alcoholism. Some complex factors include:

  • Acetaldehyde, a metabolite of alcohol, which may cause toxic effects
  • Malnutrition, especially thiamine deficiency
  • Cirrhosis of the liver which may cause brain damage
  • Head injury and sleep apnea can contribute to brain damage

Permanent or Transient

Much of the brain damage done from alcohol can be reversed if the person stops drinking and is abstinent for awhile. Some is permanent and irreversible. The most significant permanent damage caused by alcohol is nerve cell loss. Some nerve cells cannot be replaced once they are lost, and that includes those in the frontal cortex, cerebellum, and other regions in the brain.Sometimes the shrinkage is reversed with abstinence, where studies have shown they may grow again and spread after weeks or months of abstinence. This has been linked to improved brain function. Brain damage in alcoholics is due to thiamine deficiency and is easily treated with doses of thiamine. People who have alcoholism induced brain damage suffer from chemical changes in the brain’s reward system to the point the drinker’s pursuit of rewards becomes pathological. The frontal lobe of the brain that deals with inhibition, decision-making, problem-solving, and judgment is impaired also but may reverse slightly depending on the person’s past behavior with drinking.

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