White matter lesions and alcohol dependence

Objectives: White matter lesions (WML) increase the risk of vascular encephalopathy and dementia. The knowledge on vascular risk factors is broad, but non-vascular factors like alcohol have been investigated insufficiently yet. Age and higher alcohol consumption increases the risk for dementia. Therefore the parameters being linked to the presence of WML were studied in alcohol addicts. Methods: N=100 alcohol dependent inpatients (ICD F10.2, age 25–60y) were investigated by 1.5 T Magnetic resonance imaging (T2-weighted and proton-density, 5mm slice thickness, no interslice gap) according to a standard protocol. WML were rated by an experience neuroradiologist blind for clinical data according to the ratings developed by other groups (1,2). Findings were related to parameters of alcohol consumption, nutrition, vascular risk factors, serum analysis including lipoproteins, APO E-Status. Results: 39 patients exhibited WML, 26 of them small focal subcortical WML. Only 5 patients had exclusively periventricular WML. Significant positive associations were found to higher alcohol consumption and to duration of alcohol dependence, higher age, periods of malnutrition, early smoking. Conclusion: Higher age is a strong risk factor for WML. However higher alcohol consumption and longer duration of alcohol dependence as well as alcohol abuse associated factors like malnutrition, early smoking etc. seem to be relevant cofactors.