It’s discouraging watching a loved one struggle with alcohol dependence as the addict is compelled to make decisions that are self-destructive and damaging to their relationships, career and families. The individual may be fully aware of the problems they’re creating and yet be unable to make healthy choices. A new study provides clues to unhealthy behavior patterns in alcohol dependent individuals. The research focused on frontal lobe deficiency, a condition resulting in problems with executive function that can manifest itself in memory difficulties, attention deficits and an inability to curb alcohol consumption. The researchers noted that many high-functioning alcoholics exhibit both frontal executive dysfunction yet seem to have no major cognitive issues. The study sought to understand this combination through the use of magnetic resonance imaging (MRI) to measure segmented brain structures by volume. The findings show that mental status and executive function are each independently affected by long-term alcohol use. Ester M. Nakamura-Palacios, a senior scientist and associate professor at the Federal University of Espirito Santo in Brazil, was the corresponding author for the study. She explained that executive dysfunction may make it impossible for an individual to anticipate and plan for the future. Even simple problem-solving can require levels of attention that are not possible for the individual with executive dysfunction, and they may struggle to control their own behaviors, which can lead to injury. The frontal lobes are the area of the brain that are responsible for inhibiting risky behaviors, or those behaviors that are considered deviant or damaging to the good of a community. As J. Leon Morales-Quezada, a research associate in the Neuromodulation Laboratory at Harvard Medical School explains, the frontal lobes are the part of the brain that separate humans from others in the animal kingdom. Morales-Quezada gives the example of a professional, such as an engineer, who is able to function well in their job, skilled in regular duties and calculating solutions to concrete problems. However, this same individual may struggle to control their drug or alcohol consumption due to frontal impairment. Even though the individual knows that their behavior is destructive, they may be unable to behave otherwise. The individual with frontal executive dysfunction may also struggle to make urgent decisions. In order to better understand the effects of alcohol on this region of the brain the researchers used MRI screenings to examine 60 alcoholics that were all long-term heavy drinkers – 52 males and eight females, with an average age of 47.2 years. The participants completed the Frontal Assessment Battery (FAB) and the Mini-Mental State Examination (MMSE), including the MRI. The researchers also conducted cortical and sub cortical corrections and segmentation. The data was used to create multiple linear regression analyses using the volume of segmented brain structures to predict the scores on the MMSE or FAB. The researchers found that changes in the structure of the prefrontal area, as well as the cerebellum on the left side of the brain, are predictive of executive performance among alcoholics. The volume of certain areas of the brain can indicate executive dysfunctions, even in situations where the individual may not meet criteria for alcohol dependence or when the overall mental status is preserved. The researchers believe the findings may lead to tools for the purpose of earlier diagnosis of alcohol dependence and, in turn, earlier treatment. One area of concern for experts that study the impact of alcohol on the brain is that the initiation of alcohol consumption is heavily concentrated during the teen and early adult years. The prefrontal cortex is still in a developmental stage and the consumption of alcohol during this development may cause damage that significantly impacts executive functioning.
