Metabolic Brain Disease

, Volume 10, Issue 1, pp 1–8

Pathophysiology of alcoholic brain damage: synergistic effects of ethanol, thiamine deficiency and alcoholic liver disease

  • Roger F. Butterworth

DOI: 10.1007/BF01991777

Cite this article as:
Butterworth, R.F. Metab Brain Dis (1995) 10: 1. doi:10.1007/BF01991777


Chronic alcoholism results in brain damage and dysfunction leading to a constellation of neuropsychiatric symptoms including cognitive dysfunction, the Wernicke-Korsakoff Syndrome, alcoholic cerebellar degeneration and alcoholic dementia. That these clinically-defined entities result from independent pathophysiologic mechanisms is unlikely. Alcohol and its metabolite acetaldehyde are directly neurotoxic. Alcoholics are thiamine deficient as a result of poor diet, gatrointestinal disorders and liver disease. In addition, both alcohol and acetaldehyde have direct toxic effects on thiamine-related enzymes in liver and brain. Alcoholics frequently develope severe liver disease and liver diseaseper se results in altered thiamine homeostasis, in cognitive dysfunction and in neuropathologic damage to astrocytes. The latter may result in the loss of neuron-astrocytic trafficking of neuroactive amino acids and thiamine esters, essential to CNS function. The present review article proposes mechanisms whereby the effects of alcohol, thiamine deficiency and liver disease combine synergistically to contribute to the phenomena of cognitive dysfunction and “alcoholic brain damage”.

Key words

Alcoholic brain damage Ethanol neurotoxicity Thiamine deficiency Alcoholic liver disease Hepatic Encephalopathy Cerebral energy deficit NMDA receptors 

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Roger F. Butterworth
    • 1
  1. 1.Neuroscience Research UnitHôpital Saint-Luc (University of Montreal)MontrealCanada

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