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Pontocerebellar volume deficits and ataxia in alcoholic men and women: no evidence for “telescoping”

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Abstract

Introduction

Brain volume shrinkage is common in treatment-seeking patients with alcohol use disorders. Whether women are more vulnerable to brain dysmorphology than men despite lower alcohol consumption levels or shorter dependency (“telescoping effect”) remains controversial and has not been considered with respect to infratentorial structures or their potential contribution to ataxia.

Methods

The 200 participants included 64 men and 31 women with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol dependence and 105 controls. An infratentorial region (pons, cerebellar hemispheres, vermis (anterior, posterior, and inferior sectors), fissures, cisterns, fourth ventricle) was quantified with atlas-based parcellation. To enable comparison of men and women, regional tissue volumes were expressed as ratios of tissue in the volume. Participants also completed quantitative ataxia testing.

Results

Total infratentorial and vermian tissue ratios were significantly smaller in alcoholics than controls; alcoholic women did not show disproportionately greater volume deficits than alcoholic men. A re-analysis including alcoholic men and women matched in alcohol consumption, onset age, abstinence duration, and age revealed again that alcoholic women did not have disproportionately greater regional vermian volume deficits than alcoholic men. Alcoholic men and women were impaired in all measures of ataxia, which correlated with low infratentorial tissue ratios in men.

Discussion

Alcoholic men showed deficits of pontocerebellar volume ratios, yet alcoholic women did not display signs of “telescoping”. Further, alcoholic men and women both showed signs of ataxia of gait and balance, related to affected pontocerebellar systems in the men but not the women, suggesting the need to consider other neural substrates for ataxia in women.

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Acknowledgment

Support for this work was provided by the US National Institutes of Health grants AA010723, AA017168, AA005965, and EB008381. The registration tools are available as source code in the Computational Morphometry Toolkit: http://www.nitrc.org/projects/cmtk/

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None of the authors have any conflicts to disclose.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305-5723, USA

    Edith V. Sullivan & Adolf Pfefferbaum

  2. Neuroscience Program, School of Medicine, Stanford University, Stanford, CA, USA

    Edith V. Sullivan

  3. Neuroscience Program, SRI International, Menlo Park, CA, USA

    Torsten Rohlfing & Adolf Pfefferbaum

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  1. Edith V. Sullivan
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  2. Torsten Rohlfing
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Correspondence to Edith V. Sullivan.

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Sullivan, E.V., Rohlfing, T. & Pfefferbaum, A. Pontocerebellar volume deficits and ataxia in alcoholic men and women: no evidence for “telescoping”. Psychopharmacology 208, 279–290 (2010). https://doi.org/10.1007/s00213-009-1729-7

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