Article

Neuroimaging of Gender Differences in Alcohol Dependence: Are Women More Vulnerable?

Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.31). 06/2005; 29(5):896-901. DOI: 10.1097/01.ALC.0000164376.69978.6B
Source: PubMed

ABSTRACT Alcoholic brain damage has been demonstrated in numerous studies using neuropathology and brain imaging techniques. However, gender differences were addressed only in a few studies. Recent research has shown that development, course, and consequences of alcohol dependence may differ between female and male patients. Our investigation was built upon earlier research where we hypothesized that women develop alcoholic brain damage more readily than men do. To further compare the impact of alcohol dependence between men and women, we examined brain atrophy in female and male alcoholics by means of computed tomography (CT).
The study group consisted of a total of 158 subjects (76 women: 42 patients, 34 healthy controls; 82 age-matched men: 34 patients, 48 healthy controls). All patients had a DSM-IV and ICD-10 diagnosis of alcohol dependence. CT with digital volumetry was performed twice in patients (at the beginning and end of the 6-week inpatient treatment program) and once in controls.
Patients of both genders had consumed alcohol very heavily. Although the average alcohol consumption in the year before the study was significantly lower in female alcoholics, this gender difference disappeared when controlled for weight. However, women had a significantly shorter duration of alcohol dependence. Despite this fact, both genders developed brain atrophy to a comparable extent. Brain atrophy was reversible in part after 6 weeks of treatment; it did not reach the level in the control groups.
Gender-specific differences in the onset of alcohol dependence were confirmed. This is in line with the telescoping effect, where a later onset and a more rapid development of dependence in women were described. Under the assumption of a gradual development of consequential organ damage, brain atrophy seems to develop faster in women. As shown in other organs (i.e., heart, muscle, liver), this may confirm a higher vulnerability to alcohol among women.

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    • "Although not all studies agree (Hommer, 2003), women appear more vulnerable than men to the widespread damaging effects of alcohol on the brain, including volumetric loss in frontolimbic regions that subserve affective processing despite, on average, having fewer years of drinking and consuming less alcohol in their lifetimes (Mann et al., 1992; Medina et al., 2008). On par, both men and women with AD demonstrate atrophy following years of chronic drinking, however, atrophy appears to develop faster in women, suggesting an increased vulnerability (Mann et al., 2005). However, Pfefferbaum and colleagues (2010) did not find a gender vulnerability to the effects of alcohol when examining white matter bundles, nor were there gender differences in gray or white matter volumes in recently detoxified individuals with AD (Demirakca et al., 2011). "
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    • "Gender telescoping has been observed among users of nicotine (Oncken et al., 2004), cannabis (Hernandez-Avila et al., 2004), cocaine (Haas and Peters, 2000), and both heroin and prescription opioids (Sartor et al., 2014) as well as non-treatment seeking prescription opioid users (Back et al., 2011a). Findings are equivocal among alcoholdependent populations: some studies replicated the Piazza et al. (1989) findings of gender telescoping (Bravo et al., 2013; Diehl et al., 2007; Johnson et al., 2005; Mann et al., 2005; Piazza et al., 1989; Randall et al., 1999) whereas others did not (Alvanzo et al., 2011; "
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    Drug and Alcohol Dependence 01/2015; 148. DOI:10.1016/j.drugalcdep.2015.01.010 · 3.28 Impact Factor
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    • "For instance, males use illicit substances more frequently and in greater quantities than females (Berkowitz and Perkins, 1987; Thomas, 1995). Although female substance users typically begin using substances later than males do, they demonstrate an accelerated transition to addiction (Brady and Randall, 1999; Mann et al., 2005). Furthermore, imaging studies also supported gender differences in the influence of cocaine use on cerebral responses (Adinoff et al., 2001, 2006; Andersen et al., 2012; Ernst et al., 2000; Li et al., 2005b, 2005c; Levin et al., 1994; Luo et al., 2013; Tucker et al., 2004; Volkow et al., 2011). "
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