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: 3.21). 06/2005; 29(5):896-901. DOI: 10.1097/01.ALC.0000164376.69978.6B
Source: PubMed


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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    • "Effects of heavy alcohol consumption on white matter may interact with gender, age, treatment-seeking status, smoking status, or comorbid psychiatric disorder. Some studies have found greater alcohol-related white matter damage in women[18], older individuals[12], smokers[19], or treatment-seeking individuals[20]. Other studies have reported null findings with respect to group differences or have found effects in the opposite direction, such as less severe white matter atrophy in women with AUDs[21]. "
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    ABSTRACT: Damage to the brain's white matter is a signature injury of alcohol use disorders (AUDs), yet understanding of risks associated with clinical and demographic characteristics is incomplete. This study investigated alcohol problem severity, recent drinking behavior, and demographic factors in relation to white matter microstructure in heavy drinkers. Magnetic resonance imaging (MRI) scans, including diffusion tensor imaging (DTI), were collected from 324 participants (mean age = 30.9 ± 9.1 years; 30% female) who reported five or more heavy drinking episodes in the past 30 days. Drinking history and alcohol problem severity were assessed. A common white matter factor was created from fractional anisotropy (FA) values of five white matter tracts: body of corpus callosum, fornix, external capsule, superior longitudinal fasciculus, and cingulate gyrus. Previous research has implicated these tracts in heavy drinking. Structural equation modeling (SEM) analyses tested the hypothesis that, after controlling for duration of alcohol exposure, clinical and behavioral measures of alcohol use severity would be associated with lower white matter factor scores. Potential interactions with smoking status, gender, age, treatment-seeking status, and depression or anxiety symptoms also were tested. Controlling for number of years drinking, greater alcohol problem severity and recent drinking frequency were significantly associated with lower white matter factor scores. The effect of drinking frequency differed significantly for men and women, such that higher drinking frequency was linked to lower white matter factor scores in women but not in men. In conclusion, alcohol problem severity was a significant predictor of lower white matter FA in heavy drinkers, after controlling for duration of alcohol exposure. In addition, more frequent drinking contributed to lower FA in women but not men, suggesting gender-specific vulnerability to alcohol neurotoxicity.
    Full-text · Article · Nov 2015 · PLoS ONE
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    • "Asimismo, las personas con PD presentan mayores problemas biopsicosociales en comparación con los que no la tienen, por lo que reportan mayor uso de servicios de urgencias y hospitalización (Martín-Santos et al., 2006), más riesgo de contagio de enfermedades de trasmisión sexual como VIH, hepatitis B y C (Carey, Carey, Maisto, Gordon, & Vanable , 2001), altas tasas de suicidio, recaída y abandono de tratamiento (Gomberg, 1989; Szerman et al., 2013). Debido a diversas diferencias biológicas por género, se sabe que las mujeres desarrollan mayor severidad de los TCS con menos años de consumo en comparación con los hombres (Hernández-Ávila, Rounsanville, & Kranzler, 2004; Piazza, Vrbka, Yeager, 1989; Johnson, Richter, Kleber, McLellan, & Carise, 2005), situación que se asocia con el desarrollo de otros problemas de salud mental y física (Antai-Ontog, 2006; Mann et al., 2005). De ahí que diversos estudios reporten que las mujeres con TCS presentan altas prevalencias de problemas médicos , como es el caso de cáncer de mama y de otros tipos (Bagnardi, Blangiardo, La Vecchia, & Corrao, 2001; Key et al., 2006; Tiemersma et al., 2003), osteoporosis en mujeres premenopáusicas (Sampson, 2002), neuropatía periférica, deterioro cognitivo (Flannery et al., 2007; Sohrabji , 2002), cirrosis hepática y enfermedades "
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    ABSTRACT: Introduction: women with substance use disorders (SUD) are more likely to endorse dual disorders (DD) in comparison to men with the same condition, defining DD as the co-occurrence of SUD with other psychiatric disorders (OPD). This relationship causes negative consequences in the severity of the symptomatology and treatment of both conditions. Objective: to analyze the clinical characteristics and treatment history of women with DD. Method: psychiatric interview of women receiving treatment in two residential treatment centers. Disorders and their characteristics were compared in relation to previous treatments, GEE was used to determine the differences in medical prescriptions over time. Results: data from 100 women was analyzed, 30 of them reported not having received any previous treatments, and less than 20% reported important medical illness. Women with borderline personality disorder had approximately a third of the odds of reporting previous treatments (OR= .33; IC 95% .13-.84). Significant differences were found in antidepressant (17.6% vs 41.8%; p<.05), mood stabilizers (12.1% vs 32.7%; p<.05), antipsychotics (15.4% vs 48.0%; p<.05), others (4.4% vs 29.6%; p<.05) over time. Discussion and conclusions: this study represents an approximation based on the clinical evaluation of women with SUD and OPD, where the change in medical prescription over time might be related to the pharmacological treatment needs, which are not adequately treated.
    Full-text · Article · Oct 2015
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    • "Instead, a woman's problems with alcohol are thought to affect her children, the family, and society at large, and therefore, her use of alcohol prompts an out- cry [14]. Different studies363738 have provided biological explanations on the effects of alcohol on the human body, stating that females are more vulnerable [39] , but this appears to be over exaggerated or 'magnified by cultural norms for how women and men should or should not use alcohol' (p742) [4]. Although evidence shows that men continue to dominate drinking spaces [40] and consume greater quantities of alcohol [41,42], research suggested that females now binge and engage in other forms of heavy drinking rituals [5]. "
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    ABSTRACT: Background: The misuse of alcohol and other drugs among young people, especially students, is a growing global phenomenon. In traditional Nigerian society, different locally-produced alcoholic beverages served complex roles but were mainly consumed among adult males for pleasure. Though adult females in some communities consumed alcohol, the practice of drinking was culturally controlled. In contemporary Nigeria, available quantitative studies reveal changing patterns of alcohol use amongst youth but fail to unravel the social variables that motivate alcohol use among this group. Methods: Qualitative data were collected through in-depth interviews with 31 (22 males and 9 females, aged 19-23 years) undergraduate students attending a university located in a metropolitan city in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of Nvivo 10 software. Results: There appears to be a resilient socio-cultural belief in which men see alcohol as ‘good for males’ while the females in contrast believe that alcohol ‘does not discriminate against feminine or masculine gender’ and should be drunk by both males and females. Findings also point to the ways in which male-gendered drinking behaviours, such as heavy or fast drinking are employed by women to develop social capital. Conclusions: These results do suggest how gendered constructions of alcohol consumption create risks for both men and women, how they negotiate and ameliorate those risks, and how women challenge gender roles through their use of alcohol. Some focus on formulating evidence-based policies and comprehensively evaluated campaigns are needed to disseminate information about the risks and potential consequences of heavy alcohol consumption in order to promote safer alcohol use by young people.
    Full-text · Article · Feb 2015 · BMC Public Health
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