How Smoking and Drinking Cause Brain Injury

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Chronic smoking and drinking cause both separate and interactive neurobiological and functional injuries to the brain, bad news for alcoholics because a vast majority of them are chronic smokers as well.

At the June 2005 annual meeting of the Research Society on Alcoholism in Santa Barbara, California, a symposium reviewed the effects of smoking and drinking on brain neurobiology and function.

In a news release about the symposium, Dieter J. Meyerhoff, professor of radiology at the University of California, San Francisco, associate researcher at the Veterans' Affairs Medical Center San Francisco, and other participants discussed the findings:

"Recent neuroimaging studies of chronic smokers have shown brain structural and blood-flow abnormalities," said Meyerhoff, symposium organizer.

"Specific cognitive dysfunction among active chronic smokers has been reported for auditory-verbal learning and memory, prospective memory, working memory, executive functions, visual search speeds, psychomotor speed and cognitive flexibility, general intellectual abilities, and balance," Meyerhoff said.

"We also believe that the adverse effects of smoking, just like drinking, likely take many years to impact brain function significantly, and interact with age to produce a level of dysfunction that is apparent on cognitive tests."

"Any behavioral manifestation, including alcoholism or addiction to nicotine, is a result of genetic-environment interactions," said co-author Yousef Tizabi. "Drugs, including alcohol and nicotine, may affect different individuals differently, depending on their genetic make-up. Similarly, drug-drug interactions are also influenced by genetic factors.

"Therefore, co-morbidity of drinking and smoking can be considered to be a final outcome of genetics, environment, and pharmacological interactions between alcohol and nicotine."

Equilibrium Is out of Balance

"GABA is an inhibitory amino acid in the human brain and is critical in counterbalancing the biological action of the excitatory amino acid glutamate," explained Meyerhoff. "In a healthy human brain, both amino acids are present in equilibrium. In disease stages such as addiction, to either alcohol or nicotine, this equilibrium is out of balance. During alcohol withdrawal, GABA concentrations may increase, but the densities of receptors are still relatively low.

"Benzodiazepines may strengthen the responses of (GABA)A receptors to GABA binding, thereby having a soothing effect on the user."

Greater Brain Abnormalities

"We studied recently detoxified alcoholics in treatment using in-vivo magnetic resonance," said Meyerhoff. "The specific methods we used were magnetic resonance imaging (MRI), which measures the size of many different brain structures, and magnetic resonance spectroscopic imaging (MRSI), which measures certain naturally occurring chemicals in the brain that tell us about injury to specific brain cells.

"Our analyses showed that chronically smoking alcoholics have greater brain abnormalities – that is, less brain tissue measured by structural MRI, and more neuronal injury measured by MRSI – at the beginning of their treatment for alcoholism than non-smoking alcoholics. And both groups had more brain abnormalities than non-smoking light drinkers."

Affects Metabolite Recovery

"We found significant increases of two important brain metabolite markers of cell viability in the frontal and parietal lobes of recovering alcoholics," said co-author Timothy Durazzo. "For most brain regions, these increases were apparent in non-smoking recovering alcoholics, not smoking recovering alcoholics, which suggests that chronic cigarette smoking may adversely affect metabolite recovery.

"It is possible that continued smoking in recovering alcoholics during short-term abstinence imparts a major [and] sustained the direct source of harmful free radical species and, in combination with carbon monoxide exposure and possibly reduced brain perfusion, may hinder brain tissue recovery in smoking recovering alcoholics."

Grey Matter Loss

"Our quantitative MRI results suggest chronic alcoholism and smoking both are associated with cortical gray matter loss," said Meyerhoff. "This leads to atrophy, which in general is a risk factor for greater-than-normal global cognitive decline and memory impairment in the elderly and, if occurring in middle age, may increase the risk for earlier and more rapid cognitive decline in old age.

"Therefore, smoking alcoholics, particularly those who are in their late 40s or older, may place themselves at even greater risk for abnormal cognitive function with advancing age."

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By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.