Cerebral dysfunction associated with alcohol consumption.

Intellectual dysfunction, usually involving short-term memory, abstract reasoning, visuomotor coordination, intellectual flexibility, and spatial reasoning, is a well-documented finding among alcohol imbibers of various drinking styles. Despite the diversity of groups examined and the attempted control of variables other than alcohol consumption, little concensus has been reached with regard to the chronology of dysfunction (as related to lifetime drinking style, duration of alcoholism, quantity consumed per session, or type of potable). In many instances, diet, age, and even sex have outweighed the relative influence of alcohol in the degree of intellectual dysfunction. Morphologically, brain changes tend to be in the anterior/basal areas and may involve the third ventricle, diencephalic areas, and other focal variations. Cerebellar changes also are not uncommon yet may reflect a subgroup of alcoholics rather than a generalised trend. Generally, many intellectual deficits partially rebound rapidly within the first two or three weeks after cessation of drinking, with perhaps modest further improvement if sobriety is sustained for several months. Because of the extreme heterogeneity of the alcoholic population and the potent effect of ancillary variables upon measures of intellectual functioning, control and matching of demographic factors is a paramount consideration. Demographic variables of primary concern include age, sex, socio-economic status, education, duration of alcoholism, quantity of alcohol consumed per session, diet, psychotropic medications, secondary psychiatric diagnoses, secondary medical diagnoses, exact duration of abstinence, and prior exposure to psychometric instruments.