The Effects of Alcohol Abuse or Binge Drinking on a Diagnostic Imaging Department - Literature review Example

Alcohol consumption is increasing at an startling rate since the last century. Excessive alcohol consumption is becoming one of the major reasons of untimely death of a large number of people across most of the nations of the world. According to the factsheets published by the “Centers for Disease Control and Prevention” (Alcohol and Public Health, 2012) approximately eighty thousand people die due to excessive alcohol consumption every year in the United States of America. Death due to excessive alcohol consumption is categorized as a “lifestyle related cause of death” (Alcohol and Public Health, 2012) and stands third in this category of causal death. The “Years of Potential Life Lost” (YPLL) (Alcohol and Public Health, 2012) due to excessive alcohol consumption has been estimated at 2.3 million years or on an average thirty years of “potential life is lost for each death” (Alcohol and Public Health, 2012). The emergency room visits and physician office visits of patients in the year of 2006 were 1.2 million and 2.7 million respectively. This makes the United States incur huge economic costs which have been estimated at $223.5 billion for the year of 2006. Binge drinking and Excessive drinking The standard drink in the United States is set at the proportion of 0.6 ounces of pure alcohol in any drink. Drinking beyond this permissible limit is marked as excessive drinking. It includes “heavy drinking, binge drinking and any drinking by pregnant women or underage youth” (Alcohol and Public Health, 2012). The most commonly found pattern of excessive drinking is binge drinking. For women, if they consume four or more number of drinks at a single sitting, it is termed as binge drinking. For men, this limit is set at five drinks or more at one particular occasion. Research made on this issue has shown that people that are binge drinkers are not generally alcoholics or dependent upon alcohol in their daily life. But women that consume on an average “more than 1 drink per day” (Alcohol and Public Health, 2012) are labeled as heavy drinkers. For men “more than 2 drinks per day” (Alcohol and Public Health, 2012) rate them as heavy drinkers. Guidelines for safe drinking The “Dietary Guidelines for Americans” (Alcohol and Public Health, 2012) say that both men and women, that consume alcohol, should maintain a moderate level of consumption. This level is defined by keeping within lower the limits of heavy drinking. But there are restrictions laid down by the Guidelines. It is not safe for some people to consume alcohol at all; among which the following categories are included. They are, pregnant women or women trying to get pregnant, youths lesser than twenty one years of age, people taking medicines which might react in an adverse way if mixed with alcohol or individuals that are suffering form some ailment and the condition might be worsened due to consumption of alcohol, individuals recovering alcoholism or is not being able to control the quantity of alcohol consumed by them, or people that participate in activities which require “skill, coordination, and alertness” (Alcohol and Public Health, 2012). Diagnostic imaging The doctors use different technologies to look inside the body of the patient or “create pictures of the structures and activities” (Diagnostic Imaging, 2012) that are taking place inside the body. This uses a multiplicity of machines and requires an array of technological know how. The symptoms reflected by the patient and the body part to be examined are taken into consideration for choosing the technology to be used for the imaging process. Depending upon this the machines used vary. The different technologies used for diagnostic imaging include “X-rays, CT Scans, Nuclear medicine scans, MRI scans and ultrasound” (Diagnostic Imaging, 2012). Prenatal exposure to alcohol One of the major problems associated with alcohol abuse is the Fetal Alcohol Syndrome (FAS) which is found in children born to mothers that consume large amounts of alcohol during the period of pregnancy. These babies are exposed to alcohol before birth. The severity of the impairments noticed in the children depends upon the level of alcohol consumption by the mother during pregnancy. Researches have been conducted to assess the “overall cognitive ability in FAS children” (Mattson, Schoenfeld & Riley, n.d.). These studies reveal that the children may be intellectually deficient to average. The studies have been conducted with children having fatal alcoholic syndrome (FAS), fatal alcoholic effect (FAE) and prenatal exposure to alcohol (PEA). The researchers have analyzed the results obtained in these reports from these studies to evaluate the cognitive functioning areas of these children, that include their learning skills, visual-spatial functioning, memorizing abilities and academic performance; functioning skills such as problem solving skills, abstract thinking abilities and planning skills; and behaviors that include their behavioral patterns and the deficits associated with these patterns. In these studies the researchers have considered the effects on the different parts of the brain, which include “the basal ganglia, corpus callosum, cerebellum, and hippocampus” (Mattson, Schoenfeld & Riley, n.d). The process of MRI has been used in these studies, that captures the images of the brains of the children exposed to alcohol before birth and those that have not been exposed to alcohol in prenatal stage. The studies of these images have shown that “the over-all size of the brain of FAS children” (Mattson, Schoenfeld & Riley, n.d.) is smaller than the size of the brain of the other children. Detailed results reveal that the basal ganglia, which is “a group of nerve cell clusters” (Mattson, Schoenfeld & Riley, n.d.) in the brain, gets diminished in volume disproportionately in these children. The corpus callosum, which is “a large bundle of nerve fibers connecting the two hemispheres of the brain” (Mattson, Schoenfeld & Riley, n.d.) shows abnormalities leading to inattentiveness, loss of verbal memory and deficits in reading, learning and psychosocial functioning. Excessive prenatal alcohol exposure may cause displacement, thinning or complete nonappearance of the corpus callosum. The rate displacement directly affects the level of performance of the children with FAS. The cerebellum located at the base of the brain and responsible for the motor functioning and the cognitive skills, when impaired by prenatal alcohol exposure leads to loss of balance and coordination in the brain. The cerebellum shows a reduction in size due to affect of alcohol. The memory of a person is related to the hippocampus present “within the temporal lobe of the brain” (Mattson, Schoenfeld & Riley, n.d). The damage is related to the “loss of the ability to store new memories” (Mattson, Schoenfeld & Riley, n.d). The hippocampus also shows reduction in overall volume. One finding from these studies indicate that the reduction of volume of hippocampus takes proportionally to the reduction in the total volume of the brain, while the other components of the brain show disproportionate reduction in size. The methodology adopted for the researches positively work towards yielding relevant results regarding the changes in the brain structure and functioning. However these studies have some limitations. Studies regarding prenatal exposure of the brain to alcohol show the indirect effect of alcohol on the brain. Further studies have to be made to find out the way in which the behavior of these children on becoming adults is affected by such effects. Besides the studies have taken into consideration only the patients that have undergone severe changes in the brain structure. All these results may not hold equally true for all people that are living with the FAS (Mattson, Schoenfeld & Riley, n.d). Effect of alcohol on white matter integrity The white mater integrity of the brain is found in a compromised state in adult alcoholics. A research study has been conducted on this issue to assess the “micro structural white matter integrity among adolescent binge drinkers” (McQueeny et al., 2009), who have no history of any kind of disorder related to consumption of alcohol. Twenty eight adolescent substance users had been selected for the subjection of the study. They were aged from sixteen to nineteen years of age. Fourteen of the teenagers were binge drinkers that had consumed at the minimum four to five alcoholic drinks in one occasion during the three months before imaging was done. The other fourteen teen aged participants were control teens that did not have any history of binge drinking episodes that matched the other binge drinkers in age, gender, level of education and other demographic measures. The methodology of primary survey was followed for this research of the issue. Both the youths and their parents were screened through interviews to rule out the likelihood of the presence of psychiatric disorders in the participants. The participants’ socio-economic backgrounds had also been noted. The durations of consumption of alcohol, “peak and typical drinking amounts” (McQueeny et al., 2009) and body ass indices of the participants were used for the estimation of the concentration of alcohol in the blood. A bi-variate analysis was conducted in order to check the differences of impacts between the type of binge drinkers and the other involved with intake of alcohol. The FA values were calculated using the procedure of log linear estimation. T-tests were conducted upon independent samples “across the skeletonized FA map” (McQueeny et al., 2009). To explore the extent to which the white matter integrity is influenced by alcohol use, “follow up bivariate correlation analyses” (McQueeny et al., 2009) were made on the variables involved in the binge drinkers’ alcohol consumption. From the findings it was revealed that teen aged binge drinkers exhibit lower FA “in 18 white matter areas throughout the brain” (McQueeny et al., 2009). “Peak estimated blood alcohol concentration” (McQueeny et al., 2009) in the past three months before the scanning was done was found to be inversely related to the FA of the corpus callosum. The study has made comparisons regarding the white matter integrity of the brain, between the adolescent binge drinkers with the controls matched in terms of “age, gender, verbal IQ, ethnicity, and socio-economic status” (McQueeny et al., 2009). In spite of the demographic similarities, vast reductions of FA were found in the heavy drinkers which suggests the possibility of the white matter integrity being compromised in the frontal, “cerebellar, temporal, and parietal regions” (McQueeny et al., 2009) regions of the brain. This report is the first of its kind that reveals information on reduction of FA in the alcohol consumers at an age as early as adolescence and youth. White matter aberrancies depend on consumption of alcoholic drinks on the basis of the dose of intake. Higher estimations of the “peak blood alcohol concentrations” (McQueeny et al., 2009) directly bear relations with the poor quality of the fiber tract of the corpus callosum. The teens that experience multiple hangover symptoms are more probable to show deficit white matter in the body of the corpus callosum, compared to the others that do not experience such hangover. Such post-drinking effects are consistent with the compromised white matter observed in the adult drinkers who have past histories of heavy alcohol consumption. Contrast to the studies that show the relationship between the white matter integrity and the prolonged consumption of alcohol in adults, this current study has focused up on the teenagers who are in the beginning steps of hazardous alcohol consumption. Particularly in adolescents the hippocampus is susceptible to adverse affects of ethanol. Disorders related to alcohol use have demonstrated to have caused impairments in the individual’s ability to learn and memorize. In teenagers, it can be detected that effects of excessive intake of alcohol strongly relates to white matter abnormalities. Imaging study of the ‘anxiolytic effects’ of alcohol Alcohol use ranks third among the most commonly found “lifestyle related cause of death in the United States” (Gilman et al., 2009). It is known that people like to drink since alcohol has the ability to intervene into the emotional phases of an individual. The person, under effect of alcohol, experiences reduced levels of stress and perceives the existence in a state of “euphoria, relaxation, and, disinhibition” (Gilman et al., 2009). A study was conducted by Gilman et al. from the National Institute on Alcohol Abuse and Alcoholism in Maryland with the aim of characterizing “the response of the brain to alcohol intoxication and emotional stimuli” (Gilman et al., 2009). The effects were measured by the process of “functional magnetic resonance imaging (fMRI)” (Gilman et al., 2009). This was the first study that used fMRI for the measurement of “BOLD activation during intravenous alcohol infusion” (Gilman et al., 2009). The participants in the study were “twelve community recruited healthy social drinkers” (Gilman et al., 2009), seven of which were women. None of these participants had ever suffered any severe heads injury necessitating hospitalization. The study revealed that the visual and limbic regions of the brain are “sensitive to the effects of alcohol” (Gilman et al., 2009). The results obtained indicate the existence of “interaction between alcohol and fearful emotional stimuli” (Gilman et al., 2009). The emotional processing taking place in the limbic and visual areas of the brain is modulated by the interference of alcohol and it leads to decrease in “the difference in activation between threatening and non threatening stimuli” (Gilman et al., 2009). It has been concluded that alcohol plays a major part in the decision making process of an individual when intoxicated. However the study has not shed any light up on the gender differences in the assessment of affects of alcohol on the brain. Further information can be extracted relating to the gender differences in the relation between emotions and response to alcohol. Conclusion Binge drinking practices lay adverse impact on the formations of the brain and affects the decision making process of the individuals (Gourdriaan, Grekin & Sher, 2007). There is substantial amount of literature depicting diminished behavioral patterns in the individuals that highly dependent on substance intake. The class of high binge drinkers is found to make less advantageous decisions which are measured through the diagnostic imaging technologies. This correlation is more apparent in the phase of emerging adulthood. Impulsivity is not a deciding factor is such decision making. Compared to the general onset of consumption of alcoholic drinks, the association of compromised white matter in brains and disturbed behavioral patterns is more vivid with those who indulge in binge or heavy drinking at some early age. The adolescents are more prone to become victims of disorders such as depression and extreme behavior. Like teenagers or adolescents adults exposed to overdose of alcohol might also face such consequences and suffer from symptoms such as lack of concentration, irregular breathing, vomiting, seizures or other fatal physical reactions. There are various technologies to capture the images of the different elements of the brain which are used for the studies of the effects of heavy alcohol consumption in humans. These researches are directed to discover the facts underlying the known facts of drinking, which is attracting increasing number of people from a large range of age groups and income levels. Binge drinking has been categorized as a growing social problem both in developing and developed countries. References 1. Alcohol and Public Health, 2012. Available from: . [2 February 2013]. 2. Diagnostic Imaging, 2012. Available from: < http://www.nlm.nih.gov/medlineplus/diagnosticimaging.html>. [2 February 2013]. 3. Gilman et al., 2009, Why we like to drink: An fMRI Study of the Rewarding and Anxiolytic Effects of Alcohol. Available from: < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730732/>. [2 February 2013]. 4. Gourdriaan, AE, Grekin, ER & Sher, KJ 2007, Decision Making and Binge Drinking: A Longitudinal Study. Available from: < http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2007.00378.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false>. [2 February 2013]. 5. Mattson, SN, Schoenfeld, AM & Riley, EP n.d., Teratogenic Effects of Alcohol on Brain and Behavior. Available from: < http://pubs.niaaa.nih.gov/publications/arh25-3/185-191.htm>. [2 February 2013]. 6. McQueeny et al., 2009, Altered White Matter Integrity in Adolescent Binge Drinkers. Available from: < http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2009.00953.x/full>. [2 February 2013]. Read More