Women appear to be more vulnerable to chronic drinking than men are. Yet few studies have looked at gender differences in alcohol's effects on the brain. A study in the May 2005 issue of Alcoholism: Clinical & Experimental Research addresses this gap in research, using computed tomography (CT) to examine brain atrophy in the brains of alcoholic men and women.
The findings support and build upon a prior hypothesis that women develop alcohol-related brain damage more readily than men.
"Telescoping" is a term that refers to the later onset and possibly accelerated negative effects that chronic alcohol consumption may have on the brain's structural and functional systems in women.
"Epidemiological studies have demonstrated gender differences in alcohol-consumption behavior and the course of alcohol dependence," said said Karl Mann, full professor in the department for addictive behavior and addiction medicine at the University of Heidelberg and first author of the study. "Women typically start to drink later in life, consume less per occasion and are, in general, less likely to develop alcohol dependence. One could reason that women are less affected by alcohol. But there is, in fact, evidence for a faster progression of the developmental events leading to dependence among female alcoholics and an earlier onset of adverse consequences of alcoholism. This suggests that women may be more vulnerable to chronic alcohol consumption."
Gender-Specific Differences
For this study, researchers examined 158 subjects: 76 women (42 patients, 34 healthy "controls"), and 82 age-matched men (34 patients, 48 healthy "controls"). All of the alcoholics were recruited from a six-week inpatient treatment program, and met Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition and International Classification of Diseases 10 criteria for alcohol dependence.Control subjects were recruited by advertisement. CT scans were performed twice among the patients – at the beginning and end of their six-week program – and once among the controls.
Results confirm gender-specific differences in the onset of alcohol dependence.
Faster Development of Dependence
"We were able to confirm the telescoping course of alcohol dependence in women," said Mann, "meaning faster progression of the developmental events leading to dependence among female alcoholics and an earlier onset of adverse consequences."Results also show that brain atrophy seems to develop faster in women.
"We confirmed greater brain atrophy in alcoholic women and men compared to healthy controls," said Mann. "Furthermore, the women developed equal brain-volume reductions as the men after a significantly shorter period of alcohol dependence than the men. These results corroborate previous studies that have found other gender-related consequences of alcohol, such as cognitive deficits, alcoholic cardiomyopathy, myopathy of skeletal muscle, and alcoholic liver disease - all of which occur earlier in women than in men despite a significantly shorter exposure to alcohol."
Telescoping Effect
"The higher depression index in alcoholic women than men was also of interest," added Edith Sullivan, a professor in the department of psychiatry and behavioral sciences at Stanford University School of Medicine, "and may actually serve as a useful trigger to family members that 'something is wrong' with the affected individual.The good news is that abstinence seems to partially reverse the brain atrophy, for both genders.
"Because of the 'telescoping' effect," said Mann, "early diagnosis and early prevention are even more important for women with alcohol problems than for men. Despite the fact that men, in general, drink more alcohol and are more likely to develop alcohol dependence, it is those women who consume alcohol who probably develop alcohol dependence and adverse consequences more readily than men."
