| Smoking May Hinder Brain's Recovery from Alcoholism -
18-03-2006, 07:29 PM
SAN FRANCISCO - For alcoholics whose drinking brings on cognitive deficits, smoking seems to retard their cognitive recovery when they go on the wagon, a study here suggested.
"It is pretty well established that long-term chronic drinking of the amount that alcoholics do leads to abnormalities of brain structure, chemistry, and blood flow as well as cognition," said Timothy Durazzo, Ph.D., of the San Francisco VA in an interview.
Alcoholics may appear to be functioning normally, but cognitive tests will usually reveal abnormalities or "frank deficits," he added.
So it stands to reason that diminished cognition should reverse itself when alcoholics stop drinking. But, Dr. Durazzo found, cognitive recovery can be retarded by cigarette smoking, at least during the first month of abstinence from alcohol.
Smoking appears to interfere with metabolic brain recovery and cognitive improvement, Dr. Durazzo and colleagues reported in the March issue of Alcoholism: Clinical and Experimental Research.
They evaluated 25 recovering alcoholics-14 smokers and 11 non-smokers.
Using MRI, the investigators examined participants' brains for N-acetylaspartate, a marker of neuronal viability, and choline, a marker of cell membrane health. Measurements were made after seven and 35 days of abstinence.
Concentrations of N-acetylaspartate in the parietal white matter of the non-smokers increased from an average of about 28 institutional units on day seven to 29 units on day 35, but concentrations significantly decreased in smokers from 28 to 26.5 units (P<.05).
Similarly, choline concentrations in the non-smokers increased from an average of about 4.5 to 5.2 units (P<.05), but in non-smokers the average concentration stayed put at 4.7 units.
The authors reported that increases in N-acetylaspartate and choline concentrations were positively correlated with improvement in various cognitive domains including executive function, visuospatial learning/skills, fine motor skills, auditory verbal learning and general intelligence.
At one month of abstinence, the investigators also found "huge" differences between the smokers and non-smokers in performance on cognitive tests that measured such things as visual-spatial learning and memory, Dr. Durazzo said. However, these data are in another paper which has been submitted to a peer-reviewed journal, he added.
Cigarette smoke contains many toxic compounds, such as carbon monoxide and free radicals, that may directly or indirectly compromise the central nervous system tissue, the authors said.
The study's results suggest that for faster brain recovery, it may be beneficial for alcoholics in early abstinence to stop smoking as well, the authors said.
"This may be a lot to ask from an alcoholic individual going through drastic brain chemical imbalances in early recovery," Dr. Durazzo said.
On the other hand, "cigarettes and alcohol tend to go together," he said. "One may elicit cravings for the other. So if you are able to give up both at the same time, it may increase your chances of staying sober, because you don't have one substance serving as a trigger for use of the other."
The results of this study should be considered preliminary and must be confirmed by larger and longer-term prospective studies, the authors concluded.
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