A Magnetic Resonance Imaging Study Of Gray Matter Volume In Male AUD With Cognitive Deficits

Background:Alcohol use disorder(AUD)was a psychiatric disorder characterized by craving,foraging for alcohol and being out of control.Long-term drinking can cause damage to the nervous system,cardiovascular and digestive systems,especially to the former,which can manifest a series of neuropsychiatric symptoms,such as decreased memory and executive control,decision-making disorder,cognitive deficits.Individual differences in cognitive ability were related to a bundle of alcohol-related variables,ranging from type,concentration,average,frequency and total,groups to onset age of drinking.It was not difficult to understand that an individual’s cognitive performance deteriorates with drinking.Although there were some structural or functional MRI literature investigating AUD,the neural structures basis of its cognitive impairment remains incompletely understood.Purpose:To evaluate the changes in gray matter(GM)volume and cognitive function in male patients with AUD,and to examine the relationship between overall drinking,GM volume and MoCA scores in AUD patients by mediation analysis.Materials and Methods:A total of 40 male AUD patients who came to Zhongshan Third People’s Hospital from October 2017 to February 2019 underwent 3D-T1WI scans on 1.5T Siemens,while obtaining clinical scales through questionnaires,such as the Mini-Mental State Assessment(MMSE),Michigan Alcoholism Screening Test(MAST),Montreal Cognitive Assessment(MoCA),and drinking parameters,for example drinking-years,average,type,concentration.During the same period,40 healthy controls(HC)matched with their age,education and right-handedness were recruited through advertisements.First,the whole-brain GM volume of all subjects were calculated by VBM,and the interrelationship of the MoCA scores,overall drinking and reduced GM volume were analyzed by Pearson’s correlation,and then using the mediation analysis explored their relationships.Finally,the decreased GM volume was obtained for support vector machine analysis.Results:The AUD patients demonstrated significant GM volume deficits,including left amygdala,thalamus,hippocampus,precentral gyrus,cerebellum,calcarine,right supplementary motor area and bilateral superior temporal gyri(voxel-wise p<0.05,FWE corrected).GM volume in the bilateral cerebellum and thalamus,left anterior medial temporal lobe,left nucleus ambiguus+parahippocampus gyrus,left fusiform gyrus,left lingual gyrus,left hippocampus,and right nucleus accumbens had positive correlations with MoCA scores.The mediation analysis showed that left cerebellum crus 1 partially mediated the relationship between overall drinking and MoCA scores {standardized beta coefficient=0.0973,SE=0.0002,95%CI=(0.0006,0.0000)}.The SVM results could distinguish AUD from HC with satisfactory classification results(0.8275)and had potential transformation ability from diagnosis to clinic.Conclusions:AUD had extensive GM volume deficits and cognitive impairments,which may be related to the neuropathological mechanism of AUD.The left cerebellum crus 1 may be a biomarker for predicting risk in men with AUD and the possible neuroanatomical basis for cognitive decline.