Alcohol and brain health: from mechanisms to interventions

ABSTRACT

Alcohol-related problems are prevalent and lead to substantial economic, physical, and psychological burden. Among the various effects of alcohol, the effect on the brain is a matter of importance. The brain controls drinking behaviors and may be damaged earlier than other organs by alcohol. Moreover, alcohol-related brain pathologies are difficult to treat once they have progressed. Therefore, we overviewed the mechanisms and results of alcohol-induced brain damage and interventions against it in this article. Alcohol exerts neurotoxic effects mediated by various mechanisms, such as acetaldehyde toxicity, glutamate excitotoxicity, increased oxidative stress, and chronic inflammatory responses. In both functional and structural neuroimaging studies, the evidence of alcohol-induced brain damage was observed in various regions of gray and white matter. Brain damage has been known to be more prominent when it begins during the period of brain development and in women. Symptomatically, alcohol hangovers and alcohol-induced blackouts, which are highly prevalent alcohol-related problems, have been suggested to be early signs of alcohol-related brain damage. However, neurological changes induced by alcohol have been reported to be partly recovered by abstinence. The development of effective interventions would be clinically important. Although following the rules of low-risk drinking and abstinence have been the primary approaches up to the present, studies on mechanism-based neuroprotective interventions, such as acamprosate and memantine, have attempted. Further prospective and well-designed studies of neuroprotective interventions against neurotoxic effects of alcohol are required.