Cognitive impairment and alcohol dependence, clinical implications
By way of conclusion, it could be said that brain damage caused by excessive alcohol consumption (ARBD) is dimensional, from mild deterioration to dementia. In any case, ARBD worsens the response to treatment and the evolution of patients, ARBD is associated with two dimensions that usually interact in all cases and are also dimensional: the direct neurotoxicity of alcohol associated especially with glutamatergic excitotoxicity and which is related to episodes of intense consumption and subsequent abstinence, and on the other hand, the thiamine deficit that gives rise to the EK-SK complex and that tends to imply greater severity. ARBD appears to severely damage the white matter of the prefrontal cortex, corpus callosum, and cerebellum, and cause neuronal damage to the prefrontal cortex, hypothalamus, and cerebellum. However, ARBD is reversible if prolonged cessation of alcohol is achieved, of at least 1-2 years.