アルコール疾患群間におけるCT所見による脳萎縮の比較

抄録

The alcoholics were diagnosed and classified based on the criteria, offered at the Alcoholism Diagnostic Conference (1977) which was held under the auspices of the Ministry of Welfare, Japan. Grade of cerebral atrophy was estimated. Measurement items on the Computed Tomography (CT Scan) which contributed to discrimination among these groups were investigated simultaneously.
The study consisted of seventy-five alcoholic patients and control group of ninety-four who were devoid of any evidence for alcoholism. Influential factors which were involved in cerebral atrophy of the alcoholic groups were investigated and factorial analysis was completed. There was a definite increase in cerebral atrophy during the aging process in patients with long term durations of drinking alcohol. There was a close correlation between age and duration of drin-king alcohol.
Each group was compared by one-way classification analysis of variance on power normal distribution. There were significant differences between the alcoholics and the controls among all CT items. Enlargement of ventricles was recognized in the alcoholics. Also, significant differences were recognized according to the Ventricle index, the Evans' index, the Huckman number, and the width of Sylvian fissure between alcoholic dementia and other alcoholic psycho-ses. The degree of the enlargement of ventricles was extremely striking in alcoholic dementia.
The results of one-way classification analysis of variance concerning the vertical diameter of the fourth ventricle showed a significant difference between the alcoholics and the controls. A tendency for cerebellar atrophy existed in the alcoholics.
A regression analysis of CT items on age was performed. It was noticed that there was a parallel between the regression lines of the alcoholics and the controls, with the only difference being in the grade of CT items. Furthermore, another important finding was noticed in the 27-78 year range which indicated the same ratio between the alcoholics and the controls in the development of the enlargement of the ventricular systems (central atrophy). The mean value and standard deviation of each measurement item in each age stratum and each diagnostic group indicated that cerebral atrophy was much higher in the younger alcoholic group than in the aged control group. It was suggested that cerebral atrophy which developed as a result of the abnormal process of alcohol dependence appeared in the early stages of dependence and was more severe than atrophy caused by the physiological process of aging. In spite of continuous alcohol depen-dence, this atrophy did not make any rapid progress as anticipated in comparison with the control group. Once the initial atrophy developed, the rate of progression was the same in both the alcoholics and the controls. However, it was shown that cerebral atrophy started early in the initial stages of alcohol dependence, whereas physiological atrophy mainly started later in the natural process of aging.
It was observed that a significant difference existed between the alcoholics and the controls after Kruskal-Wallis Test and Dunn-Multiple Comparison Test against the cortical sulcus (C.S) item. That is, cerebral cortical atrophy was seen in the alcoholics.
After the results of canonical discriminant analysis against 9 CT items, the Ventricle index definitely contributed both in the discrimination between the alcoholics and the controls and in the discrimination between alcoholic dementia and other alcoholic psychoses. Furthermore, the horizontal diameter of the third ventricle contributed to the latter discrimination, while the Evans' index contributed to the former discrimination.