Objectives: To study the damage of the alcoholic brain on MRI films and the relationship between brain injury with symptoms of delusion and hallucination. Subjects and methods: 30 alcoholic patients with delusion and hallucination. A cross-sectional prospective study described each specific case on 30 patients who are alcoholics.
Journal of military pharmaco-medicine n08-2017 STUDYING THE BRAIN’S MRI IMAGING, DELUSION AND HALLUCINATION SYMPTOMS IN PATIENTS WITH ALCOHOL DEPENDENCE Nguyen Huu Thang*; Bui Quang Huy**; Nguyen Sinh Phuc** SUMMARY Objectives: To study the damage of the alcoholic brain on MRI films and the relationship between brain injury with symptoms of delusion and hallucination Subjects and methods: 30 alcoholic patients with delusion and hallucination A cross-sectional prospective study described each specific case on 30 patients who are alcoholics Results: 63.63% of alcohol-dependent patients had brain lesions on MRI films Parietal lobe was the most vulnerable region of brain, accounted for 56.56% The most common type of injury was the widening gap between two parietal lobes, accounted for 36.66% and myelin degeneration in the parietal lobes (33.33%) The delusions and hallucinations in alcoholic patients could not be associated with brain atrophy and degeneration of myelin in the brain Conclusion: Most of patients have brain lesions on MRI, psychotic symptoms can not be associated with brain lesions * Keywords: Delusion; Hallucination; Alcohol dependence; MRI image INTRODUCTION Alcoholism is a social problem, which is about - 10% of the population The alcoholics usually have brain lesions and some symptoms of mental disorders such as delusions and hallucinations Nowadays, in Vietnam, there has not been any clear researches about brain lesions and the relation among brain lesions, hallucinations and delusions in alcoholic patients Therefore, this research aims: To comment brain lesions on MRI films of the alcoholic and relation among brain lesions, hallucinations and delusions SUBJECTS AND METHODS Subjects 30 patients who were diagnosed as alcoholic They also suffered from the hallucinations and delusions They were treated in 103 Hospital from - 2013 to - 2016 All of the patients were mentally examined and underwent MRI of the brain Methods A cross-sectional prospective study describes each specific case on 30 patients who are alcoholics All patient had their own medical files All of the data were set by using medical statistic method * National Psychiatric Hospital, Bienhoa, Dongnai ** 103 Military Hospital Corresponding author: Buif Quang Huy (bshuy2003@yahoo.com) Date received: 20/08/2017 Date accepted: 28/09/2017 199 Journal of military pharmaco-medicine n08-2017 RESULTS AND DISCUSSION Table 1: The number of patients having brain lesions on MRI films Patients n % Have brain lesions on MRI films 19 63.33 Have no brain lesions on MRI films 11 36.67 30 100 p Brain lesions Total < 0.01 There were 19 patients with brain lesions (63.33%) (p < 0.01) This result matched with the opinion of Sadock B.J (2015) He assumed that there were about 2/3 of the patients having brain lesions on MRI films Table 2: The type of brain lesions on MRI films Patients n % Parietal lobe gap dilation 11 36.66 Myelin degeneration in the parietal lobe 10 33.33 Myelin degeneration in the near lateral ventricle 3.33 Cerebellum liquid lesions (left) 3.33 p Type of brain lesions Lateral ventricle dilation 6.66 Sylvius dilation 3.33 Arachnoid cyst in right frontal lobe 3.33 < 0.01 The most common kind of brain lesions was parietal lobe gap dilatation (36.66%) The following was myelin degeneration in the parietal lobe (33.33%) This result was similar to the opinion of Chiu T.M (2004) He assumed that parietal lobe dilation and degeneration of myelin arised in 35% of the alcoholic patients In case of the long-terms alcoholic, the more alcohol they drink, the more clearly degeneration and atrophy brain can be observed Table 3: Damaged brain region on MRI films Patients n % Parietal lobe 17 56.66 Left cerebellum 3.33 Lateral ventricle 10 Sylvius 3.33 Right frontal lobe 3.33 Damaged brain region p < 0.01 The most vulnerable region in brain was parietal lobe (56.66%) Other regions were at minimum percent This result matched with the opinion of Kawarabuki K et al (2003) He assumed that the percentage of parietal lobe lesions could come to 60% 200 Journal of military pharmaco-medicine n08-2017 Table 4: Degenerated myelin region on MRI films Patient n % Parietal lobe 10 33.33 Near lateral ventricle 3.33 Degenerated myelin region p < 0.01 Degeneration of myelin mainly happened in parietal lobe (33.33%) Degeneration of myelin in near lateral ventricle was only at 3.3% This result matched with Kenneth J.M (2013) He assumed that there was about 32.5% of the alcoholic patients losing myelin in parietal lobe Table 5: Dilated brain region Patient Dilated brain region n % Parietal lobe gap 11 36.66 Lateral ventricle 6.66 Sylvius 3.33 p < 0.01 Brain dilation usually happened in parietal lobe (36.66%) The following was lateral ventricle (6.66%) This result was equivalent with the opinion of Uchino A et al (2003) He assumed that parietal lobe gap dilation could arise in 35% of the patients Table 6: The relation between hallucinations and degeneration of myelin Degeneration of myelin Degeneration Nondegeneration Total Hallucinations 12 18 No hallucinations 12 10 20 30 Hallucinations Total p > 0.05 18 patients had hallucinations However, the hallucinations could not be associated with degeneration of myelin in brain Table 7: The relation between hallucinations and brain atrophy Brain atrophy Brain atrophy No brain atrophy Total Hallucinations 10 18 No hallucinations 12 12 18 30 p Hallucinations Total > 0.05 Hallucinations could not be associated with brain atrophy However, hallucinations had no relation with degeneration of myelin and brain atrophy (p > 0.05) This result matched with the opinion of Gender M (2011) He assumed that brain atrophy and myelin degeneration had no clear relation with hallucinations in alcoholic patients 201 Journal of military pharmaco-medicine n08-2017 Table 8: The relation between delusions and degeneration of myelin Degeneration of myelin Degeneration Nondegeneration Total Delusions 10 20 30 No delusions 0 10 20 30 Delusions Total All of 30 patients took MRI having delusions 10 patients had degeneration of myelin on MRI films (33.33%) There was no relation between delusions and degeneration of myelin Table 9: The relation between delusions and brain atrophy Brain atrophy Brain atrophy No brain atrophy Total Delusions 12 18 30 No delusions 0 12 18 30 Delusions Total All of 30 patients taken MRI had delusions 12 patients had brain atrophy on MRI films (40.00%) There was no relation between delusions and brain atrophy Delusions had no relation with degeneration of myelin and brain atrophy This result matched with the opinion of Gelder M (2011) He assumed that there was no clear relation among delusions, brain atrophy and degeneration of myelin CONCLUSION with and without a paternal history of alcoholism J Stud Alcohol 2004, Jan, 65 (1), pp.16-21 - 63.63% of alcohol-dependent patients have brain lesions on MRI films Parietal lobe is the most vulnerable regions of brain (56.56%) The most common type of injury is the widening gap between two parietal lobes (36.66%) and myelin degeneration in the parietal lobes (33.33%) Gelder M, Gath D, Mayou R Oxford textbook of psychiatry Second edition Oxford University press 2011, pp.507-537 - The delusions and hallucinations in alcoholic patients can not be associated with brain atrophy and degeneration of myelin in the brain REFERENCES Chiu T.M, Mendelson J.H, Sholar M.B et al Brain alcohol detectability in human subjects 202 Kawarabuki K, Sakakibara T, Hirai M et al Marchiafava-Bignami disease: magnetic resonance imaging findings in corpus callosum and subcortical white matter Eur J Radiol 2003, 48 (2), pp.175-177 Sadock B.J, Sadock V.A Kaplan and Sadock’s Synopsis of Psychiatry 10th edition William and Wilkins 2015, pp.189-217 Uchino A, Yuzuriha T, Murakami M et al Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers Neuroradiology 2003, 45 (12), pp.877-880 ... dilation and degeneration of myelin arised in 35% of the alcoholic patients In case of the long-terms alcoholic, the more alcohol they drink, the more clearly degeneration and atrophy brain can... 30 Hallucinations Total p > 0.05 18 patients had hallucinations However, the hallucinations could not be associated with degeneration of myelin in brain Table 7: The relation between hallucinations... hallucinations and brain atrophy Brain atrophy Brain atrophy No brain atrophy Total Hallucinations 10 18 No hallucinations 12 12 18 30 p Hallucinations Total > 0.05 Hallucinations could not be associated with