Handout: Your Brain Off Alcohol

I can vividly remember the clever ad from the 80’s about your brain and your brain on drugs. It was a simple egg that was then placed in a frying pan to symbolize that “you’re frying your brain.” Regardless of whether it is legal, alcohol is still a drug.

The good news is that for those recovering from alcohol abuse disorder (AUD), a new study shows how fast the brain can mend once a person has quit drinking. Regions of the cortex of the brain tend to become thinner in individuals with excessive alcohol intake. The cortex is the outer layer of the brain responsible for critical thinking and other cognitive functions.

Your Brain Bounces Back

The US research discovered that cortical thickness may return over time, fastest in the first month after drinking stops and continuing over 7.3 months. After several months, the cortical thickness is similar to those without AUD (1).

Past research has indicated that some regions in the brain return to normal when a person quits drinking, but it wasn’t clear how much or how fast this recovery happens (2).

According to psychiatrist and behavioral scientist Timothy Durazzo from Stanford University, "The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety… However, the extent of regional cortical thickness recovery over an extended period of abstinence (e.g., greater than 6 months) is unknown."

Alcohol Use Disorder in the US

Alcohol use disorder is a major public health issue, impacting an estimated 16 million people in the US. Understanding this disorder is vital for prevention, treatment and reducing stigma associated with it.

Changes in brain structure and function when someone is drinking chronically can make it hard for people to stop drinking, despite their best efforts. For example, the prefrontal cortex, a part of the brain needed for planning and decision making, may become less active, making it difficult for those with alcohol use disorder to make healthy choices.

Durazzo and his team also evaluated how some health conditions, such as smoking, psychiatric diseases, and substance use disorder, impact longer-term cortical thickness changes in those recovering from alcohol use disorder.

Abstinence from Alcohol

His small study of 88 subjects with AUD received brain scans at 1 week, 1 month, and 7.3 months of abstinence. Some subjects joined at the 1 month point, so 23 subjects missed scans taken at 1 week, and just 40 of the 88 abstained from alcohol for the full time frame.

They also measured the cortical thickness of 45 subjects who did not have AUD at baseline and then 9 months later to confirm that the parts of the brain measured had not changed.

An MRI that’s useful for seeing clear pictures of the body’s internal organs was utilized to see the subjects’ brains. Cortical thickness in 34 regions was recorded, with averages used across the brain’s right and left hemispheres.

After 7.3 months of abstinence, recovery of thickness in individuals without AUD was widespread. This thickness was adequate to be statistically significant in 25 of the 34 regions, with 24 of them being statistically the same in thickness to controls.

Durazzo and his colleagues observed a faster rate of thickness change in AUD subjects from 1 week to 1 month after quitting in all 34 cortical regions compared to 1 month to 7.3 months.

Alcohol and other Conditions

Individuals with AUD who also had high blood pressure or high cholesterol had lower rates of cortical thickening in some parts of the brain. This was also true for current smokers with AUD.

Significant links between cortical thickness changes and current substance abuse (other drugs except alcohol), past smoking, or psychiatric disorders were not observed. Smoking cessation may also add to recovery of cortical thickness.

Reasons to Stop Drinking

The results of this study may be encouraging and offer a new understanding of how the brain recovers after stopping alcohol intake, though the study was small and lacked diversity. Because of this, it is not generalizable. In addition, the results don’t show if these changes have any impact on brain function.

Durazzo’s team suggests, "Larger longitudinal studies are required to examine the neurocognitive and psychosocial correlates of cortical thickness recovery during sustained abstinence in AUD,"

Other factors the authors didn’t account for include physical activity, family history, and the individual’s lung and liver health, which could impact their findings.

The authors conclude that "this data provides clinically relevant information on the beneficial effects of sustained sobriety on human brain morphology, and reinforces the adaptive effects of abstinence-based recovery in AUD."

Fortunately, there is help for those suffering from AUD. Below are some tips.

• Seek help early through Alcoholics Anonymous, individual or group therapy (3).

• Ask for support from family and friends in your recovery. Don’t keep alcohol in your house while trying to recover.

• Find social activities that don’t involve alcohol.

• Reduce sweets if possible. Research indicates that limiting added sugar in your diet may reduce alcohol cravings and the risk of AUD relapse (4).

• Get adequate sleep to reduce stress and the urge to drink. A study in mice found that sleep regulation reduces alcohol cravings (5).

• Don’t skip breakfast. A Japanese study found that university students that skipped their morning meal were at higher risk to drink excessive alcohol than those that ate breakfast (6).

• Do regular exercise. Exercise helps reduce stress and improves sleep. It can also be a way to socialize without alcohol.

Lisa Andrews, MEd, RD, LD

References:

1.    Timothy C. Durazzo, Lauren H. Stephens, Dieter J. Meyerhoff, Regional cortical thickness recovery with extended abstinence after treatment in those with alcohol use disorder, Alcohol, 2023, ISSN 0741-8329, https://doi.org/10.1016/j.alcohol.2023.08.011.(https://www.sciencedirect.com/science/article/pii/S074183292300263X)

2.    Patrick Bach, Anne Koopmann, J. Malte Bumb, Sabine Vollstädt-Klein, Iris Reinhard, Marcella Rietschel, Stephanie H. Witt, Klaus Wiedemann, Falk Kiefer,Leptin predicts cortical and subcortical gray matter volume recovery in alcohol dependent patients: A longitudinal structural magnetic resonance imaging study, Hormones and Behavior,Volume 124, 2020, 104749,ISSN 0018-506X, https://doi.org/10.1016/j.yhbeh.2020.104749

3.    https://www.aa.org/

4.    Abrantes AM, Kunicki Z, Braun T, Miranda R Jr, Blevins CE, Brick L, Thomas G, Marsh E, Feltus S, Stein MD. Daily associations between alcohol and sweets craving and consumption in early AUD recovery: Results from an ecological momentary assessment study. J Subst Abuse Treat. 2022 Jan;132:108614. doi: 10.1016/j.jsat.2021.108614. Epub 2021 Aug 28. PMID: 34493429.

5.    Hühne A, Echtler L, Kling C, Stephan M, Schmidt MV, Rossner MJ, Landgraf D. Circadian gene × environment perturbations influence alcohol drinking in Cryptochrome-deficient mice. Addict Biol. 2022 Jan;27(1):e13105. doi: 10.1111/adb.13105. Epub 2021 Oct 20. PMID: 34672045.

6.    Matsumura Y, Yamamoto R, Shinzawa M, Matsushita T, Yoshimura R, Otsuki N, Mizui M, Matsui I, Kaimori J, Sakaguchi Y, Ishibashi C, Ide S, Nakanishi K, Nishida M, Kudo T, Yamauchi-Takihara K, Nagatomo I, Moriyama T. Skipping Breakfast and Incidence of Frequent Alcohol Drinking in University Students in Japan: A Retrospective Cohort Study. Nutrients. 2022 Jun 27;14(13):2657. doi: 10.3390/nu14132657. PMID: 35807842; PMCID: PMC9267987.