Re-investigating the effects of chronic smoking on the pathology of alcohol-related human brain damage.

Both pathological and neuroimaging studies have shown that chronic alcohol abuse causes generalized white matter, but limited gray matter, volume loss. Recent neuroimaging studies suggest that tobacco smoking also causes brain atrophy in both alcoholics and neurologically normal individuals. However, a recent pathological study, employing a manual technique to determine regional volumes, found no significant effects of smoking on either global or selected regional gray matter volumes in smokers or smoking alcoholics. Here a high-resolution computerized method was employed in the same cohort to evaluate four regions where neuroimaging studies have found atrophy in smokers and alcoholics: insula, thalamus, prefrontal cortex, and anterior cingulate cortex. Brain images from 44 cases comprising 16 non-smoking controls, nine smoking controls, eight non-smoking alcoholics, and 11 smoking alcoholics were quantified. No significant differences between the groups were found, although the alcoholic groups tended to have smaller volumes in most regions. Furthermore, there were no smoking or interactive effects, and no correlation between gray matter volumes and either tobacco pack-years or lifetime alcohol consumption. These results do not support the hypotheses that tobacco smoking causes gray matter loss or that smoking potentiates gray matter atrophy in chronic alcoholics.