How Does Alcohol Affect Your Brain?

Cerebellum and its Role in Your Coordination

Alcohol-Cerebellum Created with Sketch. 🧠 🍺 🥃 🍸 🍷

Alcohol and the Brain

Binge drinking (drinking 5 units over a 2 hour period, followed by a period of abstinence) and high alcohol intake (more than 5 units a day), can lead to dependence, tolerance and cravings, which lead to a continuation of alcohol abuse to prevent withdrawal symptoms.

Chronic alcohol abuse can have adverse effects such as loss of balance and gait, slurred speech, slower reactions, poor memory consolidation, compromised emotional modulation and judgement. These effects in turn can lead to difficulties in social and emotional interactions, and a reduction in motivation, attention and impulse control.

These effects are studied and proven using methods such as MRI scans which show loss of neurons, particularly in the frontal lobe, the area most associated with reasoning, decision-making and rationality, however it can affect other areas of the brain such as the cerebellum (associated with balance and movement), hippocampus (memory) and amygdala (memory, decision making and emotional responses). [1]

Every year millions of people suffer from Alcohol use disorder, leading to physical and mental health problems. Prevalence of alcohol abuse and direct death caused by alcohol dependance across the world [2]

What is Cerebellum and what does it do?

Cerebellum (latin for "little brain") is one of the important areas of the brain with a primary function of motor control, which includes all directed movement, stability and balance, posture, gait and even reflexes. [3] Cerebellum is also important for cognition, emotion, attention, language control and more. [4] Antomatically, the cerebellum is located at the bottom of the brain, separate from the hemispheres. [5] You can see the cerebellum highlighted in the model below.

Our understanding of Cerebellum's function with regards to its primary function, namely motor control, is that it does not initiate movement, but rather calibrates and coordinates the movement for precision and accurate timing, this can in turn affect stability while standing or walking, general posture and coordination. [6]

How does Alcohol damage your Cerebellum?

Alcohol consumption has a detrimental effect on the motor functions of the cerebellum, in particular postural control and coordination. Damage to the cerebellum can also cause speech control problems and poor muscle coordination. For example, it is very common for patrol officers to check the driver’s ability to perform counting or walking exercises. This is why it is extremely dangerous to drive under the influence of alcohol since it could severely affect your visual and motor skills.

Brain imaging technology like computed tomography and magnetic resonance imaging (MRI) showed that heavy alcohol abuse is correlated to brain tissue shrinkage (significant loss of nerve cells) that could increase the risk of having a stroke. Moreover, long-term alcohol abuse can damage nerve signals that can result in permanent functional deficits in cognitive reasoning and mental balance. For instance, chronic alcoholics might no longer recover their ability to perform smooth and rapid movements as a result of motor control deficits. Abstinence from alcohol may show significant signs of improvement although it depends on how reversible their brain tissue injury is.

Past research shows how alcoholics perform poorly in visual and cognitive tasks that involve organizing information in the right temporal order. Lack of coordination between visual and motor skills could increase the danger of head injuries and accidental falls. Cerebellar degeneration can provoke severe adaptation issues to changes in visuospatial perception that makes them unable to walk straight or in the dark with their eyes closed. It can also have a significant impact in the cognitive control of self-movement and sense of position.

It is still unclear whether instability arising from alcohol abuse is directly caused from cerebellum dysfunction or from deficiency of the peripheral nervous system in body position and motor balance. Hence, more research is still needed to understand whether the cerebellar damage represents the prime cause of certain functional deficits in alcoholics. “New research must be conducted to determine if alcohol-related imbalance results from cerebellar pathology or from poor functioning of the peripheral nervous system in the body’s extremities, such as the hands and feet. Peripheral neuropathy can occur in alcoholics, resulting in decreased sensation that may lead to imbalance ” [7]. Knowledge of this kind would be crucial for quickening recovery processes.

How does damage to Cerebellum affect you?

Loss of balance, dizziness, ...

How to assess your Cerebellum function?

Loss of balance, dizziness, ...

Treatment and Rehabilitation

Loss of balance, dizziness, ...

References

  1. Crichton, R., & Ward, R. (2013). Metal-based neurodegeneration: from molecular mechanisms to therapeutic strategies. John Wiley & Sons. https://doi.org/10.1002/9781118553480.ch12
  2. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020. Available from http://ghdx.healthdata.org/gbd-results-tool
  3. Holmes, G. (1939). The cerebellum of man. Brain, 62(1), 1-30. https://doi.org/10.1093/brain/62.1.1
  4. Schmahmann, J. D. (2019). The cerebellum and cognition. Neuroscience letters, 688, 62-75. https://doi.org/10.1016/j.neulet.2018.07.005
  5. Purves, D., Augustine, G. J., Fitzpatrick, D., Hall, W. C., LaMantia, A. S., & White, L. E. (2011). Neuroscience, 5th edn. Sunderland, MA. pp. 417–423.
  6. Ghez, C. (1985). Fahn S. The cerebellum. Principles of neural science, 2nd edition. pp. 502–522
  7. Sullivan, E. V., Rosenbloom, M. J., Deshmukh, A., Desmond, J. E., & Pfefferbaum, A. (1995). Alcohol and the Cerebellum: Effects on Balance, Motor Coordination, and Cognition. Alcohol health and research world, 19(2), 138–141.