Most people are aware of the minor side effects of alcohol, but what many don’t know is that extensive use of alcohol can lead to brain damage. Brain damage is a condition that involves the destruction or deterioration of brain cells.

Brain damage can affect certain functions that many people take for granted, such as walking, using the bathroom or even breathing. Brain damage can also lead to various neurological diseases. In some cases, the damage is irreversible.

How Does Alcohol Affect the Brain in the Short-Term?

When alcohol is consumed regularly over time, it can take a toll on the brain, especially in the prefrontal cortex and regions of the cerebellum. The prefrontal cortex is linked to executive functions like planning and decision making, and the cerebellum is responsible for balance and motor function. When these portions of the brain are affected, it can lead to problems with:

  • Multitasking
  • Short-term memory
  • Organization
  • Walking
  • Balance
  • Normal thoughts
  • Speech
  • Alertness

Even small amounts of alcohol can cause the entire brain to shrink if consumed habitually over an extended period of time, according to research from the Boston University School of Public Health. The reasons for this brain shrinkage are unclear, but the study states that alcohol dehydrates tissues, and constant dehydration can have negative effects on any sensitive tissue.

Other studies indicate that smaller brains (commonly seen in alcoholics) are also lighter in weight than those without an alcohol use disorder. The good news, however, is that some of the damage can be reversed when the drinking stops.

How Does Alcohol Affect the Brain in the Long-Term?

High blood alcohol content (BAC) can affect the cerebral cortex, hypothalamus, pituitary gland and medulla. This is what results in the most common minor side effects, including slow reaction time, slurred speech and sluggish movements. When the medulla (responsible for autonomic functions) is affected, it can cause sleepiness, slow breathing and decrease body temperature (hypothermia). These effects can be fatal.

There have also been studies regarding the link between excessive alcohol consumption and complex brain problems, some of which are the direct result of alcohol use. These include:

  • Dementia: Impaired cognitive ability that becomes worse over time
  • Wernicke-Korsakoff Syndrome (WKS or wet brain): Chronic memory disorder caused by vitamin B1 (thiamine) deficiency
  • Alcoholic neuropathy: Damage to peripheral nerves, which is irreversible
  • Alcoholic cerebellar degeneration: Deterioration of nerve cells in the cerebellum
  • Marchiafava-Bignami Disease: A progressive condition characterized by the corrosion of the corpus callosum, a nerve tract in the brain
  • Fetal Alcohol Syndrome: Brain damage or growth problems in a child incurred during a mother’s pregnancy

What Is Alcohol-Induced Dementia?

Alcohol-related dementia (ARD) is a broad term used by medical professionals to describe dementia-like symptoms associated with alcohol use. Dementia is a decline in cognitive function severe enough that it interferes with daily life. It is a set of symptoms involving declining memory and thinking skills. There are many causes of dementia, but all result in damage to brain cells.

ARD is typically an effect of long-term alcohol use and takes several years to develop. It is possible to develop ARD as early as age 30, but it usually occurs between the ages of 50 and 70. The speed at which ARD develops is influenced by many factors, but the amount and frequency of alcohol use have the greatest effects on the development of ARD.

While there are treatments that can be done to help stop the progression of ARD, the damage that causes the condition is irreversible in almost every case. ARD results in damage to brain cells, and this damage cannot be repaired. The progression of ARD may be stopped in some cases by ending alcohol use.

While ARD is known to be caused by alcohol, the exact way in which alcohol causes dementia is not understood by the medical field. ARD may sometimes be mistaken for Korsakoff Syndrome, another type of brain damage caused by a thiamine deficiency due to alcohol use. Some sources consider Korsakoff Syndrome to be a type of ARD, while others view both conditions as separate types of alcohol-related brain damage.

Signs and Side Effects of ARD

Signs of alcoholic dementia are gradual and more varied, and they may include:

  • Difficulty with decision making, planning, organization or judgment
  • Impulsive behavior
  • Difficulty controlling emotions
  • Inability to maintain attention
  • Slowed reasoning
  • Change in personality
  • Psychosis
  • Difficulty with complicated movements
  • Difficulty speaking or understanding

What Is Wernicke-Korsakoff Syndrome (WKS)?

Wernicke-Korsakoff Syndrome (WKS), commonly referred to as “wet brain,” is brought on by alcohol abuse and causes the body to shut down. WKS is a combination syndrome that involves both Wernicke encephalopathy and Korsakoff Syndrome, which are thought to be the two stages in this progressive illness. These stages are defined as follows:

  • Wernicke Encephalopathy (WE): Wernicke’s Syndrome is a brain disorder that is brought on by thiamine deficiency. The condition, also known as Wernicke encephalopathy, is an acute and life-threatening inflammation of the brain that can lead to permanent brain damage if not treated. Symptoms may look similar to alcoholic intoxication but are not the same thing. Hallmarks of encephalopathy that help distinguish it from intoxications include abnormal eye movements and impaired coordination. During WE, brain cells are not able to process fuel because they do not have enough thiamine to do so. Damage from WE can be permanent if not treated immediately.
  • Korsakoff Syndrome (KS): Korsakoff Syndrome is the permanent consequence of WE. The longer it takes a person to receive medical attention, the worse the symptoms can become. This syndrome impacts the brain cells and spinal cord cells as well as associated functions within the mind and body. Symptoms of KS include an inability to form new memories, making up stories, loss of memory and hallucinations. KS damage cannot be reversed.

Symptoms and Causes of WKS

The impact of this condition can be catastrophic without treatment. By the time someone is facing WKS, there has often been a severe progression of alcohol use disorder and medical intervention is necessary.

Memory Issues
People struggling with WKS experience severe memory issues as a result of thiamine deficiency. The deficiency results in the brain having a limited ability to create new memories or recall memories from the past. This amnesia worsens as the syndrome progresses, and even after treatment, one may not fully recover memory and cognitive function.

Other symptoms may include:

  • Amnesia
  • Difficulty understanding others
  • Difficulty speaking
  • Impaired coordination, even when sober
  • Hallucinations
  • Double vision

Since symptoms of WE are so similar to alcohol intoxication, it is important to understand hallmark symptoms. The most obvious and common signs of WE are abnormal eye movement, loss of muscle coordination and tremors. People with encephalopathy are usually confused in a way that is not normal for them or their drinking habits. People with WE will have symptoms even when they are sober.

Causes of WKS
WKS is associated with a deficiency of thiamine in the brain, which can occur due to an alcohol use disorder, chemotherapy, gastrointestinal surgery, eating disorder or nutritional deficiency. However, alcohol is by far the most common cause of WKS.

What Is Alcoholic Neuropathy?

Neuropathy is weakness, numbness and tingling in the nerves, typically affecting the nerves of the feet and hands. Alcoholic neuropathy describes nerve damage caused by alcohol use. Alcoholic neuropathy can exist all by itself or as a part of Wernicke-Korsakoff syndrome. It can also lead to nerve pain and lasting discomfort.

Symptoms and Causes of Alcoholic Neuropathy

Alcohol can affect the way that vitamins are processed by the body and the way they are able to enter into nerve cells. This leads to impaired function of nerve cells and affects their ability to interact with the body. Alcohol also generates reactive molecules called “free radicals” that can cause damage to sensitive nerve cells. Nerve cells, especially in the hands and feet, are more likely to be affected by the damage caused by alcoholic neuropathy.

Nerve cells influence the body’s ability to receive and send signals from the brain. Damage to these nerve cells affects signals from the brain, leading to impaired muscle movements and impaired coordination. Damage affecting signals to the brain can impair temperature sensation, pressure sensation, pain sensation and other sensory functions of the nerves. Impaired sensation can lead to increased risk of injury, further damaging the nerves.

Symptoms of alcoholic neuropathy can include:

  • Weakness
  • Impaired sensation
  • Clumsy movements
  • Nerve pain
  • Numbness

In most cases, alcoholic neuropathy is permanent. Stopping alcohol use and starting a healthy diet may help to reduce further alcoholic neuropathy, but once alcoholic neuropathy has developed, it will not be reversible. The damage that occurs to the nerves cannot be repaired by the body or by any medical procedures. However, certain types of physical therapy can help people compensate for the damage caused by alcoholic neuropathy and increase their coordination.

What Is Alcoholic Cerebellar Degeneration?

Alcoholic cerebellar degeneration is damage that occurs to the cerebellum, a part of the brain in the lower back of the head. The cerebellum controls muscle movement and is the part of the brain that learns movement patterns. Patterns that involve a huge variety of movements include walking, riding a bike, turning a doorknob, using a fork and many other movement patterns. Athletes, musicians and many other professions use very specific, finely tuned movement patterns that are only made possible through the cerebellum.

Symptoms and Causes of Alcoholic Cerebellar Degeneration

Alcoholic cerebellar degeneration is a deterioration of the cerebellum that is due to alcohol use, but its exact cause is not known to science. It appears that while heavy drinking over long periods of time increases the risk of alcoholic cerebellar degeneration, heavy drinking over a short-term basis can also lead to this condition.

Alcoholic cerebellar degeneration often occurs in combination with other alcohol-related brain damage and may not initially be detected, as it is a less common form of brain damage caused by alcohol. The main symptom of alcoholic cerebellar degeneration is impaired muscle movements. Because this is also a symptom of many other types of alcohol-related brain damage, this specific form of brain damage is difficult to detect.

Some common symptoms of alcoholic cerebellar degeneration include:

  • Difficulty walking
  • Impaired coordination
  • Difficulty doing repetitive movements
  • Impaired fine movements, such as playing an instrument
  • Tremors

Alcoholic cerebellar degeneration is a permanent condition in most cases and is not reversible, but stopping alcohol use may help to reduce the progression.

What Is Marchiafava-Bignami Disease?

Marchiafava-Bignami Disease is a very rare condition caused by alcohol use. This disease causes the degeneration and death of the brain’s corpus callosum. The corpus callosum connects the two sides of the brain, and the malfunction of this part of the brain can have severe neurological consequences. Marchiafava-Bignami Disease is almost always caused by alcohol use.

Symptoms and Causes of Marchiafava-Bignami Disease

Because Marchiafava-Bignami Disease is so rare, very little is known about how it is caused. Scientists know that Marchiafava-Bignami Disease is related to alcohol use, but the amount of alcohol needed to cause this disease is unknown. Alcohol is thought to affect myelin, or the lining of the conducting portion of brain cells, within the corpus callosum. The way that alcohol causes damage to myelin is still being studied.

The symptoms of Marchiafava-Bignami Disease may be different in each case, and because there are not many cases to study, there may be symptoms that have not yet been discovered. Symptoms that are known to be caused by Marchiafava-Bignami Disease include:

  • Seizures
  • Problems walking
  • Dementia
  • Psychiatric disturbances
  • Incontinence
  • Paralysis on one side
  • Problems speaking
  • Problems moving

There is no known cure for Marchiafava-Bignami Disease, although stopping alcohol use could help prevent progression of the disease.

Treatment for Alcohol-Related Brain Damage

Alcohol-related brain damage can be treated. However, while symptoms like memory recall issues can be reversed if detected early enough, they may not be entirely repaired.

Treatment for alcohol-related brain damage consists of supplementing the person with thiamine. Thiamine treatment is usually not given by mouth because it will not absorb quickly enough to be effective. To ensure the person absorbs thiamine quickly, it is injected into the muscle (intramuscular) or the vein (intravenous). Thiamine supplementation continues for several days while the person is stabilized by hospital staff.

Unfortunately, there is not a cure-all for severe bodily damage caused by a thiamine deficiency. The progression of alcohol-related brain damage can, however, be halted or slowed down. To prevent WE, people who drink alcohol regularly should, at a minimum, supplement their diet with B-complex vitamins. The most effective prevention is to stop drinking alcohol and maintain a healthy diet and lifestyle.

In patients whose alcohol-related brain damage is not due to a thiamine deficiency, however, there are no known cures. The only real treatment option in these cases is to stop drinking alcohol as soon as possible and halt the progression of the brain damage. In some cases, the brain may be able to make some small spontaneous recovery by itself, but the damage is usually permanent.

FAQs

  • Does alcohol kill brain cells?

    In some types of alcohol-related brain damage, alcohol doesn’t kill brain cells. Instead, it impacts the movement between neurons and neurotransmitters, which are the command center for major bodily functions like breath, speech, thought and movement. Other types of alcohol-related brain damage do cause damage to brain cells that may result in these brain cells dying.

  • What happens to the brain while under the influence?

    The brain has certain levels of neurotransmitters, which are the chemical runners that transfer and deliver vital signals throughout the body. When drinking alcohol, this chemistry in the brain is interrupted, and neurotransmitters begin to have a hard time functioning as they normally do for our thought processes, behavior, and emotions.

    Alcohol influences both excitatory and inhibitory neurotransmitters. These include:

    • Glutamate: This neurotransmitter is responsible for energy levels and brain activity. Alcohol suppresses the release of glutamate, causing the brain’s pathways to be slowed down tremendously.
    • Gama-aminobutyric acid (GABA): GABA does the opposite of glutamate. It is responsible for helping people calm down and reduce energy levels. Alcohol amplifies the production of GABA in the brain, which can lead to feelings of drowsiness.
    • Dopamine: This neurotransmitter is part of the reward center of the brain. Alcohol increases the release of dopamine in the reward center, tricking a person into feeling that alcohol makes them feel great when it is actually creating simultaneous feelings of depression.

  • Why does chronic alcohol use result in a thiamine deficiency?

    People who abuse alcohol can develop a thiamine deficiency for a variety of reasons. First, a person who constantly drinks alcohol generally has poor nutrition. Their diet may be poor in vitamins and minerals, or they may frequently replace meals with alcohol, not eat enough food or binge eat.

    Second, alcohol consumption can inflame the lining of the stomach and affect the way thiamine is absorbed at a chemical level, which makes it more difficult for other essential vitamins and minerals to be absorbed. In a vicious cycle, a person struggling with alcohol use may feel even less inclined to eat, become constipated or experience general illness as a consequence of thiamine deficiency.

    If a thiamine deficiency continues (along with excessive alcohol consumption), individuals can go on to develop a condition known as dry or wet beriberi. Dry beriberi is defined as a condition where thiamine deficiency causes damage to the nervous system, leading to muscle weakness and other problems. Wet beriberi causes damage to the heart and circulatory system. Either condition can quickly become life-threatening if not treated.

    A severe consequence of alcohol-related thiamine deficiency is called Wernicke-Korsakoff’s Syndrome. First, a person may develop Wernicke’s encephalopathy, which is a serious brain injury. Second, if left untreated or if insufficiently treated, this condition can develop into Korsakoff’s Syndrome, which is a long-term condition involving memory loss.

  • Should I drink if I have a thiamine deficiency?

    If a person experiences a minor thiamine deficiency due to poor nutrition or recent diet changes (but not due to excessive alcohol consumption), it is unlikely that having a drink or two would seriously damage their health. However, a chronic or major thiamine deficiency can be extremely dangerous, regardless of alcohol use. Therefore, it is not advised for anyone to drink alcohol when they are already aware of a thiamine deficiency.

  • Is Wernicke-Korsakoff Syndrome the same as wet brain? What about alcoholic encephalopathy?

    Yes, wet brain syndrome is another term for Wernicke-Korsakoff Syndrome. Alcoholic encephalopathy is a condition where a person’s thinking becomes impaired from long-term alcohol abuse; it is also known as Wernicke’s encephalopathy.

  • Can you die from alcohol-related brain damage?

    It is possible to die from Wernicke-Korsakoff syndrome, or wet brain. However, wet brain is a disease that gets progressively worse over time. If a person does not receive adequate treatment for this disease, then it is possible to progress into a coma or death.

If you or a loved one is struggling with an alcohol use disorder or co-occurring mental health condition, The Recovery Village is here to help. Contact us today to learn more about treatment plans and programs that can work well for your needs.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.