알코올 의존 : 화학적 뇌손상

Alcohol Dependence：The Chemical Brain Injury

Objectives：The purpose of this study is, by the evaluation of a neuropsychological test, to identify how severe executive cognitive function impairment in chronic alcoholism compares to that of traumatic brain injury (TBI). Methods：42 alcoholic patients and 41 TBI patients, matched for age, educational level, premorbid IQ, and executive cognitive score, were enrolled in this study. Korean versions of the Wechsler Adult Intelligence Scale (k-WAIS) and EXIT (Executive intelligence test) were ad-ministered for both groups. Results：In between-group com-parison, the decrease of IQ (Mean=-5.45/-11.12, p=.010) and EIQ (Mean=-17.98/-32.46, p=.002) from the estimated pre-morbid level in the TBI subjects were significantly higher than that of alcoholic subjects. The decrease of IQ and EIQ of alcoholic subjects reached 49.01% and 55.39%, respectively, compared with that of TBI subjects. Subtest TBI subjects, with the exception of figural fluency (Mean=21.14/17.68, p=.094), showed statistically significant poor performance on the Stroop test (Sim-ple ： Mean=22.16/48.44, p=.000 ； Medial ： Mean=33.14/ 56.44, p=.002 ； Interference ： Mean=43.52/73.71, p=.001), verbal fluency (Mean=20.07/15.05, p= .025), and the auditory verbal learning test (Recognition：Mean=11.36/8.54, p=.000; Recall：Mean=7.00/4.27, p=.000). In within-group comparison, IQ and EIQ significantly decreased from the estimated premor-bid level in both groups (IQ：p=.000, EIQ：p=.000), but EIQ decreased more than that of IQ in both groups (Alcoholic：p=.000, TBI：p=.000). Conclusion：This study supports the “frontal lobe hypothesis” and shows that chronic alcoholism could lead to more serious executive function impairment than we expected. Given this condition, concern about the need of cognitive rehabilitation should be increased.