Addiction Alcohol Use How Alcohol Compounds Its Damage to the Brain By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on November 23, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Rafe Swan / Getty Images One effect of chronic alcoholism is the damage that long-term heavy alcohol consumption does to the brain. Certain regions in the brains of alcoholics shrink, creating lesions that result in deficits in brain function. Brain imaging research has shown that the prefrontal cortex (in the front of the brain) and regions of the cerebellum (in the lower back of the brain) are particularly vulnerable to the effects of long-term alcohol abuse. This means that heavy alcohol use over a long period of time will damage regions of the brain that control executive function (the prefrontal cortex) and balance and postural stability (the cerebellum). Alcohol can also cause damage to the white matter of the brain. People with alcohol use disorder who relapse tend to have decreased white matter. Maintained abstinence is associated with increased white matter in certain areas of the brain including the corpus callosum and subcortical white matter. Brain Damage Due to Alcoholism Therefore, chronic alcoholics can progress to the point that they no longer have the ability to walk a straight line even when "sober" or stand on one foot, especially in the dark or when their eyes are closed. Additionally, long-time alcoholics can develop deficits in the executive functioning of their brains, meaning they can demonstrate problems in putting items in order, solving problems, multitasking, and problems with their working memory. Neuroinflammation is also thought to be a key part of the brain changes that occur with alcohol use disorders. Research also suggests that nutritional deficiencies caused by alcohol use can also have an effect on the brain. Scientific studies of the brain damage caused by alcoholism have consistently shown disproportionately greater deficits in executive and balance functions compared with other components of brain function. How Alcohol Damages the Brain Circuitry Also Damaged by Alcohol A Stanford University School of Medicine researcher theorized that the deficits caused by lesions in the prefrontal cortex and the cerebellum are compounded because the circuitry in the brain that the two regions use to communicate with each other is likewise damaged by shrinkage due to alcohol abuse. Information from the frontal cortex of the brain flows through the pons to the cerebellum, while in the meantime, information from the cerebellum flows through the thalamus to the frontal cortex. Previous MRI studies of the brains of alcoholics found significant volume deficits in the cerebellar hemispheres and vermis, pons, and thalamus as well as the prefrontal, frontal, and parietal cortex. How Alcohol Shrinks Brain Circuitry Circuitry Deficits Compound the Problem Research has shown that alcohol use disorder results in circuitry volume deficits. Studies have also shown that the disruption of these brain circuits could compound the deficits produced by shrinkage in the frontal cortex and the cerebellum either by interruption of the circuitry or by abnormalities found in the individual nodes themselves. The cerebellum, through the brain circuitry, could significantly affect the function of the prefrontal cortex, perhaps explaining why a lack of balance in those with alcohol use disorder is a predictor of a loss of executive function. The good news is that other studies have found that the brain shrinkage caused by alcoholism will begin to reverse itself when people stop drinking. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Shanmugarajah PD, Hoggard N, Currie S, et al. Alcohol-related cerebellar degeneration: not all down to toxicity?. Cerebellum Ataxias. 2016;3:17. doi:10.1186/s40673-016-0055-1 Zahr NM, Pfefferbaum A. Alcohol's effects on the brain: neuroimaging results in humans and animal models. Alcohol Res. 2017;38(2):183-206. Houston RJ, Derrick JL, Leonard KE, Testa M, Quigley BM, Kubiak A. Effects of heavy drinking on executive cognitive functioning in a community sample. Addict Behav. 2014;39(1):345–349. doi:10.1016/j.addbeh.2013.09.032 Umhau JC, Schwandt M, Solomon MG, Yuan P, Nugent A, Zarate CA, Drevets WC, Hall SD, George DT, Heilig M. Cerebrospinal fluid monocyte chemoattractant protein-1 in alcoholics: support for a neuroinflammatory model of chronic alcoholism. Alcohol Clin Exp Res. 2014 May;38(5):1301-6. doi: 10.1111/acer.12367 Fama R, Le Berre AP, Hardcastle C, Sassoon SA, Pfefferbaum A, Sullivan EV, Zahr NM. Neurological, nutritional and alcohol consumption factors underlie cognitive and motor deficits in chronic alcoholism. Addict Biol. 2019;24(2):290-302. doi:10.1111/adb.12584 Le Berre AP, Fama R, Sullivan EV. Executive functions, memory, and social cognitive deficits and recovery in chronic alcoholism: a critical review to inform future research. Alcohol Clin Exp Res. 2017;41(8):1432-1443. doi:10.1111/acer.13431 Moulton EA, Elman I, Becerra LR, Goldstein RZ, Borsook D. The cerebellum and addiction: insights gained from neuroimaging research. Addict Biol. 2014;19(3):317–331. doi:10.1111/adb.12101 Fama R, Le Berre AP, Sassoon SA, et al. Relations between cognitive and motor deficits and regional brain volumes in individuals with alcoholism. Brain Struct Funct. 2019;224(6):2087-2101. doi:10.1007/s00429-019-01894-w Additional Reading Bartsch, AJ, et al. "Manifestations of Early Brain Recovery Associated With Abstinence From Alcoholism." Brain December 2006. Mervis, CB, et al. "Visuospatial Construction." Journal of Human Genetics October 1999. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.