Alcoholic cerebellar degeneration: A clinicopathological study of six Japanese autopsy cases and proposed potential progression pattern in the cerebellar lesion

Osamu Yokota, Kuniaki Tsuchiya, Seishi Terada, Kenichi Oshima, Hideki Ishizu, Masaaki Matsushita, Shigetoshi Kuroda, Haruhiko Akiyama

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Alcoholic cerebellar degeneration (ACD) is one of the most common neurological complications in alcoholics. As far as we know, however, only four Japanese autopsy cases of ACD have been reported, and only limited clinicopathological data on this disease are now available in Japan. The aims of this study were: (i) to examine the clinicopathological correlation of six Japanese autopsy cases of ACD, including three asymptomatic cases; and (ii) to elucidate the pattern of progression of the cerebellar lesion in ACD. All six alcoholics were histopathologically diagnosed as having "pure" ACD without Wernicke's encephalopathy. The characteristics of the topographical distribution of the cerebellar lesion were as follows. Symptomatic cases (cases 1-3) showed more severe and widespread change than asymptomatic cases (cases 4-6). Even in case 6, which had the mildest lesion, the anterior vermis developed a moderate change (Purkinje cell loss and narrowing of the molecular layer). In cases 4 and 5 with more severe and widespread lesions, the superior and posterior vermis and the adjacent regions of the superior hemisphere, including the anterior lobe and simple lobule, were involved. In all symptomatic cases, the anterior superior hemisphere had severe lesions involving the granular cell layer. In contrast to asymptomatic cases, all symptomatic cases also had severe to moderate lesions in the anterior inferior hemisphere. In cases 1 and 2 with the most severe lesions, the moderate to severe changes were distributed in the posterior and inferior portions of both the vermis and hemisphere. These findings suggest that in ACD, severe lesions successively develop: (i) in the anterior superior vermis; (ii) anterior superior hemisphere; (iii) anterior inferior hemisphere; and (iv) anterior inferior vermis. In addition, cerebellar symptoms may frequently occur if the anterior superior hemisphere and anterior inferior hemisphere, in addition to the anterior superior vermis, are involved.

Original languageEnglish
Pages (from-to)99-113
Number of pages15
JournalNeuropathology
Volume27
Issue number2
DOIs
Publication statusPublished - Apr 2007

Keywords

  • Alcohol
  • Alcohol dependence
  • Asymptomatic
  • Cerebellar degeneration

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology

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