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Frequency and clinicopathological characteristics of alcoholic cerebellar degeneration in Japan: a cross-sectional study of 1,509 postmortems

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Abstract

Alcoholic cerebellar degeneration (ACD) is a pivotal neurological complication in alcoholics. However, although there are a few autopsy reports and some data on its frequency, it is considered very rare in Japan. The aims of this study were (1) to estimate the frequency of the disease in Japanese autopsy cases, and (2) to examine the clinicopathological features of symptomatic and asymptomatic cases of ACD. We reviewed the records of 1,509 Japanese autopsies obtained from three autopsy series in Japan, and selected all 55 cases (3.6%) with alcoholism. On neuropathological reexamination, ACD was confirmed in six male alcoholics [0.4% of all subjects; 10.9% of all alcoholics; mean age at death 59.3±13.4 years (± SD)], including three asymptomatic cases. These frequencies were much lower than some previous Western findings, but more common than that has been expected in Japan. The frequencies of memory impairment and ataxia in ACD cases were significantly higher than those in alcoholics without any alcohol-related pathologies. In ACD cases, loss of Purkinje cells, narrowing of the width of the molecular layer, and tissue rarefaction in the granular layer were observed in the anterior and superior portions of the vermis of the cerebellum. In adjacent regions, the Purkinje cell and molecular layers were more mildly affected. The distribution of severely affected regions was more restricted in the asymptomatic cases than in the symptomatic cases. This study confirmed the frequency of asymptomatic cerebellar degeneration in alcoholics, suggesting that early intervention in alcoholism in the subclinical phase is important to prevent the development of cerebellar symptoms.

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Acknowledgment

We would like to thank Ms. M. Onbe (Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences) and Ms. A. Kajitani (Department of Laboratory Medicine, Zikei Institute of Psychiatry) for collecting clinical information, and Mr. A. Sasaki for help with the creation of the manuscript. This work was supported by a grant in aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology (14570957) and a research grant from the Zikei Institute of Psychiatry.

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Authors and Affiliations

  1. Department of Neuropathology, Tokyo Institute of Psychiatry, Tokyo, Japan

    Osamu Yokota, Kuniaki Tsuchiya & Haruhiko Akiyama

  2. Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, 700-8558, Okayama, Japan

    Osamu Yokota, Seishi Terada & Shigetoshi Kuroda

  3. Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan

    Kuniaki Tsuchiya

  4. Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan

    Kenichi Oshima & Masaaki Matsushita

  5. Department of Laboratory and Medicine, Zikei Institute of Psychiatry, Okayama, Japan

    Hideki Ishizu

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  1. Osamu Yokota
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  2. Kuniaki Tsuchiya
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  3. Seishi Terada
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Correspondence to Osamu Yokota.

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Yokota, O., Tsuchiya, K., Terada, S. et al. Frequency and clinicopathological characteristics of alcoholic cerebellar degeneration in Japan: a cross-sectional study of 1,509 postmortems. Acta Neuropathol 112, 43–51 (2006). https://doi.org/10.1007/s00401-006-0059-7

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