Brain damage assessment in chronic alcoholics on early-stage recovery by Lacks' adaptation of Bender's Visual Motor Gestalt Test.

It is now established that heavy alcohol intake lasting for more than 10-15 years may lead to a dramatic impairment of brain function, as in severe alcohol related pathologies, like liver cirrhosis. It is common opinion, however, that mild impairment of the cognitive functions can be of detoxification, as a consequence above all of alcohol neurotoxicity. In this study, in a series of alcoholics on early stage abstinence from alcohol, brain damage was assessed by Bender's Visual Motor Gestal Test (BVMGT) as a clinical tool for sampling visual-motor proficiency, and as a standard projective technique in the assessment of personality. According to Lacks' specific adaptation, 12 parameters (standardized "errors") were evaluated, as well as some standardized behavioral observations allowing a discrimination between patients with brain organic damage and with psychosis. The cut-off between organic and non-organic patients was set at five errors. The patients were tested on the first days of treatment, to assess the possibility of obtaining a test suitable for diagnosis and for the choice of treatment at such an early stage. According to Lacks' adaption and interpretation of BVMGT, our series was split into two subsets, <5 and ≥5 cumulative error score: only 77 patients out of 187 were in the ≥5 subset of organic brain damaged patients. The heterogeneity of our total sample for organic damage was confirmed by the cumulative score, 4.24 ± 1.62, showing a high dispersion of individual data. According to Abbate and Ferracuti, patients affected by different diseases (organic brain damage, schizophrenia, personality disorders) could be discriminated by the percent distribution of errors. In our series of chronic alcoholics, a characteristic feature is very high score for closure difficulty (85%) and for cohesion (73%); while closure difficulty is very high score in all subjects in Abbate and Ferracuti's study, the score of cohesion was low in all their groups. Thus the presence of high score only for closure difficulty and cohesion could suggest a diagnosis of alcoholism. This hypothesis, however, must be confirmed by a validation of BVMGT versus referece tests for the diagnosis of alcoholism(at present, this research is in progress in our Center).