Biological differences in alcohol metabolism have been thought to contribute to a “telescoping effect” whereby women experience more severe consequences within a shorter timeframe (Brady and Randall, 1999; Randall et al., 1999). Studies have found that alcoholic cirrhosis develops after shorter drinking duration, accompanies lower levels of consumption, and progresses more quickly in women than men (Saunders et al., 1981). Yet controversy exists over a telescoping effect specific to alcohol-related brain damage (Hommer, 2003). Jacobson (1986) reported that alcohol-dependent women with shorter duration of dependence and lower estimated intake than their male counterparts had comparable brain atrophy on CT scan, a finding that persisted even in subsets matched on age and duration of dependence. A recent CT study also demonstrated a similar extent of brain atrophy in alcohol-dependent women and men, even though average duration of dependence in women was about half that reported by men (Mann et al., 2005). This study closely replicated the results of an earlier CT study on an independent sample (Mann et al., 1992). However, other studies have found lesser damage in women even when controlling for or matching gender groups on intake and duration (Pfefferbaum et al., 2006; Sullivan et al., 2010).
