to the presence of significant polysubstance use in Groups I-II, while Group III cases had little or no drugs-of-abuse present at death but had significant other comorbid disease and causes of death. A third example was reported in alcoholic cases with liver cirrhosis.26 The presence of cirrhosis, which often follows and compounds long-term heavy alcohol use, impacted brain gene expression to the extent that specific transcriptional patterns from cirrhotic cases were clearly different from those of non-cirrhotic alcoholics. The authors further noted that where similar transcripts were changed in both the cirrhotic and non-cirrhotic cases, these changes were augmented in cirrhotic cases, and suggested this to reflect a further impairment of normal brain function in cirrhotic cases.
