Neurotoxic mechanisms of alcohol and their relationship with neurodegenerative diseases: a literature review

Excessive and prolonged alcohol consumption constitutes a major public health problem and is associated with various systemic and neurological consequences. The objective of this work is to analyze the relationship between chronic alcohol consumption and the development of neurological alterations and neurodegenerative processes, with emphasis on the cellular and molecular mechanisms involved. This is a descriptive literature review conducted in the PubMed database, prioritizing publications between 2020 and 2026, as well as earlier studies considered relevant to establishing the background of the topic. Descriptors related to alcohol consumption, the central nervous system, neurotoxicity, neurodegeneration, and cognitive impairment were used, combined using the Boolean operators AND and OR. The analysis of the literature demonstrated that chronic alcohol exposure is associated with alterations in neurotransmission, neuroinflammation, oxidative stress, mitochondrial dysfunction, and blood–brain barrier impairment, as well as structural alterations in gray and white matter. These mechanisms may contribute to neuronal injury, deficits in memory, attention, and executive functions, as well as increase brain vulnerability to neurodegenerative processes. Recent evidence also indicates an association between heavy alcohol consumption and a higher risk of cognitive impairment and dementia, including Alzheimer's disease and vascular dementia. Thus, chronic and excessive alcohol consumption may be considered an important modifiable factor associated with brain damage and cognitive impairment, reinforcing the need for strategies for prevention, harm reduction, and early identification of neurological alterations related to its use.