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Ulasoglu-Yildiz C, Yildirim Z, Myers CE, Gluck MA, Gurvit H. Altered learning and transfer abilities in Korsakoff's syndrome depending on task complexity. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-13. [PMID: 37243624 DOI: 10.1080/23279095.2023.2217975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Korsakoff's syndrome (KS) is characterized by episodic memory impairment due to damage to the medial diencephalic structures. Although commonly associated with chronic alcoholism, starvation due to the hunger strike is one of its nonalcoholic causes. Learning the stimulus-response associations and transferring the just-learned associations to novel combinations were previously tested by specific tasks in memory-impaired patients with hippocampal, basal forebrain, and basal ganglia damage. To add to this previous research, we aimed to use the same tasks in a group of patients with hunger strike-related KS presenting a stable isolated amnestic profile. Twelve patients with hunger strike-related KS and matched healthy controls were tested in two tasks varying in task complexity. Each task included two phases: the initial phase is feedback-based learning of (simple vs. complex) stimulus-response associations, and the following phase is transfer generalization (in the presence vs. absence of feedback). On a task involving simple associations, five patients with KS failed to learn the associations, while the other seven patients showed intact learning and transfer. On the other task involving more complex associations, seven patients showed slower learning and failed at transfer generalization, whereas the other five patients failed even at the acquisition phase. These findings of a task-complexity-related impairment on associative learning and transfer represent a distinct pattern from the spared learning but impaired transfer previously observed on these tasks in patients with medial temporal lobe amnesia.
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Affiliation(s)
- Cigdem Ulasoglu-Yildiz
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
- Hulusi Behcet Life Sciences Research Laboratory, Neuroscience Unit, Istanbul University, Istanbul, Turkey
| | - Zerrin Yildirim
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Catherine E Myers
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | - Mark A Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Hakan Gurvit
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Oudman E, Schut MJ, Ten Brink AF, Postma A, Van der Stigchel S. Visual working memory capacity in Korsakoff's amnesia. J Clin Exp Neuropsychol 2020; 42:363-370. [PMID: 32028852 DOI: 10.1080/13803395.2020.1722800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Despite the interest in memory functioning in Korsakoff's syndrome (KS), visual working memory capacity in KS is still poorly understood. Results from the last decades on working memory limitations in KS appear to be mixed, clearly calling for further investigations.Method: We investigated visual working memory storage capacity of patients diagnosed with KS using a change detection paradigm. Nine patients diagnosed with KS and thirty age- and education- matched healthy controls were presented twice with 2, 3, 4, or 6 bars with different orientations and had to detect whether the orientation of the target bar had changed.Results: As a group, KS patients performed significantly worse than controls on all set sizes, with an average capacity of 1.13 items, compared to 1.75 items in the control participants. In case study analysis, 4 out of 9 patients performed significantly worse than control participants, while 5 had relatively intact visual working memory capacity. In patients, deficits in visual working memory could not be explained by other cognitive deficits.Conclusion: Based on these results, we conclude that visual working memory deficits are a prominent characteristic in some, but not all KS patients. Training visual working memory capacity could possibly optimize other cognitive difficulties in this population.
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Affiliation(s)
- Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Korsakoff Center Slingedael, Lelie Care Group, Rotterdam, The Netherlands
| | - Martijn J Schut
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Antonia F Ten Brink
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Department of Psychology, University of Bath, Bath, UK
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Korsakoff Center Slingedael, Lelie Care Group, Rotterdam, The Netherlands
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Hunt RR, Smith RE, Toth JP. Category cued recall evokes a generate-recognize retrieval process. J Exp Psychol Learn Mem Cogn 2016; 42:339-50. [PMID: 26280355 PMCID: PMC4757519 DOI: 10.1037/xlm0000136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The experiments reported here were designed to replicate and extend McCabe, Roediger, and Karpicke's (2011) finding that retrieval in category cued recall involves both controlled and automatic processes. The extension entailed identifying whether distinctive encoding affected 1 or both of these 2 processes. The first experiment successfully replicated McCabe et al., but the second, which added a critical baseline condition, produced data inconsistent with a 2 independent process model of recall. The third experiment provided evidence that retrieval in category cued recall reflects a generate-recognize strategy, with the effect of distinctive processing being localized to recognition. Overall, the data suggest that category cued recall evokes a generate-recognize retrieval strategy and that the subprocesses underlying this strategy can be dissociated as a function of distinctive versus relational encoding processes.
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Affiliation(s)
- R Reed Hunt
- Department of Psychology, The University of Texas at San Antonio
| | - Rebekah E Smith
- Department of Psychology, The University of Texas at San Antonio
| | - Jeffrey P Toth
- Department of Psychology, The University of North Carolina at Wilmington
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Brion M, Pitel AL, Beaunieux H, Maurage P. Revisiting the continuum hypothesis: toward an in-depth exploration of executive functions in korsakoff syndrome. Front Hum Neurosci 2014; 8:498. [PMID: 25071526 PMCID: PMC4081760 DOI: 10.3389/fnhum.2014.00498] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022] Open
Abstract
Korsakoff syndrome (KS) is a neurological state mostly caused by alcohol-dependence and leading to disproportionate episodic memory deficits. KS patients present more severe anterograde amnesia than Alcohol-Dependent Subjects (ADS), which led to the continuum hypothesis postulating a progressive increase in brain and cognitive damages during the evolution from ADS to KS. This hypothesis has been extensively examined for memory but is still debated for other abilities, notably executive functions (EF). EF have up to now been explored by unspecific tasks in KS, and few studies explored their interactions with memory. Exploring EF in KS by specific tasks based on current EF models could thus renew the exploration of the continuum hypothesis. This paper will propose a research program aiming at: (1) clarifying the extent of executive dysfunctions in KS by tasks focusing on specific EF subcomponents; (2) determining the differential EF deficits in ADS and KS; (3) exploring EF-memory interactions in KS with innovative tasks. At the fundamental level, this exploration will test the continuum hypothesis beyond memory. At the clinical level, it will propose new rehabilitation tools focusing on the EF specifically impaired in KS.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Anne-Lise Pitel
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Hélène Beaunieux
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
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Oudman E, Nijboer TCW, Postma A, Wijnia JW, Kerklaan S, Lindsen K, Van der Stigchel S. Acquisition of an instrumental activity of daily living in patients with Korsakoff's syndrome: a comparison of trial and error and errorless learning. Neuropsychol Rehabil 2013; 23:888-913. [PMID: 24047431 DOI: 10.1080/09602011.2013.835738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with Korsakoff's syndrome show devastating amnesia and executive deficits. Consequently, the ability to perform instrumental activities such as making coffee is frequently diminished. It is currently unknown whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities. A good candidate for an effective teaching technique in Korsakoff's syndrome is errorless learning as it is based on intact implicit memory functioning. Therefore, the aim of the current study was two-fold: to investigate whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities, and to compare the effectiveness of errorless learning with trial and error learning in the acquisition and maintenance of an instrumental activity, namely using a washing machine to do the laundry. Whereas initial learning performance in the errorless learning condition was superior, both intervention techniques resulted in similar improvement over eight learning sessions. Moreover, performance in a different spatial layout showed a comparable improvement. Notably, in follow-up sessions starting after four weeks without practice, performance was still elevated in the errorless learning condition, but not in the trial and error condition. The current study demonstrates that (re)learning and maintenance of an instrumental activity is possible in patients with Korsakoff's syndrome.
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Affiliation(s)
- Erik Oudman
- a Helmholtz Institute, Experimental Psychology , Utrecht University , Utrecht , The Netherlands
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Van der Stigchel S, Reichenbach RCL, Wester AJ, Nijboer TCW. Antisaccade performance in Korsakoff patients reveals deficits in oculomotor inhibition. J Clin Exp Neuropsychol 2012; 34:876-86. [DOI: 10.1080/13803395.2012.692771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fama R, Pitel AL, Sullivan EV. Anterograde episodic memory in Korsakoff syndrome. Neuropsychol Rev 2012; 22:93-104. [PMID: 22644546 PMCID: PMC4724416 DOI: 10.1007/s11065-012-9207-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 05/09/2012] [Indexed: 12/22/2022]
Abstract
A profound anterograde memory deficit for information, regardless of the nature of the material, is the hallmark of Korsakoff syndrome, an amnesic condition resulting from severe thiamine (vitamin B1) deficiency. Since the late nineteenth century when the Russian physician, S. S. Korsakoff, initially described this syndrome associated with "polyneuropathy," the observed global amnesia has been a primary focus of neuroscience and neuropsychology. In this review we highlight the historical studies that examined anterograde episodic memory processes in KS, present a timeline and evidence supporting the myriad theories proffered to account for this memory dysfunction, and summarize what is known about the neuroanatomical correlates and neural systems presumed affected in KS. Rigorous study of KS amnesia and associated memory disorders of other etiologies provide evidence for distinct mnemonic component processes and neural networks imperative for normal declarative and nondeclarative memory abilities and for mnemonic processes spared in KS, from whence emerged the appreciation that memory is not a unitary function. Debate continues regarding the qualitative and quantitative differences between KS and other amnesias and what brain regions and neural pathways are necessary and sufficient to produce KS amnesia.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA 94305-5723, USA.
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Jung YC, Chanraud S, Sullivan EV. Neuroimaging of Wernicke's encephalopathy and Korsakoff's syndrome. Neuropsychol Rev 2012; 22:170-80. [PMID: 22577003 PMCID: PMC4728174 DOI: 10.1007/s11065-012-9203-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 04/23/2012] [Indexed: 11/27/2022]
Abstract
There is considerable evidence that neuroimaging findings can improve the early diagnosis of Wernicke's encephalopathy (WE) in clinical settings. The most distinctive neuroimaging finding of acute WE are cytotoxic edema and vasogenic edema, which are represented by bilateral symmetric hyperintensity alterations on T2-weighted MR images in the periphery of the third ventricle, periaqueductal area, mammillary bodies and midbrain tectal plate. An initial bout of WE can result in Korsakoff's syndrome (KS), but repeated bouts in conjunction with its typical comorbidity, chronic alcoholism, can result in signs of tissue degeneration in vulnerable brain regions. Chronic abnormalities identified with neuroimaging enable examination of brain damage in living patients with KS and have expanded the understanding of the neuropsychological deficits resulting from thiamine deficiency, alcohol neurotoxicity, and their comorbidity. Brain structure and functional studies indicate that the interactions involving the thalamus, mammillary bodies, hippocampus, frontal lobes, and cerebellum are crucial for memory formation and executive functions, and the interruption of these circuits by WE and chronic alcoholism can contribute substantially to the neuropsychological deficits in KS.
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Affiliation(s)
- Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea.
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Hayes SM, Fortier CB, Levine A, Milberg WP, McGlinchey R. Implicit memory in Korsakoff's syndrome: a review of procedural learning and priming studies. Neuropsychol Rev 2012; 22:132-53. [PMID: 22592661 PMCID: PMC3955262 DOI: 10.1007/s11065-012-9204-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
Abstract
Korsakoff's syndrome (KS) is characterized by dense anterograde amnesia resulting from damage to the diencephalon region, typically resulting from chronic alcohol abuse and thiamine deficiency. This review assesses the integrity of the implicit memory system in KS, focusing on studies of procedural learning and priming. KS patients are impaired on several measures of procedural memory, most likely due to impairment in cognitive functions associated with alcohol-related neural damage outside of the diencephalon. The pattern of performance on tasks of implicit priming suggests reliance on a residual, non-flexible memory operating more or less in an automatic fashion. Our review concludes that whether measures of implicit memory reveal intact or impaired performance in individuals with KS depends heavily on specific task parameters and demands, including timing between stimuli, the specific nature of the stimuli used in a task, and the integrity of supportive cognitive functions necessary for performance.
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Affiliation(s)
- Scott M Hayes
- Memory Disorders Research Center, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA.
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10
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Abstract
Memory for contextual information and target-context integration are crucial for successful episodic memory formation and are impaired in patients with Korsakoff's syndrome. In this paper we review the evidence for the notion that a context memory deficit makes an important contribution to the amnesia in these patients. First, we focus on anterograde memory for contextual (spatial and temporal) information. Next, the use of contextual cues in memory retrieval is examined and their role in retrograde amnesia and confabulation. Evidence on the role of contextual cues and associations in working memory is discussed in relation to the underlying neurocognitive mechanisms and their dissociation from long-term encoding. Finally, we focus on implicit learning of contextual information in Korsakoff patients. It can be concluded that Korsakoff patients are impaired in the explicit processing of contextual information and in target-context binding, both in long-term (retrograde and anterograde) memory and in working memory. These results extend the context memory deficit hypothesis. In contrast, implicit contextual learning is relatively preserved in these patients. These findings are discussed in relation to evidence of dysfunction of the extended diencephalic-hippocampal memory circuit in Korsakoff's syndrome.
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Affiliation(s)
- Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Korsakoff Clinic, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Michael D. Kopelman
- King’s College London, Institute of Psychiatry, Division of Psychological Medicine, Neuropsychiatry and Memory Disorders Clinic, Academic Unit of Neuropsychiatry, 3rd Floor Adamson Centre, South Wing, St. Thomas’s Hospital, Lambeth Palace Road, London, SE1 7EH UK
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Vetreno RP, Hall JM, Savage LM. Alcohol-related amnesia and dementia: animal models have revealed the contributions of different etiological factors on neuropathology, neurochemical dysfunction and cognitive impairment. Neurobiol Learn Mem 2011; 96:596-608. [PMID: 21256970 PMCID: PMC3086968 DOI: 10.1016/j.nlm.2011.01.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 11/09/2010] [Accepted: 01/04/2011] [Indexed: 12/21/2022]
Abstract
Chronic alcoholism is associated with impaired cognitive functioning. Over 75% of autopsied chronic alcoholics have significant brain damage and over 50% of detoxified alcoholics display some degree of learning and memory impairment. However, the relative contributions of different etiological factors to the development of alcohol-related neuropathology and cognitive impairment are questioned. One reason for this quandary is that both alcohol toxicity and thiamine deficiency result in brain damage and cognitive problems. Two alcohol-related neurological disorders, alcohol-associated dementia and Wernicke-Korsakoff syndrome have been modeled in rodents. These pre-clinical models have elucidated the relative contributions of ethanol toxicity and thiamine deficiency to the development of dementia and amnesia. What is observed in these models--from repeated and chronic ethanol exposure to thiamine deficiency--is a progression of both neural and cognitive dysregulation. Repeated binge exposure to ethanol leads to changes in neural plasticity by reducing GABAergic inhibition and facilitating glutamatergic excitation, long-term chronic ethanol exposure results in hippocampal and cortical cell loss as well as reduced hippocampal neurotrophin protein content critical for neural survival, and thiamine deficiency results in gross pathological lesions in the diencephalon, reduced neurotrophic protein levels, and neurotransmitters levels in the hippocampus and cortex. Behaviorally, after recovery from repeated or chronic ethanol exposure there is impairment in working or episodic memory that can recover with prolonged abstinence. In contrast, after thiamine deficiency there is severe and persistent spatial memory impairments and increased perseverative behavior. The interaction between ethanol and thiamine deficiency does not produce more behavioral or neural pathology, with the exception of reduction of white matter, than long-term thiamine deficiency alone.
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Affiliation(s)
- Ryan P. Vetreno
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Joseph M. Hall
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Lisa M. Savage
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
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Oudman E, Van der Stigchel S, Wester AJ, Kessels RP, Postma A. Intact memory for implicit contextual information in Korsakoff's amnesia. Neuropsychologia 2011; 49:2848-55. [DOI: 10.1016/j.neuropsychologia.2011.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 06/06/2011] [Accepted: 06/08/2011] [Indexed: 10/18/2022]
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Damme I, d'Ydewalle G. Confabulation versus experimentally induced false memories in Korsakoff patients. J Neuropsychol 2010; 4:211-30. [DOI: 10.1348/174866409x478231] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Van Damme I, Menten J, d'Ydewalle G. The effect of articulatory suppression on implicit and explicit false memory in the DRM paradigm. Memory 2010; 18:822-30. [PMID: 20924945 DOI: 10.1080/09658211.2010.509733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Several studies have shown that reliable implicit false memory can be obtained in the DRM paradigm. There has been considerable debate, however, about whether or not conscious activation of critical lures during study is a necessary condition for this. Recent findings have revealed that articulatory suppression prevents subsequent false priming in an anagram task (Lovden & Johansson, 2003). The present experiment sought to replicate and extend these findings to an implicit word stem completion task, and to additionally investigate the effect of articulatory suppression on explicit false memory. Results showed an inhibitory effect of articulatory suppression on veridical memory, as well as on implicit false memory, whereas the level of explicit false memory was heightened. This suggests that articulatory suppression did not merely eliminate conscious lure activation, but had a more general capacity-delimiting effect. The drop in veridical memory can be attributed to diminished encoding of item-specific information. Superficial encoding also limited the spreading of semantic activation during study, which inhibited later false priming. In addition, the lack of item-specific and phenomenological details caused impaired source monitoring at test, resulting in heightened explicit false memory.
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Van Damme I, d'Ydewalle G. Incidental versus intentional encoding in the Deese–Roediger–McDermott paradigm: Does amnesic patients' implicit false memory depend on conscious activation of the lure? J Clin Exp Neuropsychol 2009; 32:536-54. [DOI: 10.1080/13803390903310990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Damme IV, d'Ydewalle G. Memory loss versus memory distortion: The role of encoding and retrieval deficits in Korsakoff patients’ false memories. Memory 2009; 17:349-66. [DOI: 10.1080/09658210802680349] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Do amnesic patients with Korsakoff’s syndrome use feedback when making decisions under risky conditions? An experimental investigation with the Game of Dice Task with and without feedback. Brain Cogn 2009; 69:279-90. [DOI: 10.1016/j.bandc.2008.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 07/26/2008] [Accepted: 08/01/2008] [Indexed: 11/24/2022]
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Kopelman MD, Thomson AD, Guerrini I, Marshall EJ. The Korsakoff syndrome: clinical aspects, psychology and treatment. Alcohol Alcohol 2009; 44:148-54. [PMID: 19151162 DOI: 10.1093/alcalc/agn118] [Citation(s) in RCA: 256] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS The Korsakoff syndrome is a preventable memory disorder that usually emerges (although not always) in the aftermath of an episode of Wernicke's encephalopathy. The present paper reviews the clinical and scientific literature on this disorder. METHODS A systematic review of the clinical and scientific literature on Wernicke's encephalopathy and the alcoholic Korsakoff syndrome. RESULTS The Korsakoff syndrome is most commonly associated with chronic alcohol misuse, and some heavy drinkers may have a genetic predisposition to developing the syndrome. The characteristic neuropathology includes neuronal loss, micro-haemorrhages and gliosis in the paraventricular and peri-aqueductal grey matter. Lesions in the mammillary bodies, the mammillo-thalamic tract and the anterior thalamus may be more important to memory dysfunction than lesions in the medial dorsal nucleus of the thalamus. Episodic memory is severely affected in the Korsakoff syndrome, and the learning of new semantic memories is variably affected. 'Implicit' aspects of memory are preserved. These patients are often first encountered in general hospital settings where they can occupy acute medical beds for lengthy periods. Abstinence is the cornerstone of any rehabilitation programme. Korsakoff patients are capable of new learning, particularly if they live in a calm and well-structured environment and if new information is cued. There are few long-term follow-up studies, but these patients are reported to have a normal life expectancy if they remain abstinent from alcohol. CONCLUSIONS Although we now have substantial knowledge about the nature of this disorder, scientific questions (e.g. regarding the underlying genetics) remain. More particularly, there is a dearth of appropriate long-term care facilities for these patients, given that empirical research has shown that good practice has beneficial effects.
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Pitel AL, Beaunieux H, Witkowski T, Vabret F, de la Sayette V, Viader F, Desgranges B, Eustache F. Episodic and Working Memory Deficits in Alcoholic Korsakoff Patients: The Continuity Theory Revisited. Alcohol Clin Exp Res 2008; 32:1229-41. [DOI: 10.1111/j.1530-0277.2008.00677.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Elaborative processing in the Korsakoff syndrome: Context versus habit. Brain Cogn 2008; 67:212-24. [DOI: 10.1016/j.bandc.2008.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 01/17/2008] [Accepted: 01/18/2008] [Indexed: 11/18/2022]
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