Study Expands Understanding of Alcoholic Memory Disorder

New research finds that deficiencies in the hippocampus play a key role in alcoholism-related Korsakoff’s syndrome, a memory disorder. The deficiencies are comparable to those found in the brains of Alzheimer’s disease, according to a study published in the December 23 issue of Neurology, the scientific journal of the American Academy of Neurology.

Researchers used MRI to compare the brains of five men with alcoholic Korsakoff’s syndrome to 20 men with Alzheimer’s disease and 36 healthy men. The brains of all Korsakoff’s patients and Alzheimer’s patients were comparable in significant volume loss in the hippocampus, which plays an important role in memory functions. Greater hippocampal damage was correlated to a higher memory deterioration index score for the Korsakoff’s patients. The study authors also reported a similar correlation in Alzheimer’s patients, where poor memory performance correlated with smaller hippocampal size.

“Awareness of the clinical and radiological similarities between Korsakoff’s syndrome and Alzheimer’s disease may help with the detection of each,” said study author Edith V. Sullivan, PhD, of Stanford University School of Medicine in Stanford, Calif. “Although controversial, we believe that the nature of the memory impairment in these disorders is the same, while their overall profiles are different.”

The amnesia of alcoholic Korsakoff’s syndrome was long believed to be rooted in the thalamus (relay center for impulses) and other deep structures of the brain. The Korsakoff’s patients in the study had twice the hippocampal damage previously observed in alcoholics without amnesia. This suggests that a threshold may need to be crossed before memory impairment can be detected, noted Sullivan.

Resulting from a lack of thiamine (vitamin B1), Korsakoff’s syndrome is typically a consequence of chronic alcohol dependence. Individuals at risk include those with nutritional deficiency disorders like anorexia. The nutrient thiamine helps restore certain brain functions like recalling past events and storing new information.

Current treatment of Korsakoff’s patients includes thiamine and other B-complex vitamins. If treated early enough, Korsakoff’s patients may have at least partial recovery, according to Sullivan.

“It would be important for clinicians who diagnose and treat dementia disorders to consider Korsakoff’s syndrome in their diagnoses,” said Sullivan. “It is also important to inquire about alcohol consumption and diet, bearing in mind the potential of denial and inaccuracies in history such patients may provide.”

The study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Aging.

The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, autism and multiple sclerosis.

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Marilee Reu AAN

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