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Vlot N, Postma A, Oudman E. When Do Korsakoff Patients Justify Immoral Behaviors? The Influence of Premorbid Delinquency and Self-Other Perspectives in Moral Decision-Making and Moral Reasoning. J Clin Med 2023; 12:6257. [PMID: 37834901 PMCID: PMC10573903 DOI: 10.3390/jcm12196257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Korsakoff's syndrome (KS) is a chronic neuropsychiatric disorder caused by a vitamin B1 deficiency. KS is characterized by profound amnesia and often accompanied by poor executive functioning, decreased social-cognitive abilities, and difficulties in behavioral regulation. As moral behaviors and attitudes may provide insight in socio-behavioral interactions, the current study aimed to evaluate everyday moral maturity by administering self- versus other-oriented moral dilemmas in a group of KS patients (n = 20) and healthy controls (n = 20). Responses were scored according to the Kohlberg stages of moral reasoning. Furthermore, we assessed premorbid delinquency and current neurocognitive functioning as possible relevant factors. Our results show that KS patients were prone to lower levels of moral maturity when confronted with moral dilemmas relating to themselves, compared to dilemmas relating to (un)personal others in KS patients, while healthy subjects showed an opposite pattern. Moral immaturity could find its origin already before the onset of the KS diagnosis, as suggested by the elevated premorbid levels of delinquent behavior and correlation between premorbid delinquency and moral maturity in KS. Lower moral maturity could therefore be a possible predisposing factor to both delinquency and later development of Korsakoff's syndrome.
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Affiliation(s)
- Nairobi Vlot
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
| | - Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
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El Haj M, Moustafa AA. "Ten dollars today or 50 dollars after one month?" Temporal discounting in Korsakoff syndrome. Cogn Neuropsychiatry 2023; 28:116-129. [PMID: 36724487 DOI: 10.1080/13546805.2023.2173059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Little research has investigated decision making in patients with Korsakoff syndrome (KS). Specifically, to our knowledge, there is a lack of research investigating whether patients with KS may tend to prefer immediate over future rewards (i.e., temporal discounting). Further, we investigated the relationship between temporal discounting and inhibition. METHODS We, for the first time, invited patients with KS and control participants to perform a temporal discounting task, in which they answered questions probing preferences between an immediate, but smaller amount of money, and a delayed, but larger amount of money (e.g., "would you prefer 10 dollars today or 50 dollars after one month?"). Furthermore, inhibition was measured using the Stroop Colour Word Test. RESULTS Analysis demonstrated higher temporal discounting in patients with KS than in control participants. Temporal discounting in both populations was significantly correlated with inhibition. CONCLUSIONS Patients with KS may have difficulties to suppress the temptation of smaller, but immediate, rewards.
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Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers Nantes, France
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
- Institut Universitaire de France, Paris, France
| | - Ahmed A Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Australia
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Exploring episodic and semantic contributions to past and future thinking performance in Korsakoff's syndrome. Mem Cognit 2022; 50:630-640. [PMID: 35084717 DOI: 10.3758/s13421-021-01262-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/08/2022]
Abstract
Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterized by severe declarative memory disruption. While episodic memory deficits and confabulation are well documented, it remains unclear to what extent semantic memory is compromised in this syndrome. Moreover, how such impairments relate to the capacity for future-oriented thinking remains unknown. Here, we sought to determine the extent to which episodic and semantic forms of past and future thinking are impacted in KS and the interrelationship between different classes of memory in this syndrome. Twenty patients with KS and 17 matched healthy controls took part in this study. We included well-established indices of past and future thinking capacity, enabling us to compare episodic (event-based) versus semantic (nonpersonal knowledge) across past and future conditions. We also included a novel event generation task to probe implausible event simulation (i.e., spending a day on the moon). Our findings revealed marked impairments in KS across all forms of past and future thinking, as well as the generation of episodic details on the implausible event simulation task. Correlation analyses revealed significant associations between implausible event construction and episodic and semantic future thinking in KS; however, no significant associations were found between future thinking performance and confabulation. This study is the first, to our knowledge, to reveal striking impairments in the capacity for past and future thinking across episodic and semantic domains in KS. Our findings resonate with current theoretical perspectives in which the lines between episodic and semantic memory systems are viewed as increasingly blurred.
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El Haj M. Autobiographical memory in Korsakoff syndrome: A review. Encephale 2021; 47:356-361. [PMID: 33832714 DOI: 10.1016/j.encep.2020.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
Autobiographical memory (AM) (i.e., memory for personal information) is a unique form of memory that goes beyond recalling information such as what, where and when of an event, to include what that event means and why it is important to our life story. This paper therefore reviews the available literature on AM in Korsakoff syndrome (KS). It summarizes the characteristics of AM disorders in KS patients. These disorders are mainly characterized by the difficulties that patients with KS have in retrieving and reliving specific AMs and in retrieving recent and remote memories. Another core characteristic of AM disorders in KS is confabulations. This paper hypothesizes that patients with KS may produce autobiographical confabulations to support their objectives and beliefs or even to answer a social demand or simply to share personal experiences with others. Although the current evidence demonstrates disorders of AM in KS, there is a need for more research about the characteristics of these disorders. This review thus proposes several perspectives for theoretical and clinical research.
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Affiliation(s)
- M El Haj
- Nantes Université, University Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), 44000 Nantes, France; Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France; Institut Universitaire de France, Paris, France.
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El Haj M, Nandrino JL, Kessels RPC, Ndobo A. High emotional experience during autobiographical retrieval in women with Korsakoff syndrome. Cogn Neuropsychiatry 2021; 26:136-148. [PMID: 33563089 DOI: 10.1080/13546805.2021.1885369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In this exploratory study, we investigated gender differences regarding autobiographical memory in KS. METHOD We invited 33 patients with KS and 35 matched control participants to retrieve autobiographical memories and, afterward, to rate mental time travel during retrieval, emotional value and importance of memories. RESULTS Analysis demonstrated lower specificity (i.e., lower ability to retrieve memories situated in a specific time and space), mental time travel, and importance in patients with KS compared to control participants. Analysis also demonstrated no significant difference between patients with KS and control participants regarding emotion. Critically, analysis demonstrated no significant differences neither women and men with KS, nor between women and men in the control group, regarding autobiographical specificity, mental time travel, or importance. However, women with KS attributed higher emotional value for memories compared to men with KS, and the same results were observed in the control group. DISCUSSION These findings demonstrate that the higher emotional experience during autobiographical retrieval, as observed in the general population, can also be observed in KS.
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Affiliation(s)
- Mohamad El Haj
- Faculté de Psychologie, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Université d'Angers, Nantes, France.,Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France.,Institut Universitaire de France, Paris, France
| | - Jean-Louis Nandrino
- UMR 9193 SCALab - Sciences Cognitives et Sciences Affectives, Université de Lille, CNRS, CHU Lille, Lille, France
| | - Roy P C Kessels
- Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - André Ndobo
- Faculté de Psychologie, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Université d'Angers, Nantes, France
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Electrophysiological correlates of emotional crossmodal processing in binge drinking. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:1076-1088. [PMID: 30094563 DOI: 10.3758/s13415-018-0623-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Emotional crossmodal integration (i.e., multisensorial decoding of emotions) is a crucial process that ensures adaptive social behaviors and responses to the environment. Recent evidence suggests that in binge drinking-an excessive alcohol consumption pattern associated with psychological and cerebral deficits-crossmodal integration is preserved at the behavioral level. Although some studies have suggested brain modifications during affective processing in binge drinking, nothing is known about the cerebral correlates of crossmodal integration. In the current study, we asked 53 university students (17 binge drinkers, 17 moderate drinkers, 19 nondrinkers) to perform an emotional crossmodal task while their behavioral and neurophysiological responses were recorded. Participants had to identify happiness and anger in three conditions (unimodal, crossmodal congruent, crossmodal incongruent) and two modalities (face and/or voice). Binge drinkers did not significantly differ from moderate drinkers and nondrinkers at the behavioral level. However, widespread cerebral modifications were found at perceptual (N100) and mainly at decisional (P3b) stages in binge drinkers, indexed by slower brain processing and stronger activity. These cerebral modifications were mostly related to anger processing and crossmodal integration. This study highlights higher electrophysiological activity in the absence of behavioral deficits, which could index a potential compensation process in binge drinkers. In line with results found in severe alcohol-use disorders, these electrophysiological findings show modified anger processing, which might have a deleterious impact on social functioning. Moreover, this study suggests impaired crossmodal integration at early stages of alcohol-related disorders.
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Heirene R, John B, Roderique-Davies G. Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review. Front Psychol 2018; 9:2618. [PMID: 30619013 PMCID: PMC6305333 DOI: 10.3389/fpsyg.2018.02618] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/05/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population. Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings. Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation. Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.
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Affiliation(s)
- Robert Heirene
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, United Kingdom
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El Haj M, Nandrino JL. Phenomenological characteristics of autobiographical memory in Korsakoff’s syndrome. Conscious Cogn 2017; 55:188-196. [PMID: 28886469 DOI: 10.1016/j.concog.2017.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/25/2017] [Accepted: 08/25/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Mohamad El Haj
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France.
| | - Jean-Louis Nandrino
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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Brion M, D'Hondt F, Lannoy S, Pitel AL, Davidoff DA, Maurage P. Crossmodal processing of emotions in alcohol-dependence and Korsakoff syndrome. Cogn Neuropsychiatry 2017; 22:436-451. [PMID: 28885888 DOI: 10.1080/13546805.2017.1373639] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Decoding emotional information from faces and voices is crucial for efficient interpersonal communication. Emotional decoding deficits have been found in alcohol-dependence (ALC), particularly in crossmodal situations (with simultaneous stimulations from different modalities), but are still underexplored in Korsakoff syndrome (KS). The aim of this study is to determine whether the continuity hypothesis, postulating a gradual worsening of cognitive and brain impairments from ALC to KS, is valid for emotional crossmodal processing. METHODS Sixteen KS, 17 ALC and 19 matched healthy controls (CP) had to detect the emotion (anger or happiness) displayed by auditory, visual or crossmodal auditory-visual stimuli. Crossmodal stimuli were either emotionally congruent (leading to a facilitation effect, i.e. enhanced performance for crossmodal condition compared to unimodal ones) or incongruent (leading to an interference effect, i.e. decreased performance for crossmodal condition due to discordant information across modalities). Reaction times and accuracy were recorded. RESULTS Crossmodal integration for congruent information was dampened only in ALC, while both ALC and KS demonstrated, compared to CP, decreased performance for decoding emotional facial expressions in the incongruent condition. CONCLUSIONS The crossmodal integration appears impaired in ALC but preserved in KS. Both alcohol-related disorders present an increased interference effect. These results show the interest of more ecological designs, using crossmodal stimuli, to explore emotional decoding in alcohol-related disorders. They also suggest that the continuum hypothesis cannot be generalised to emotional decoding abilities.
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Affiliation(s)
- Mélanie Brion
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Fabien D'Hondt
- b Univ. Lille, CNRS , UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives , Lille , France.,c CHU Lille , Clinique de Psychiatrie, CURE , Lille , France
| | - Séverine Lannoy
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Anne-Lise Pitel
- d INSERM, École Pratique des Hautes Études , Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Donald A Davidoff
- e Harvard Medical School , Boston , MA , USA.,f Department of Neuropsychology , McLean Hospital , Belmont , USA
| | - Pierre Maurage
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
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Brion M, Pitel AL, D'Hondt F. New Perspectives in the Exploration of Korsakoff's Syndrome: The Usefulness of Neurophysiological Markers. Front Psychol 2016; 7:168. [PMID: 26909060 PMCID: PMC4754411 DOI: 10.3389/fpsyg.2016.00168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/29/2016] [Indexed: 01/17/2023] Open
Abstract
This perspective aims at underlining the usefulness of event-related potentials (ERP) to better understand the brain correlates of Korsakoff’s syndrome (KS), a neuropsychiatric disease characterized by severe memory impairment and most frequently resulting as a neurological complication of alcohol-dependence (AD). While ERP have been broadly used in AD, it has up to now been very little applied in KS or in the comparison of KS and AD. Within the framework of dual-process models, an influential theory postulating that addictive states result from an imbalance between under-activated reflective system and over-activated automatic-affective one, this paper proposes: (1) a brief synthesis of the main results of ERP studies in AD and KS, and (2) new research avenues using ERP to identify the electrophysiological correlates of cognitive and emotional dysfunction in KS. These experimental perspectives aim at exploring the continuity hypothesis, which postulates a gradient of impairments from AD to KS. We conclude on the possibility of developing neuropsychological strategies with electrophysiological follow-up to ensure KS diagnosis and test the efficacy of patient’s neurocognitive rehabilitation.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium
| | - Anne-Lise Pitel
- INSERM, Unité U1077, École Pratique des Hautes Études, Université de Caen-Basse Normandie - GIP Cyceron - CHU Caen Caen, France
| | - Fabien D'Hondt
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium
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