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Fama R, Sassoon SA, Müller-Oehring EM, Saranathan M, Pohl KM, Zahr NM, Pfefferbaum A, Sullivan EV. Anterior and posterior thalamic volumes differentially correlate with memory, attention, and motor processes in HIV infection and alcohol use disorder comorbidity. Brain Res Bull 2024; 217:111085. [PMID: 39343322 DOI: 10.1016/j.brainresbull.2024.111085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 10/01/2024]
Abstract
The thalamus, with its reciprocal connections to and from cortical, subcortical, and cerebellar regions, is a central active participant in multiple functional brain networks. Structural MRI studies measuring the entire thalamus without respect to its regional or nuclear divisions report volume shrinkage in diseases including HIV infection, alcohol use disorder (AUD), and their comorbidity (HIV+AUD). Here, we examined relations between thalamic subregions (anterior, ventral, medial, and posterior) and neuropsychological functions (attention/working memory, executive functioning, episodic memory, and motor skills). Volumes of thalamic subregions were derived from automatic segmentations of standard T1 weighted MRIs of 65 individuals with HIV, 189 with AUD, 80 with HIV+AUD comorbidity, and 141 healthy controls (CTRL). Total thalamic volume was smaller and cognitive and motor composite scores were lower in the three diagnostic groups relative to the CTRL group. The AUD and HIV+AUD groups had significantly smaller thalamic subregional volumes than the CTRL group. The HIV+AUD group had smaller anterior thalamic volume than the HIV-only group and smaller ventral thalamic volume than the AUD-only group. In the HIV+AUD group, memory scores correlated with anterior thalamic volumes, attention/working memory scores correlated with posterior and medial thalamic volumes, and motor skill scores correlated with posterior thalamic volumes. Exploratory analyses focused on the HIV+AUD group indicated that within the posterior thalamic region, the pulvinar and medial geniculate nuclei were related to attention/working memory scores, and the pulvinar was related to motor skills scores. This study is novel in locating volume deficits in specific thalamic subregions, in addition to the thalamus as a whole, in HIV, AUD, and their comorbidity and in identifying functional ramifications of these deficits. Taken together, this study highlights the relevance of thalamic subregional volume deficits to dissociable cognitive and motor processes.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for Health Sciences, SRI International, Menlo Park, CA, USA.
| | - Stephanie A Sassoon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Eva M Müller-Oehring
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Manojkumar Saranathan
- Department of Radiology, University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Kilian M Pohl
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Natalie M Zahr
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Miyata M, Takahata K, Sano Y, Yamamoto Y, Kurose S, Kubota M, Endo H, Matsuoka K, Tagai K, Oya M, Hirata K, Saito F, Mimura M, Kamagata K, Aoki S, Higuchi M. Association between mammillary body atrophy and memory impairment in retired athletes with a history of repetitive mild traumatic brain injury. Sci Rep 2024; 14:7129. [PMID: 38531908 DOI: 10.1038/s41598-024-57383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
Cognitive dysfunction, especially memory impairment, is a typical clinical feature of long-term symptoms caused by repetitive mild traumatic brain injury (rmTBI). The current study aims to investigate the relationship between regional brain atrophy and cognitive impairments in retired athletes with a long history of rmTBI. Overall, 27 retired athletes with a history of rmTBI (18 boxers, 3 kickboxers, 2 wrestlers, and 4 others; rmTBI group) and 23 age/sex-matched healthy participants (control group) were enrolled. MPRAGE on 3 T MRI was acquired and segmented. The TBV and TBV-adjusted regional brain volumes were compared between groups, and the relationship between the neuropsychological test scores and the regional brain volumes were evaluated. Total brain volume (TBV) and regional brain volumes of the mammillary bodies (MBs), hippocampi, amygdalae, thalami, caudate nuclei, and corpus callosum (CC) were estimated using the SPM12 and ITK-SNAP tools. In the rmTBI group, the regional brain volume/TBV ratio (rmTBI vs. control group, Mann-Whitney U test, p < 0.05) underwent partial correlation analysis, adjusting for age and sex, to assess its connection with neuropsychological test results. Compared with the control group, the rmTBI group showed significantly lower the MBs volume/TBV ratio (0.13 ± 0.05 vs. 0.19 ± 0.03 × 10-3, p < 0.001). The MBs volume/TBV ratio correlated with visual memory, as assessed, respectively, by the Rey-Osterrieth Complex Figure test delayed recall (ρ = 0.62, p < 0.001). In conclusion, retired athletes with rmTBI have MB atrophy, potentially contributing to memory impairment linked to the Papez circuit disconnection.
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Affiliation(s)
- Mari Miyata
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keisuke Takahata
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan.
| | - Yasunori Sano
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Yasuharu Yamamoto
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Shin Kurose
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Manabu Kubota
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hironobu Endo
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Kiwamu Matsuoka
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Kenji Tagai
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Masaki Oya
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Kosei Hirata
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Fumie Saito
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
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3
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Boeken OJ, Cieslik EC, Langner R, Markett S. Characterizing functional modules in the human thalamus: coactivation-based parcellation and systems-level functional decoding. Brain Struct Funct 2023; 228:1811-1834. [PMID: 36547707 PMCID: PMC10516793 DOI: 10.1007/s00429-022-02603-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
The human thalamus relays sensory signals to the cortex and facilitates brain-wide communication. The thalamus is also more directly involved in sensorimotor and various cognitive functions but a full characterization of its functional repertoire, particularly in regard to its internal anatomical structure, is still outstanding. As a putative hub in the human connectome, the thalamus might reveal its functional profile only in conjunction with interconnected brain areas. We therefore developed a novel systems-level Bayesian reverse inference decoding that complements the traditional neuroinformatics approach towards a network account of thalamic function. The systems-level decoding considers the functional repertoire (i.e., the terms associated with a brain region) of all regions showing co-activations with a predefined seed region in a brain-wide fashion. Here, we used task-constrained meta-analytic connectivity-based parcellation (MACM-CBP) to identify thalamic subregions as seed regions and applied the systems-level decoding to these subregions in conjunction with functionally connected cortical regions. Our results confirm thalamic structure-function relationships known from animal and clinical studies and revealed further associations with language, memory, and locomotion that have not been detailed in the cognitive neuroscience literature before. The systems-level decoding further uncovered large systems engaged in autobiographical memory and nociception. We propose this novel decoding approach as a useful tool to detect previously unknown structure-function relationships at the brain network level, and to build viable starting points for future studies.
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Affiliation(s)
- Ole J Boeken
- Faculty of Life Sciences, Department of Molecular Psychology, Humboldt-Universität Zu Berlin, Rudower Chaussee 18, 12489, Berlin, Germany.
| | - Edna C Cieslik
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Robert Langner
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Sebastian Markett
- Faculty of Life Sciences, Department of Molecular Psychology, Humboldt-Universität Zu Berlin, Rudower Chaussee 18, 12489, Berlin, Germany
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Kopelman MD. Observations on the Clinical Features of the Wernicke-Korsakoff Syndrome. J Clin Med 2023; 12:6310. [PMID: 37834954 PMCID: PMC10573380 DOI: 10.3390/jcm12196310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/30/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
This paper begins with a short case report of florid, spontaneous confabulation in a 61-year-old man with an alcohol-induced Wernicke-Korsakoff syndrome. His confabulation extended across episodic and personal semantic memory, as well as orientation in time and place, as measured on Dalla Barba's Confabulation Battery. Five other brief case summaries will then be presented, followed by a summary of the clinical, neurological, and background neuropsychological findings in three earlier series of Korsakoff patients. These observations will be considered in light of Wijnia's recent and my own, earlier reviews of the Korsakoff syndrome. Taken together, they indicate the need for a multi-faceted approach (clinical, neurological, neuropsychological, and neuroimaging) to the assessment and diagnosis of the disorder.
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Affiliation(s)
- Michael D Kopelman
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, UK
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Bateman JR, Ferguson MA, Anderson CA, Arciniegas DB, Gilboa A, Berman BD, Fox MD. Network Localization of Spontaneous Confabulation. J Neuropsychiatry Clin Neurosci 2023; 36:45-52. [PMID: 37415502 DOI: 10.1176/appi.neuropsych.20220160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Spontaneous confabulation is a symptom in which false memories are conveyed by the patient as true. The purpose of the study was to identify the neuroanatomical substrate of this complex symptom and evaluate the relationship to related symptoms, such as delusions and amnesia. METHODS Twenty-five lesion locations associated with spontaneous confabulation were identified in a systematic literature search. The network of brain regions functionally connected to each lesion location was identified with a large connectome database (N=1,000) and compared with networks derived from lesions associated with nonspecific (i.e., variable) symptoms (N=135), delusions (N=32), or amnesia (N=53). RESULTS Lesions associated with spontaneous confabulation occurred in multiple brain locations, but they were all part of a single functionally connected brain network. Specifically, 100% of lesions were connected to the mammillary bodies (familywise error rate [FWE]-corrected p<0.05). This connectivity was specific for lesions associated with confabulation compared with lesions associated with nonspecific symptoms or delusions (FWE-corrected p<0.05). Lesions associated with confabulation were more connected to the orbitofrontal cortex than those associated with amnesia (FWE-corrected p<0.05). CONCLUSIONS Spontaneous confabulation maps to a common functionally connected brain network that partially overlaps, but is distinct from, networks associated with delusions or amnesia. These findings lend new insight into the neuroanatomical bases of spontaneous confabulation.
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Affiliation(s)
- James R Bateman
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - Michael A Ferguson
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - C Alan Anderson
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - David B Arciniegas
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - Asaf Gilboa
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - Brian D Berman
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
| | - Michael D Fox
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman)
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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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7
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Fidder H, Veenhuizen RB, Gerridzen IJ, van Wieringen WN, Smalbrugge M, Hertogh CMPM, van Loon AM. Impaired Awareness in People with Severe Alcohol-Related Cognitive Deficits Including Korskoff's Syndrome: A Network Analysis. J Clin Med 2023; 12:jcm12093139. [PMID: 37176580 PMCID: PMC10178999 DOI: 10.3390/jcm12093139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Impaired awareness of one's own functioning is highly common in people with Korsakoff's syndrome (KS). However, it is currently unclear how awareness relates to impairments in daily functioning and quality of life (QoL). METHODS We assessed how impaired awareness relates to cognitive, behavioral, physical, and social functioning and QoL by applying a network analysis. We used cross-sectional data from 215 patients with KS or other severe alcohol-related cognitive deficits living in Dutch long-term care facilities (LTCFs). RESULTS Apathy has the most central position in the network. Higher apathy scores relate positively to reduced cognition and to a greater decline in activities of daily living and negatively to social participation and the use of antipsychotic drugs. Impaired awareness is also a central node. It is positively related to a higher perceived QoL, reduced cognition and apathy, and negatively to social participation and length of stay in the LTCF. Mediated through apathy and social participation, impaired awareness is indirectly related to other neuropsychiatric symptoms. CONCLUSIONS Impaired awareness is closely related to other domains of daily functioning and QoL of people with KS or other severe alcohol-related cognitive deficits living in LTCFs. Apathy plays a central role. Network analysis offers interesting insights to evaluate the interconnection of different symptoms and impairments in brain disorders such as KS.
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Affiliation(s)
- Hester Fidder
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Ruth B Veenhuizen
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Atlant, Nursing Home Markenhof, Korsakoff Centre of Expertise, Kuiltjesweg 1, 7361 TC Beekbergen, The Netherlands
| | - Ineke J Gerridzen
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
- Atlant, Nursing Home Markenhof, Korsakoff Centre of Expertise, Kuiltjesweg 1, 7361 TC Beekbergen, The Netherlands
| | - Wessel N van Wieringen
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1081a, 1081 HV Amsterdam, The Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
| | - Anouk M van Loon
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, De Boelelaan 1109, 1081 HV Amsterdam, The Netherlands
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8
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Arts NJM, van Dorst MEG, Vos SH, Kessels RPC. Coordination and Cognition in Pure Nutritional Wernicke's Encephalopathy with Cerebellar Degeneration after COVID-19 Infection: A Unique Case Report. J Clin Med 2023; 12:2511. [PMID: 37048595 PMCID: PMC10094782 DOI: 10.3390/jcm12072511] [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: 03/01/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Alcoholic cerebellar degeneration is a restricted form of cerebellar degeneration, clinically leading to an ataxia of stance and gait and occurring in the context of alcohol misuse in combination with malnutrition and thiamine depletion. However, a similar degeneration may also develop after non-alcoholic malnutrition, but evidence for a lasting ataxia of stance and gait and lasting abnormalities in the cerebellum is lacking in the few patients described with purely nutritional cerebellar degeneration (NCD). METHODS We present a case of a 46-year-old woman who developed NCD and Wernicke's encephalopathy (WE) due to COVID-19 and protracted vomiting, resulting in thiamine depletion. We present her clinical course over the first 6 months after the diagnosis of NCD and WE, with thorough neuropsychological and neurological examinations, standardized clinical observations, laboratory investigations, and repeated MRIs. RESULTS We found a persistent ataxia of stance and gait and evidence for an irreversible restricted cerebellar degeneration. However, the initial cognitive impairments resolved. CONCLUSIONS Our study shows that NCD without involvement of alcohol neurotoxicity and with a characteristic ataxia of stance and gait exists and may be irreversible. We did not find any evidence for lasting cognitive abnormalities or a cerebellar cognitive-affective syndrome (CCAS) in this patient.
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Affiliation(s)
- Nicolaas J. M. Arts
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands
- Winkler Neuropsychiatry Clinic and Korsakoff Centre, Pro Persona Institute for Psychiatry, 6874 BE Wolfheze, The Netherlands
| | - Maud E. G. van Dorst
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands
| | - Sandra H. Vos
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands
| | - Roy P. C. Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands
- Tactus Addiction Care, 7400 AD Deventer, The Netherlands
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9
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Ritz L, Segobin S, Laniepce A, Lannuzel C, Boudehent C, Vabret F, Urso L, Pitel AL, Beaunieux H. Structural brain substrates of the deficits observed on the BEARNI test in alcohol use disorder and Korsakoff's syndrome. J Neurosci Res 2023; 101:130-142. [PMID: 36200527 DOI: 10.1002/jnr.25132] [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: 03/03/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022]
Abstract
Chronic and excessive alcohol consumption can result in alcohol use disorder (AUD) without neurological complications and in Korsakoff's syndrome (KS) when combined with thiamine deficiency. These two clinical forms are accompanied by widespread structural brain damage in both the fronto-cerebellar (FCC) and Papez circuits (PC) as well as in the parietal cortex, resulting in cognitive and motor deficits. BEARNI is a screening tool especially designed to detect neuropsychological impairments in AUD. However, the sensitivity of this tool to the structural brain damage of AUD and KS patients remains unknown. Eighteen KS patients, 47 AUD patients and 27 healthy controls (HC) underwent the BEARNI test and a 3 T-MRI examination. Multiple regression analyses conducted between GM density and performance on each BEARNI subtest revealed correlations with regions included in the FCC, PC, thalamus and posterior cortex (precuneus and calcarine regions). All these brain regions were altered in KS compared to HC, in agreement with the cognitive deficits observed in the corresponding BEARNI subtests. The comparison between KS and AUD regarding the GM density in the several nodes of the FCC and calcarine regions revealed that they were atrophied to the same extent, suggesting that BEARNI is sensitive to the severity of alcohol-related GM abnormalities. Within the PC, the density of the cingulate cortex and thalamus, which correlated with the memory and fluency subscores, was smaller in KS than in AUD, suggesting that BEARNI is sensitive to specific brain abnormalities occurring in KS.
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Affiliation(s)
- Ludivine Ritz
- Laboratoire de Psychologie Caen Normandie (LPCN, EA 7452), Pôle Santé, Maladies, Handicaps - MRSH (USR 3486, CNRS-UNICAEN), Normandie Université, UNICAEN, Caen, France
| | - Shailendra Segobin
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France
| | - Alice Laniepce
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France
| | - Coralie Lannuzel
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Céline Boudehent
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - François Vabret
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Laurent Urso
- Service d'Addictologie, Centre Hospitalier Roubaix, Roubaix, France
| | - Anne Lise Pitel
- EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, PSL Research University, Normandie Université, Caen, France.,INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandie Université, UNICAEN, Caen, France.,Institut Universitaire de France (IUF), Paris, France
| | - Hélène Beaunieux
- Laboratoire de Psychologie Caen Normandie (LPCN, EA 7452), Pôle Santé, Maladies, Handicaps - MRSH (USR 3486, CNRS-UNICAEN), Normandie Université, UNICAEN, Caen, France
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10
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Vann SD, Zachiu C, Meys KM, Ambrosino S, Durston S, de Vries LS, Groenendaal F, Lequin MH. Normative mammillary body volumes: From the neonatal period to young adult. NEUROIMAGE. REPORTS 2022; 2:None. [PMID: 36507070 PMCID: PMC9726681 DOI: 10.1016/j.ynirp.2022.100122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/16/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
The mammillary bodies may be small, but they have an important role in encoding complex memories. Mammillary body pathology often occurs following thiamine deficiency but there is increasing evidence that the mammillary bodies are also compromised in other neurological conditions and in younger ages groups. For example, the mammillary bodies are frequently affected in neonates with hypoxic-ischemic encephalopathy. At present, there is no normative data for the mammillary bodies in younger groups making it difficult to identify abnormalities in neurological disorders. To address this, the present study set out to develop a normative dataset for neonates and for children to young adult. A further aim was to determine whether there were laterality or sex differences in mammillary body volumes. Mammillary body volumes were obtained from MRI scans from 506 participants across two datasets. Measures for neonates were acquired from the Developing Human Connectome Project database (156 male; 100 female); volumes for individuals aged 6-24 were acquired from the NICHE database (166 males; 84 females). Volume measurements were acquired using a semi-automated multi-atlas segmentation approach. Mammillary body volumes increased up to approximately 15 years-of-age. The left mammillary body was marginally, but significantly, larger than the right in the neonates with a similar pattern in older children/young adults. In neonates, the mammillary bodies in males were slightly bigger than females but no sex differences were present in older children/young adults. Given the increasing presentation of mammillary body pathology in neonates and children, these normative data will enable better assessment of the mammillary bodies in healthy and at-risk populations.
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Affiliation(s)
- Seralynne D. Vann
- School of Psychology, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Cornel Zachiu
- Department of Radiotherapy, University Medical Center Utrecht, 3584 CX, Utrecht, Utrecht, the Netherlands
| | - Karlijn M.E. Meys
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine, University Medical Center Utrecht & Princess Máxima Center for Pediatric Oncology, 3508 GA, Utrecht, the Netherlands
| | - Sara Ambrosino
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Sarah Durston
- Education Center, Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Linda S. de Vries
- Deparment of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Floris Groenendaal
- Deparment of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Maarten H. Lequin
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine, University Medical Center Utrecht & Princess Máxima Center for Pediatric Oncology, 3508 GA, Utrecht, the Netherlands
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11
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Moya M, Escudero B, Gómez-Blázquez E, Rebolledo-Poves AB, López-Gallardo M, Guerrero C, Marco EM, Orio L. Upregulation of TLR4/MyD88 pathway in alcohol-induced Wernicke’s encephalopathy: Findings in preclinical models and in a postmortem human case. Front Pharmacol 2022; 13:866574. [PMID: 36225571 PMCID: PMC9549119 DOI: 10.3389/fphar.2022.866574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Wernicke’s encephalopathy (WE) is a neurologic disease caused by vitamin B1 or thiamine deficiency (TD), being the alcohol use disorder its main risk factor. WE patients present limiting motor, cognitive, and emotional alterations related to a selective cerebral vulnerability. Neuroinflammation has been proposed to be one of the phenomena that contribute to brain damage. Our previous studies provide evidence for the involvement of the innate immune receptor Toll-like (TLR)4 in the inflammatory response induced in the frontal cortex and cerebellum in TD animal models (animals fed with TD diet [TDD] and receiving pyrithiamine). Nevertheless, the effects of the combination of chronic alcohol consumption and TD on TLR4 and their specific contribution to the pathogenesis of WE are currently unknown. In addition, no studies on TLR4 have been conducted on WE patients since brains from these patients are difficult to achieve. Here, we used rat models of chronic alcohol (CA; 9 months of forced consumption of 20% (w/v) alcohol), TD hit (TDD + daily 0.25 mg/kg i.p. pyrithiamine during 12 days), or combined treatment (CA + TDD) to check the activation of the proinflammatory TLR4/MyD88 pathway and related markers in the frontal cortex and the cerebellum. In addition, we characterized for the first time the TLR4 and its coreceptor MyD88 signature, along with other markers of this proinflammatory signaling such as phospo-NFκB p65 and IκBα, in the postmortem human frontal cortex and cerebellum (gray and white matter) of an alcohol-induced WE patient, comparing it with negative (no disease) and positive (aged brain with Alzheimer’s disease) control subjects for neuroinflammation. We found an increase in the cortical TLR4 and its adaptor molecule MyD88, together with an upregulation of the proinflammatory signaling molecules p-NF-ĸB and IĸBα in the CA + TDD animal model. In the patient diagnosed with alcohol-induced WE, we observed cortical and cerebellar upregulation of the TLR4/MyD88 pathway. Hence, our findings provide evidence, both in the animal model and the human postmortem brain, of the upregulation of the TLR4/MyD88 proinflammatory pathway in alcohol consumption–related WE.
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Affiliation(s)
- Marta Moya
- Department of Psychobiology and Methods in Behavioral Science, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Berta Escudero
- Department of Psychobiology and Methods in Behavioral Science, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Carmen Guerrero
- Biobanco of Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Eva M. Marco
- Department of Genetics, Physiology and Microbiology, Faculty of Biology, Complutense University of Madrid, Madrid, Spain
| | - Laura Orio
- Department of Psychobiology and Methods in Behavioral Science, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
- Research Network in Primary Care in Addictions (Red de Investigación en Atención Primaria en Adicciones), Riapad, Spain
- *Correspondence: Laura Orio,
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12
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Chen G, Shi F, Yin W, Guo Y, Liu A, Shuai J, Sun J. Gut microbiota dysbiosis: The potential mechanisms by which alcohol disrupts gut and brain functions. Front Microbiol 2022; 13:916765. [PMID: 35966709 PMCID: PMC9372561 DOI: 10.3389/fmicb.2022.916765] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/29/2022] [Indexed: 11/24/2022] Open
Abstract
Alcohol use disorder (AUD) is a high-risk psychiatric disorder and a key cause of death and disability in individuals. In the development of AUD, there is a connection known as the microbiota-gut-brain axis, where alcohol use disrupts the gut barrier, resulting in changes in intestinal permeability as well as the gut microbiota composition, which in turn impairs brain function and worsens the patient’s mental status and gut activity. Potential mechanisms are explored by which alcohol alters gut and brain function through the effects of the gut microbiota and their metabolites on immune and inflammatory pathways. Alcohol and microbiota dysregulation regulating neurotransmitter release, including DA, 5-HT, and GABA, are also discussed. Thus, based on the above discussion, it is possible to speculate on the gut microbiota as an underlying target for the treatment of diseases associated with alcohol addiction. This review will focus more on how alcohol and gut microbiota affect the structure and function of the gut and brain, specific changes in the composition of the gut microbiota, and some measures to mitigate the changes caused by alcohol exposure. This leads to a potential intervention for alcohol addiction through fecal microbiota transplantation, which could normalize the disruption of gut microbiota after AUD.
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Affiliation(s)
- Ganggang Chen
- Department of Anatomy and Neurobiology, School of Basic Medicine, Shandong University, Jinan, China
| | - Fenglei Shi
- Department of Othopaedics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Yin
- Department of Anatomy and Neurobiology, School of Basic Medicine, Shandong University, Jinan, China
| | - Yao Guo
- Shandong Provincial Mental Health Center, Jinan, China
| | - Anru Liu
- Department of Anatomy and Neurobiology, School of Basic Medicine, Shandong University, Jinan, China
| | - Jiacheng Shuai
- Department of Anatomy and Neurobiology, School of Basic Medicine, Shandong University, Jinan, China
| | - Jinhao Sun
- Department of Anatomy and Neurobiology, School of Basic Medicine, Shandong University, Jinan, China
- *Correspondence: Jinhao Sun,
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Abstract
INTRODUCTION Alwyn Lishman was interested in how memory research could be applied to clinical psychiatry. After a brief review of his major contributions, this paper will focus on his research on the alcoholic Korsakoff syndrome. It will consider how his findings relate to contemporary debates, particularly on how the syndrome should be defined, and its relationship to broader alcohol-induced cognitive impairments. METHODS A review of the contribution of Alwyn Lishman, Robin Jacobson and colleagues to our knowledge of Korsakoff's syndrome, together with a review of the pertinent recent literature. RESULTS Lishman and colleagues followed earlier authors in defining the Korsakoff syndrome in terms of disproportionate memory impairment, but they also noted a variable degree of IQ, frontal-executive, and timed visuo-spatial impairment in their cases. More recent authors have included such features in their definitions of the syndrome. Lishman also argued for a specific "alcoholic dementia". The present paper argues that recent definitions of the Korsakoff syndrome confound its core and associated features, and also fail to recognise the multifactorial basis of alcohol-related brain damage. CONCLUSIONS Korsakoff's syndrome is best defined in terms of disproportionate memory impairment, and more widespread cognitive impairment is best encompassed within "alcohol-related brain damage".
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Affiliation(s)
- Michael D Kopelman
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Surrey, UK
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14
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Lequin MH, Steggerda SJ, Severino M, Tortora D, Parodi A, Ramenghi LA, Groenendaal F, Meys KME, Benders MJNL, de Vries LS, Vann SD. Mammillary body injury in neonatal encephalopathy: a multicentre, retrospective study. Pediatr Res 2022; 92:174-179. [PMID: 33654286 PMCID: PMC9411062 DOI: 10.1038/s41390-021-01436-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The mammillary bodies (MBs) have repeatedly been shown to be critical for memory, yet little is known about their involvement in numerous neurological conditions linked to memory impairments, including neonatal encephalopathy. METHODS We implemented a multicentre retrospective study, assessing magnetic resonance scans of 219 infants with neonatal encephalopathy who had undergone hypothermia treatment in neonatal intensive care units located in the Netherlands and Italy. RESULTS Abnormal MB signal was observed in ~40% of infants scanned; in half of these cases, the brain appeared otherwise normal. MB involvement was not related to the severity of encephalopathy or the pattern/severity of hypoxic-ischaemic brain injury. Follow-up scans were available for 18 cases with abnormal MB signal; in eight of these cases, the MBs appeared severely atrophic. CONCLUSIONS This study highlights the importance of assessing the status of the MBs in neonatal encephalopathy; this may require changes to scanning protocols to ensure that the slices are sufficiently thin to capture the MBs. Furthermore, long-term follow-up of infants with abnormal MB signal is needed to determine the effects on cognition, which may enable the use of early intervention strategies. Further research is needed to assess the role of therapeutic hypothermia in MB involvement in neonatal encephalopathy. IMPACT The MBs are particularly sensitive to hypoxia in neonates. Current hypothermia treatment provides incomplete protection against MB injury. MB involvement is likely overlooked as it can often occur when the rest of the brain appears normal. Given the importance of the MBs for memory, it is necessary that this region is properly assessed in neonatal encephalopathy. This may require improvements in scanning protocols.
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Affiliation(s)
- Maarten H Lequin
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Sylke J Steggerda
- Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Domenico Tortora
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Parodi
- Neonatal Intensive Care Unit, Department Mother and Child, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Luca A Ramenghi
- Neonatal Intensive Care Unit, Department Mother and Child, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Floris Groenendaal
- Department of Neonatology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Karlijn M E Meys
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Linda S de Vries
- Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neonatology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Seralynne D Vann
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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15
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Lin S, Guo Z, Chen S, Lin X, Ye M, Qiu Y. Progressive Brain Structural Impairment Assessed via Network and Causal Analysis in Patients With Hepatitis B Virus-Related Cirrhosis. Front Neurol 2022; 13:849571. [PMID: 35599731 PMCID: PMC9120530 DOI: 10.3389/fneur.2022.849571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives This research amid to elucidate the disease stage-specific spatial patterns and the probable sequences of gray matter (GM) deterioration as well as the causal relationship among structural network components in hepatitis B virus-related cirrhosis (HBV-RC) patients. Methods Totally 30 HBV-RC patients and 38 healthy controls (HC) were recruited for this study. High-resolution T1-weighted magnetic resonance imaging and psychometric hepatic encephalopathy score (PHES) were evaluated in all participants. Voxel-based morphometry (VBM), structural covariance network (SCN), and causal SCN (CaSCN) were applied to identify the disease stage-specific GM abnormalities in morphology and network, as well as their causal relationship. Results Compared to HC (0.443 ± 0.073 cm3), the thalamus swelled significantly in the no minimal hepatic encephalopathy (NMHE) stage (0.607 ± 0.154 cm3, p <0.05, corrected) and further progressed and expanded to the bilateral basal ganglia, the cortices, and the cerebellum in the MHE stage (p < 0.05, corrected). Furthermore, the thalamus swelling had a causal effect on other parts of cortex-basal ganglia-thalamus circuits (p < 0.05, corrected), which was negatively correlated with cognitive performance (r = −0.422, p < 0.05). Moreover, the thalamus-related SCN also displayed progressive deterioration as the disease advanced in HBV-RC patients (p < 0.05, corrected). Conclusion Progressive deterioration of GM morphology and SCN exists in HBV-RC patients during advanced disease, displaying thalamus-related causal effects. These findings indicate that bilateral thalamus morphology as well as the thalamus-related network may serve as an in vivo biomarker for monitoring the progression of the disease in HBV-RC patients.
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Affiliation(s)
- Shiwei Lin
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Zheng Guo
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shengli Chen
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Xiaoshan Lin
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen, China
| | - Min Ye
- Department of Geriatrics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Department of Geriatrics, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Min Ye
| | - Yingwei Qiu
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- Yingwei Qiu
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Moya M, López-Valencia L, García-Bueno B, Orio L. Disinhibition-Like Behavior Correlates with Frontal Cortex Damage in an Animal Model of Chronic Alcohol Consumption and Thiamine Deficiency. Biomedicines 2022; 10:biomedicines10020260. [PMID: 35203470 PMCID: PMC8869694 DOI: 10.3390/biomedicines10020260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/08/2022] [Accepted: 01/18/2022] [Indexed: 12/23/2022] Open
Abstract
Wernicke-Korsakoff syndrome (WKS) is induced by thiamine deficiency (TD) and mainly related to alcohol consumption. Frontal cortex dysfunction has been associated with impulsivity and disinhibition in WKS patients. The pathophysiology involves oxidative stress, excitotoxicity and inflammatory responses leading to neuronal death, but the relative contributions of each factor (alcohol and TD, either isolated or in interaction) to these phenomena are still poorly understood. A rat model was used by forced consumption of 20% (w/v) alcohol for 9 months (CA), TD hit (TD diet + pyrithiamine 0.25 mg/kg, i.p. daily injections the last 12 days of experimentation (TDD)), and both combined treatments (CA+TDD). Motor and cognitive performance and cortical damage were examined. CA caused hyperlocomotion as a possible sensitization of ethanol-induced excitatory effects and recognition memory deficits. In addition, CA+TDD animals showed a disinhibited-like behavior which appeared to be dependent on TDD. Additionally, combined treatment led to more pronounced alterations in nitrosative stress, lipid peroxidation, apoptosis and cell damage markers. Correlations between injury signals and disinhibition suggest that CA+TDD disrupts behaviors dependent on the frontal cortex. Our study sheds light on the potential disease-specific mechanisms, reinforcing the need for neuroprotective therapeutic approaches along with preventive treatments for the nutritional deficiency in WKS.
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Affiliation(s)
- Marta Moya
- Department of Psychobiology and Methods in Behavioral Sciences, Faculty of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain; (M.M.); (L.L.-V.)
- Red de Trastornos Adictivos (RTA), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Leticia López-Valencia
- Department of Psychobiology and Methods in Behavioral Sciences, Faculty of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain; (M.M.); (L.L.-V.)
| | - Borja García-Bueno
- Departament of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Instituto Universitario de Investigación en Neuroquímica IUIN-UCM, Avda. Complutense s/n, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Laura Orio
- Department of Psychobiology and Methods in Behavioral Sciences, Faculty of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain; (M.M.); (L.L.-V.)
- Red de Trastornos Adictivos (RTA), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence:
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17
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Fama R, Le Berre AP, Sassoon SA, Zahr NM, Pohl KM, Pfefferbaum A, Sullivan EV. Memory impairment in alcohol use disorder is associated with regional frontal brain volumes. Drug Alcohol Depend 2021; 228:109058. [PMID: 34610518 PMCID: PMC8595873 DOI: 10.1016/j.drugalcdep.2021.109058] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/03/2021] [Accepted: 09/13/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Episodic memory deficits occur in alcohol use disorder (AUD), but their anatomical substrates remain in question. Although persistent memory impairment is classically associated with limbic circuitry disruption, learning and retrieval of new information also relies on frontal systems. Despite AUD vulnerability of frontal lobe integrity, relations between frontal regions and memory processes have been under-appreciated. METHODS Participants included 91 AUD (49 with a drug diagnosis history) and 36 controls. Verbal and visual episodic memory scores were age- and education-corrected. Structural magnetic resonance imaging (MRI) data yielded regional frontal lobe (precentral, superior, orbital, middle, inferior, supplemental motor, and medial) and total hippocampal volumes. RESULTS AUD were impaired on all memory scores and had smaller precentral frontal and hippocampal volumes than controls. Orbital, superior, and inferior frontal volumes and lifetime alcohol consumption were independent predictors of episodic memory in AUD. Selectivity was established with a double dissociation, where orbital frontal volume predicted verbal but not visual memory, whereas inferior frontal volumes predicted visual but not verbal memory. Further, superior frontal volumes predicted verbal memory in AUD alone, whereas orbital frontal volumes predicted verbal memory in AUD+drug abuse history. CONCLUSIONS Selective relations among frontal subregions and episodic memory processes highlight the relevance of extra-limbic regions in mnemonic processes in AUD. Memory deficits resulting from frontal dysfunction, unlike the episodic memory impairment associated with limbic dysfunction, may be more amenable to recovery with cessation or reduction of alcohol misuse and may partially explain the heterogeneity in episodic memory abilities in AUD.
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Affiliation(s)
- Rosemary Fama
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA; Center for Health Sciences, Bioscience Division, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA.
| | - Anne-Pascale Le Berre
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA
| | - Stephanie A Sassoon
- Center for Health Sciences, Bioscience Division, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
| | - Natalie M Zahr
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA; Center for Health Sciences, Bioscience Division, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
| | - Kilian M Pohl
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA; Center for Health Sciences, Bioscience Division, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
| | - Adolf Pfefferbaum
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA; Center for Health Sciences, Bioscience Division, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
| | - Edith V Sullivan
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305, USA
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18
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Asiri AA, Aljarallah SA, Alayed KM. Polyneuropathy and Korsakoff syndrome complicating sleeve gastrectomy. Obes Res Clin Pract 2021; 15:293-296. [PMID: 33934996 DOI: 10.1016/j.orcp.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
We report a case of a 36 year old gentleman presenting with polyneuropathy and Korsakkoff Syndrome complicating Sleeve Gastrectomy.
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Affiliation(s)
- Alanood A Asiri
- Department of Internal Medicine, King Saud University Medical City and College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Salman A Aljarallah
- Department of Internal Medicine, King Saud University Medical City and College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M Alayed
- Department of Internal Medicine, King Saud University Medical City and College of Medicine, King Saud University, Riyadh, Saudi Arabia
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19
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D'Angelo EC, Ober BA, Shenaut GK. Combined Memory Training: An Approach for Episodic Memory Deficits in Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:920-932. [PMID: 33630662 DOI: 10.1044/2020_ajslp-20-00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The study aimed to test a combination of semantic memory and traditional episodic memory therapies on episodic memory deficits in adults with traumatic brain injury. Method Twenty-five participants who had been diagnosed with traumatic brain injury and had episodic memory deficits were randomly assigned either to a combined memory treatment group (n = 16) or to a wait-list control group (n = 9). Before and after treatment, they completed standardized neuropsychological testing for episodic memory and related cognitive domains, including the California Verbal Learning Test-Second Edition, the Controlled Oral Word Association Test, the University of Southern California Repeatable Episodic Memory Test, the Wechsler Abbreviated Scale of Intelligence-Second Edition Matrices, the Test of Everyday Attention, the Memory Assessment Clinics Self-Rating Scale, the Expressive Vocabulary Test-Second Edition, and the Story Recall subtest from the Rivermead Behavioural Memory Test. In addition to a traditional episodic memory therapy, the treatment group received a novel semantic memory-focused therapy, which involved participants finding meaningful connections between diverse concepts represented by sets of two or three words. Results The treatment group demonstrated statistically significant improvement in memory for list learning tasks, and there was a significant difference from pretest to posttest between the treatment group and the wait-list control group. Clinical significance was demonstrated for the treatment group using minimally important difference calculations. Conclusion Combined memory therapy resulted in significant improvements in episodic memory, semantic memory, and attention, in comparison to no treatment. Supplemental Material https://doi.org/10.23641/asha.14049968.
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Affiliation(s)
| | - Beth A Ober
- Department of Human Ecology, University of California, Davis
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20
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Ritz L, Laniepce A, Cabé N, Lannuzel C, Boudehent C, Urso L, Segobin S, Vabret F, Beaunieux H, Pitel AL. Early Identification of Alcohol Use Disorder Patients at Risk of Developing Korsakoff's Syndrome. Alcohol Clin Exp Res 2021; 45:587-595. [PMID: 33432596 DOI: 10.1111/acer.14548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of the present study was to determine whether the Brief Evaluation of Alcohol-Related Neuropsychological Impairments (BEARNI), a screening tool developed to identify neuropsychological deficits in alcohol use disorder (AUD) patients, can also be used for the early identification of AUD patients at risk of developing Korsakoff's syndrome (KS). METHODS Eighteen KS patients, 47 AUD patients and 27 healthy controls underwent BEARNI testing (including 5 subtests targeting episodic memory, working memory, executive function, visuospatial abilities, and ataxia) and a comprehensive neuropsychological examination. RESULTS Performance of AUD and KS patients on BEARNI subtests was consistent with the results on the standardized neuropsychological assessment. On BEARNI, ataxia and working memory deficits observed in AUD were as severe as those exhibited by KS patients, whereas for visuospatial abilities, a graded effect of performance was found. In contrast, the subtests involving long-term memory abilities (episodic memory and fluency) were impaired in KS patients only. AUD patients with a score lower than 1.5 points (out of 6) on the episodic memory subtest of BEARNI exhibited the lowest episodic memory performance on the neuropsychological battery and could be considered at risk of developing KS. CONCLUSIONS These findings suggest that BEARNI is a useful tool for detecting severe memory impairments, suggesting that it could be used for the early identification of AUD patients at high risk of developing KS.
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Affiliation(s)
- Ludivine Ritz
- Laboratoire de Psychologie Caen Normandie (LPCN, EA 4649), Pôle Santé, Maladies, Handicaps - MRSH (USR 3486, CNRS-UNICAEN), Normandie Univ, UNICAEN, Caen, France.,EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
| | - Alice Laniepce
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
| | - Nicolas Cabé
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Coralie Lannuzel
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Céline Boudehent
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Laurent Urso
- Service d'Addictologie, Centre Hospitalier Roubaix, Roubaix, France
| | - Shailendra Segobin
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
| | - François Vabret
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Hélène Beaunieux
- Laboratoire de Psychologie Caen Normandie (LPCN, EA 4649), Pôle Santé, Maladies, Handicaps - MRSH (USR 3486, CNRS-UNICAEN), Normandie Univ, UNICAEN, Caen, France.,EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
| | - Anne-Lise Pitel
- EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
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21
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The contribution of mamillary body damage to Wernicke's encephalopathy and Korsakoff's syndrome. HANDBOOK OF CLINICAL NEUROLOGY 2021; 180:455-475. [PMID: 34225949 DOI: 10.1016/b978-0-12-820107-7.00029-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Histopathological alterations of the mamillary bodies are the most conspicuous and the most consistent neuropathological features of several disorders that occur after severe thiamine deficiency, such as Wernicke's encephalopathy and Korsakoff's syndrome. Moreover, they are among the few abnormalities that are visible to the naked eye in these disorders. With a lifetime prevalence of approximately 1.3%, Wernicke's encephalopathy is by far the most frequent cause of damage to the mamillary bodies in humans. Still, there is a persisting uncertainty with regard to the development and the clinical consequences of this damage, because it is virtually impossible to study in isolation. As a rule, it always occurs alongside neuropathology in other subcortical gray matter structures, notably the medial thalamus. Converging evidence from other pathologies and animal experiments is needed to assess the clinical impact of mamillary body damage and to determine which functions can be attributed to these structures in healthy subjects. In this chapter, we describe the history and the current state of knowledge with regard to thiamine deficiency disorders and the contribution of mamillary body damage to their clinical presentations.
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22
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Mickelsen LE, Flynn WF, Springer K, Wilson L, Beltrami EJ, Bolisetty M, Robson P, Jackson AC. Cellular taxonomy and spatial organization of the murine ventral posterior hypothalamus. eLife 2020; 9:58901. [PMID: 33119507 PMCID: PMC7595735 DOI: 10.7554/elife.58901] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/21/2020] [Indexed: 01/02/2023] Open
Abstract
The ventral posterior hypothalamus (VPH) is an anatomically complex brain region implicated in arousal, reproduction, energy balance, and memory processing. However, neuronal cell type diversity within the VPH is poorly understood, an impediment to deconstructing the roles of distinct VPH circuits in physiology and behavior. To address this question, we employed a droplet-based single-cell RNA sequencing (scRNA-seq) approach to systematically classify molecularly distinct cell populations in the mouse VPH. Analysis of >16,000 single cells revealed 20 neuronal and 18 non-neuronal cell populations, defined by suites of discriminatory markers. We validated differentially expressed genes in selected neuronal populations through fluorescence in situ hybridization (FISH). Focusing on the mammillary bodies (MB), we discovered transcriptionally-distinct clusters that exhibit neuroanatomical parcellation within MB subdivisions and topographic projections to the thalamus. This single-cell transcriptomic atlas of VPH cell types provides a resource for interrogating the circuit-level mechanisms underlying the diverse functions of VPH circuits.
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Affiliation(s)
- Laura E Mickelsen
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States.,Connecticut Institute for the Brain and Cognitive Sciences, Storrs, United States
| | - William F Flynn
- The Jackson Laboratory for Genomic Medicine, Farmington, United States
| | - Kristen Springer
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States
| | - Lydia Wilson
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States
| | - Eric J Beltrami
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States
| | - Mohan Bolisetty
- The Jackson Laboratory for Genomic Medicine, Farmington, United States
| | - Paul Robson
- The Jackson Laboratory for Genomic Medicine, Farmington, United States.,Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, United States.,Institute for Systems Genomics, University of Connecticut, Farmington, United States
| | - Alexander C Jackson
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States.,Connecticut Institute for the Brain and Cognitive Sciences, Storrs, United States.,Institute for Systems Genomics, University of Connecticut, Farmington, United States
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23
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Cognitive impairment severity in relation to signs of subclinical Wernicke's encephalopathy in HIV and alcoholism comorbidity. AIDS 2020; 34:391-403. [PMID: 31725430 PMCID: PMC7021228 DOI: 10.1097/qad.0000000000002428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The comorbidity of HIV infection and alcoholism (ALC) is prevalent. Wernicke's encephalopathy, a neurological disorder resulting from thiamine depletion, has been generally associated with alcoholism but has also been reported in HIV infection. This study examined whether subclinical Wernicke's encephalopathy signs could contribute to the heterogeneity of cognitive and motor deficits observed in individuals with both disease conditions (HIV+ALC). DESIGN Sixty-one HIV+ALC individuals and 59 controls were assessed on attention and working memory, production, immediate and delayed episodic memory, visuospatial abilities, and upper limb motor function. METHODS Using Caine criteria (dietary deficiency, oculomotor abnormality, cerebellar dysfunction, and altered mental state), HIV+ALC individuals were classified by subclinical Wernicke's encephalopathy risk factors. RESULTS Signs of subclinical Wernicke's encephalopathy were present in 20% of the HIV+ALC participants. For attention/working memory, delayed memory, and upper limb motor function, HIV+ALC Caine 2+ (i.e. meeting two or three criteria) demonstrated the most severe deficits, scoring lower than HIV+ALC Caine 1 (i.e. meeting one criterion), HIV+ALC Caine 0 (i.e. meeting no criteria), and controls. CONCLUSION The high prevalence of subclinical signs of Wernicke's encephalopathy and relevance to performance indicate that this condition should be considered in assessment of HIV-infected individuals, especially when alcoholism comorbidity is known or suspected. Above and beyond clinical factors, such as depression, alcoholism and HIV disease-related variables, AIDS, hepatitis C and drug history known to mediate neuropsychological performance, subclinical Wernicke's encephalopathy signs could partly explain the heterogeneity in patterns and severity of cognitive and motor impairments in HIV-infected individuals with alcoholism comorbidity.
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24
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Molavi M, Vann SD, de Vries LS, Groenendaal F, Lequin M. Signal Change in the Mammillary Bodies after Perinatal Asphyxia. AJNR Am J Neuroradiol 2019; 40:1829-1834. [PMID: 31694818 DOI: 10.3174/ajnr.a6232] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/08/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Research into memory deficits associated with hypoxic-ischemic encephalopathy has typically focused on the hippocampus, but there is emerging evidence that the medial diencephalon may also be compromised. We hypothesized that mammillary body damage occurs in perinatal asphyxia, potentially resulting in mammillary body atrophy and subsequent memory impairment. MATERIALS AND METHODS We retrospectively reviewed brain MRIs of 235 clinically confirmed full-term patients with hypoxic-ischemic encephalopathy acquired at a single center during 2004-2017. MRIs were performed within 10 days of birth (median, 6; interquartile range, 2). Two radiologists independently assessed the mammillary bodies for abnormal signal on T2-weighted and DWI sequences. Follow-up MRIs were available for 9 patients; these were examined for evidence of mammillary body and hippocampal atrophy. RESULTS In 31 neonates (13.2%), abnormal high mammillary body signal was seen on T2-weighted sequences, 4 with mild, 25 with moderate, and 2 with severe hypoxic-ischemic encephalopathy. In addition, restricted diffusion was seen in 6 neonates who had MR imaging between days 5 and 7. For these 31 neonates, the most common MR imaging pattern (41.9%) was abnormal signal restricted to the mammillary bodies with the rest of the brain appearing normal. Follow-up MRIs were available for 9 patients: 8 acquired between 3 and 19 months and 1 acquired at 7.5 years. There was mammillary body atrophy in 8 of the 9 follow-up MRIs. CONCLUSIONS Approximately 13% of full-term infants with hypoxic-ischemic encephalopathy showed abnormal high mammillary body signal on T2-weighted images during the acute phase, which progressed to mammillary body atrophy in all but 1 of the infants who had follow-up MR imaging. This mammillary body involvement does not appear to be related to the severity of encephalopathy, MR imaging patterns of hypoxic-ischemic encephalopathy, or pathology elsewhere in the brain.
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Affiliation(s)
- M Molavi
- From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - S D Vann
- School of Psychology (S.D.V.), Cardiff University, Cardiff, UK
| | - L S de Vries
- From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - F Groenendaal
- From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - M Lequin
- From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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25
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Abstract
OBJECTIVES In this paper, I review three 'anomalies' or disorders in autobiographical memory: neurological retrograde amnesia (RA), spontaneous confabulation, and psychogenic amnesia. METHODS Existing theories are reviewed, their limitations considered, some of my own empirical findings briefly described, and possible interpretations proposed and interspersed with illustrative case-reports. RESULTS In RA, there may be an important retrieval component to the deficit, and factors at encoding may give rise to the relative preservation of early memories (and the reminiscence bump) which manifests as a temporal gradient. Spontaneous confabulation appears to be associated with a damaged 'filter' in orbitofrontal and ventromedial frontal regions. Consistent with this, an empirical study has shown that both the initial severity of confabulation and its subsequent decline are associated with changes in the executive function (especially in cognitive estimate errors) and inversely with the quantity of accurate autobiographical memories retrieved. Psychogenic amnesia can be 'global' or 'situation-specific'. The former is associated with a precipitating stress, depressed mood, and (often) a past history of a transient neurological amnesia. In these circumstances, frontal control mechanisms can inhibit retrieval of autobiographical memories, and even the sense of 'self' (identity), while compromised medial temporal function prevents subsequent retrieval of what occurred during a 'fugue'. An empirical investigation of psychogenic amnesia and some recent imaging studies have provided findings consistent with this view. CONCLUSIONS Taken together, these various observations point to the importance of frontal 'control' systems (in interaction with medial temporal/hippocampal systems) in the retrieval and, more particularly, the disrupted retrieval of 'old' memories.
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26
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Dillingham CM, Milczarek MM, Perry JC, Frost BE, Parker GD, Assaf Y, Sengpiel F, O'Mara SM, Vann SD. Mammillothalamic Disconnection Alters Hippocampocortical Oscillatory Activity and Microstructure: Implications for Diencephalic Amnesia. J Neurosci 2019; 39:6696-6713. [PMID: 31235646 PMCID: PMC6703878 DOI: 10.1523/jneurosci.0827-19.2019] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/08/2019] [Accepted: 06/10/2019] [Indexed: 01/13/2023] Open
Abstract
Diencephalic amnesia can be as debilitating as the more commonly known temporal lobe amnesia, yet the precise contribution of diencephalic structures to memory processes remains elusive. Across four cohorts of male rats, we used discrete lesions of the mammillothalamic tract to model aspects of diencephalic amnesia and assessed the impact of these lesions on multiple measures of activity and plasticity within the hippocampus and retrosplenial cortex. Lesions of the mammillothalamic tract had widespread indirect effects on hippocampocortical oscillatory activity within both theta and gamma bands. Both within-region oscillatory activity and cross-regional synchrony were altered. The network changes were state-dependent, displaying different profiles during locomotion and paradoxical sleep. Consistent with the associations between oscillatory activity and plasticity, complementary analyses using several convergent approaches revealed microstructural changes, which appeared to reflect a suppression of learning-induced plasticity in lesioned animals. Together, these combined findings suggest a mechanism by which damage to the medial diencephalon can impact upon learning and memory processes, highlighting an important role for the mammillary bodies in the coordination of hippocampocortical activity.SIGNIFICANCE STATEMENT Information flow within the Papez circuit is critical to memory. Damage to ascending mammillothalamic projections has consistently been linked to amnesia in humans and spatial memory deficits in animal models. Here we report on the changes in hippocampocortical oscillatory dynamics that result from chronic lesions of the mammillothalamic tract and demonstrate, for the first time, that the mammillary bodies, independently of the supramammillary region, contribute to frequency modulation of hippocampocortical theta oscillations. Consistent with the associations between oscillatory activity and plasticity, the lesions also result in a suppression of learning-induced plasticity. Together, these data support new functional models whereby mammillary bodies are important for coordinating hippocampocortical activity rather than simply being a relay of hippocampal information as previously assumed.
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Affiliation(s)
- Christopher M Dillingham
- School of Psychology, Cardiff University, Cardiff CF10 3AT, United Kingdom
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Michal M Milczarek
- School of Psychology, Cardiff University, Cardiff CF10 3AT, United Kingdom
| | - James C Perry
- School of Psychology, Cardiff University, Cardiff CF10 3AT, United Kingdom
| | - Bethany E Frost
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Greg D Parker
- EMRIC, Cardiff University, Cardiff CF10 3AX, United Kingdom
| | - Yaniv Assaf
- George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel 6997801, and
| | - Frank Sengpiel
- School of Biosciences, Cardiff University, Cardiff CF10 3AX, United Kingdom
| | - Shane M O'Mara
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Seralynne D Vann
- School of Psychology, Cardiff University, Cardiff CF10 3AT, United Kingdom,
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27
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Kasse E, Oudman E, Olivier M, Wijnia JW, Postma A. Subtle object location perception deficits in Korsakoff’s syndrome. J Clin Exp Neuropsychol 2019; 41:881-887. [DOI: 10.1080/13803395.2019.1640864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Eunice Kasse
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Erik Oudman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Marloes Olivier
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Jan W. Wijnia
- Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Albert Postma
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
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28
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Fama R, Le Berre AP, Hardcastle C, Sassoon SA, Pfefferbaum A, Sullivan EV, Zahr NM. Neurological, nutritional and alcohol consumption factors underlie cognitive and motor deficits in chronic alcoholism. Addict Biol 2019; 24:290-302. [PMID: 29243370 DOI: 10.1111/adb.12584] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 10/12/2017] [Accepted: 10/29/2017] [Indexed: 01/14/2023]
Abstract
Variations in pattern and extent of cognitive and motor impairment occur in alcoholism (ALC). Causes of such heterogeneity are elusive and inconsistently accounted for by demographic or alcohol consumption differences. We examined neurological and nutritional factors as possible contributors to heterogeneity in impairment. Participants with ALC (n = 96) and a normal comparison group (n = 41) were examined on six cognitive and motor domains. Signs of historically determined subclinical Wernicke's encephalopathy were detected using the Caine et al. criteria, which were based on postmortem examination and chart review of antemortem data of alcoholic cases with postmortem evidence for Wernicke's encephalopathy. Herein, four Caine criteria provided quantification of dietary deficiency, cerebellar dysfunction, low general cognitive functioning and oculomotor abnormalities in 86 of the 96 ALC participants. Subgroups based on Caine criteria yielded a graded effect, where those meeting more criteria exhibited greater impairment than those meeting no to fewer criteria. These results could not be accounted for by history of drug dependence. Multiple regression indicated that compromised performance on ataxia, indicative of cerebellar dysfunction, predicted non-mnemonic and upper motor deficits, whereas low whole blood thiamine level, consistent with limbic circuit dysfunction, predicted mnemonic deficits. This double dissociation indicates biological markers that contribute to heterogeneity in expression of functional impairment in ALC. That non-mnemonic and mnemonic deficits are subserved by the dissociable neural systems of frontocerebellar and limbic circuitry, both commonly disrupted in ALC, suggests neural mechanisms that can differentially affect selective functions, thereby contributing to heterogeneity in pattern and extent of dysfunction in ALC.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | - Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
| | - Cheshire Hardcastle
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | | | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
| | - Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
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29
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Toledo Nunes P, Vedder LC, Deak T, Savage LM. A Pivotal Role for Thiamine Deficiency in the Expression of Neuroinflammation Markers in Models of Alcohol-Related Brain Damage. Alcohol Clin Exp Res 2019; 43:425-438. [PMID: 30589435 DOI: 10.1111/acer.13946] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol-related brain damage (ARBD) is associated with neurotoxic effects of heavy alcohol use and nutritional deficiency, in particular thiamine deficiency (TD), both of which induce inflammatory responses in brain. Although neuroinflammation is a critical factor in the induction of ARBD, few studies have addressed the specific contribution(s) of ethanol (EtOH) versus TD. METHODS Adult rats were randomly divided into 6 conditions: chronic EtOH treatment (CET) where rats consumed a 20% v/v solution of EtOH for 6 months; CET with injections of thiamine (CET + T); severe pyrithiamine-induced TD (PTD); moderate PTD; moderate PTD during CET; and pair-fed controls. After the treatments, the rats were split into 3 recovery phase time points: the last day of treatment (time point 1), acute recovery (time point 2: 24 hours posttreatment), and delayed recovery (time point 3: 3 weeks posttreatment). At these time points, vulnerable brain regions (thalamus, hippocampus, frontal cortex) were collected and changes in neuroimmune markers were assessed using a combination of reverse transcription polymerase chain reaction and protein analysis. RESULTS CET led to minor fluctuations in neuroimmune genes, regardless of the structure being examined. In contrast, PTD treatment led to a profound increase in neuroimmune genes and proteins within the thalamus. Cytokine changes in the thalamus ranged in magnitude from moderate (3-fold and 4-fold increase in interleukin-1β [IL-1β] and IκBα) to severe (8-fold and 26-fold increase in tumor necrosis factor-α and IL-6, respectively). Though a similar pattern was observed in the hippocampus and frontal cortex, overall fold increases were moderate relative to the thalamus. Importantly, neuroimmune gene induction varied significantly as a function of severity of TD, and most genes displayed a gradual recovery across time. CONCLUSIONS These data suggest an overt brain inflammatory response by TD and a subtle change by CET alone. Also, the prominent role of TD in the immune-related signaling pathways leads to unique regional and temporal profiles of induction of neuroimmune genes.
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Affiliation(s)
- Polliana Toledo Nunes
- Behavioral Neuroscience Program (PTN, LCV, TD, LMS), Department of Psychology, Binghamton University, State University of New York, Binghamton, New York
| | - Lindsey C Vedder
- Behavioral Neuroscience Program (PTN, LCV, TD, LMS), Department of Psychology, Binghamton University, State University of New York, Binghamton, New York
| | - Terrence Deak
- Behavioral Neuroscience Program (PTN, LCV, TD, LMS), Department of Psychology, Binghamton University, State University of New York, Binghamton, New York
| | - Lisa M Savage
- Behavioral Neuroscience Program (PTN, LCV, TD, LMS), Department of Psychology, Binghamton University, State University of New York, Binghamton, New York
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30
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Jiang J, Wang GY, Luo W, Xie H, Guan JS. Mammillary body regulates state-dependent fear by alternating cortical oscillations. Sci Rep 2018; 8:13471. [PMID: 30194318 PMCID: PMC6128928 DOI: 10.1038/s41598-018-31622-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/14/2018] [Indexed: 12/16/2022] Open
Abstract
State-dependent memory describes a phenomenon that memory will be efficiently retrieved only when the brain state during retrieval matches the state during encoding. While a variety of psychoactive drugs, such as ethanol, cocaine, morphine and NMDA receptor antagonists, are able to induce state-dependent memory, the biological hallmark of brain state and neural mechanism of its regulation are still unknown. In this study, we found that MK-801 enhanced delta oscillations in awake mice, representing a drug-induced brain state, in which fear memory could only be successfully retrieved when the same drug condition was presented. We identified a key nucleus, mammillary body (MB), which regulates the specific brain state associated with MK-801. Chemogenetic silencing of MB neurons enhanced cortical delta oscillations and generated state-dependent memory. Moreover, optogenetic reconstitution of delta oscillations alone facilitated retrieval of fear memory encoded under MK-801. Our results indicated that delta oscillations in awake animals defined a specific brain state, in which memory formed is inaccessible under the normal condition, shining light on the neural mechanism underlying the fluctuation of memory retrieval and the role of MB in memory encoding and recall.
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Affiliation(s)
- Jun Jiang
- School of Life Sciences, Tsinghua University, Beijing, 100086, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Guang-Yu Wang
- School of Life Sciences, Tsinghua University, Beijing, 100086, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Wenhan Luo
- School of Life Sciences, Tsinghua University, Beijing, 100086, China.,Peking-Tsinghua Center for Life Sciences, Beijing, 100871, China.,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Hong Xie
- School of Life Sciences, Tsinghua University, Beijing, 100086, China.,Institute of Brain-intelligence Science and Technology, Zhangjiang Lab, Shanghai, 200031, China
| | - Ji-Song Guan
- School of Life Sciences, Tsinghua University, Beijing, 100086, China. .,School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
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31
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Savastano LE, Hollon TC, Barkan AL, Sullivan SE. Korsakoff syndrome from retrochiasmatic suprasellar lesions: rapid reversal after relief of cerebral compression in 4 cases. J Neurosurg 2018; 128:1731-1736. [DOI: 10.3171/2017.1.jns162719] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Korsakoff syndrome is a chronic memory disorder caused by a severe deficiency of thiamine that is most commonly observed in alcoholics. However, some have proposed that focal structural lesions disrupting memory circuits—in particular, the mammillary bodies, the mammillothalamic tract, and the anterior thalamus—can give rise to this amnestic syndrome. Here, the authors present 4 patients with reversible Korsakoff syndromes caused by suprasellar retrochiasmatic lesions compressing the mammillary bodies and adjacent caudal hypothalamic structures.Three of the patients were found to have large pituitary macroadenomas in their workup for memory deficiency and cognitive decline with minimal visual symptoms. These tumors extended superiorly into the suprasellar region in a retrochiasmatic position and caused significant mass effect in the bilateral mammillary bodies in the base of the brain. These 3 patients had complete and rapid resolution of amnestic problems shortly after initiation of treatment, consisting of resection in 1 case of nonfunctioning pituitary adenoma or cabergoline therapy in 2 cases of prolactinoma. The fourth patient presented with bizarre and hostile behavior along with significant memory deficits and was found to have a large cystic craniopharyngioma filling the third ventricle and compressing the midline diencephalic structures. This patient underwent cyst fenestration and tumor debulking, with a rapid improvement in his mental status. The rapid and dramatic memory improvement observed in all of these cases is probably due to a reduction in the pressure imposed by the lesions on structures contiguous to the third ventricle, rather than a direct destructive effect of the tumor, and highlights the essential role of the caudal diencephalic structures—mainly the mammillary bodies—in memory function.In summary, large pituitary lesions with suprasellar retrochiasmatic extension and third ventricular craniopharyngiomas can cause severe Korsakoff-like amnestic syndromes, probably because of bilateral pressure on or damage to mammillary bodies, anterior thalamic nuclei, or their major connections. Neuropsychiatric symptoms may rapidly and completely reverse shortly after initiation of therapy via surgical decompression of tumors or pharmacological treatment of prolactinomas. Early identification of these lesions with timely treatment can lead to a favorable prognosis for this severe neuropsychiatric disorder.
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Affiliation(s)
| | | | - Ariel L. Barkan
- Departments of 1Neurosurgery and
- 2Internal Medicine, University of Michigan, Ann Arbor, Michigan
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32
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Gasquoine PG. A Case of Bariatric Surgery-related Wernicke-Korsakoff Syndrome with Persisting Anterograde Amnesia. Arch Clin Neuropsychol 2018; 32:610-617. [PMID: 28430846 DOI: 10.1093/arclin/acx037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/04/2017] [Indexed: 02/06/2023] Open
Abstract
Objective To describe the theoretical and clinical implications of the neuropsychological evaluation of a case of bariatric surgery-related Wernicke-Korsakoff syndrome. Method The patient was a 37-year old, female, bilingual, bachelor's degree educated, Mexican American public relations consultant without preexisting psychiatric, neurological, or substance abuse history. Recovery from laparoscopic sleeve gastrectomy surgery for morbid obesity was complicated by intraabdominal abscess, multibacterial infection, and prolonged nausea and vomiting. About 15 weeks post-surgery she was diagnosed with Wernicke's encephalopathy. She had a positive response to thiamine supplement but was left with persisting self-reported memory problems that were confirmed by family members. Multiple neuroimaging studies were all normal. Results A neuropsychological evaluation at 14 months post-surgery revealed anterograde amnesia for verbal and visual-perceptual material. There was no clear period of temporally graded retrograde amnesia. Scores on tests of visual-perceptual, language, fine motor, and executive functions were unimpaired. She had awareness of her neurocognitive impairment, but did not exhibit emotional distress. Follow-up neuropsychological evaluation at 17 months showed a similar neurocognitive profile with increased emotional distress. Conclusions Her preserved executive functioning is theoretically important as it supports arguments that such impairment in alcohol use-related Korsakoff syndrome derives from the toxic effects of the prolonged misuse of alcohol and not vitamin deficiency. From a clinical perspective, neuropsychological evaluation of thiamine treated, bariatric surgery-related, Wernicke's encephalopathy cases is indicated if there is suspicion of residual memory impairment.
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Affiliation(s)
- Philip Gerard Gasquoine
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
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33
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Postma A, Morel SG, Slot ME, Oudman E, Kessels RPC. Forgetting the new locations of one's keys: spatial-memory interference in Korsakoff's amnesia. Exp Brain Res 2018; 236:1861-1868. [PMID: 29680910 PMCID: PMC6010480 DOI: 10.1007/s00221-018-5266-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/17/2018] [Indexed: 01/19/2023]
Abstract
The present study focused on interference in a group of patients with amnesia due to Korsakoff's syndrome (KS) within the domain of spatial memory. An object-location memory task was used in which participants first learned an array of objects on a computer screen, followed by a reconstruction of the object positions. Next a trial was given in which the same objects were presented only now in different locations. Participants had to place the objects a second time but at the new locations. This was repeated for seven pairs of baseline/interference trials. Both Korsakoff patients and matched controls did worse on the interference trials than on the baseline trials, indicating that it is difficult to relearn new spatial locations for objects that previously were remembered in other locations. When computing relative interference effects (that is the percentage change from baseline in the interference trials), Korsakoff patients were less affected than controls. It is discussed in how far interference depends on the strength of the original memories, which are markedly lower in KS patients.
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Affiliation(s)
- Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands. .,Korsakoff Center Slingedael, Rotterdam, The Netherlands.
| | - Sascha G Morel
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Margot E Slot
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Korsakoff Center Slingedael, Rotterdam, The Netherlands
| | - Roy P C Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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34
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Zafar A, Khatri IA. An overview of complications affecting the Central Nervous System following bariatric surgery. ACTA ACUST UNITED AC 2018; 23:4-12. [PMID: 29455214 PMCID: PMC6751905 DOI: 10.17712/nsj.2018.1.20170316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Bariatric surgery has been considered as an effective treatment for morbid obesity. Apart from procedures related complications, a broad spectrum of neurological disorders affecting any part of neuraxis has been reported following BS. Central nervous system complications, although less common than peripheral nervous system complications, carry significant morbidity and potential mortality. Encephalopathy, behavioral and psychiatric disorders, myelopathy and optic neuropathy are the most frequently reported CNS complications. Early detection and prompt management may improve or completely reverse these neurological complications. It is essential that the treating physicians must be aware of their clinical manifestations and management, so early diagnosis and treatment can prevent patients from suffering significant neurological deficits and even death. This review discusses the clinical manifestations of these complications in detail which will help concerned physician in earlier recognition and hence prevent the delay in specific treatment.
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Affiliation(s)
- Azra Zafar
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia. E-mail:
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35
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Arfer KB, Tomlinson M, Mayekiso A, Bantjes J, van Heerden A, Rotheram-Borus MJ. Criterion validity of self-reports of alcohol, cannabis, and methamphetamine use among young men in Cape Town, South Africa. Int J Ment Health Addict 2018; 16:45-52. [PMID: 29632453 PMCID: PMC5889135 DOI: 10.1007/s11469-017-9769-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Valid measurement of substance use is necessary to evaluate preventive and treatment interventions. Self-report is fast and inexpensive, but its accuracy can be hampered by social desirability bias and imperfect recall. We examined the agreement between self-report of recent use and rapid diagnostic tests for three substances (alcohol, cannabis, and methamphetamine) among 904 young men living in Cape Town, South Africa. Rapid diagnostic tests detected the respective substances in 32%, 52%, and 22% of men. Among those who tested positive, 61% (95% CI [56%, 66%]), 70% ([67%, 74%]), and 48% ([42%, 54%]) admitted use. Men were moderately more willing to admit use of cannabis than alcohol (log OR 0.42) or admit use of alcohol than methamphetamine (log OR 0.53). Our findings show that self-report has reasonable criterion validity in this population, but criterion validity can vary substantially depending on the substance.
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Affiliation(s)
- Kodi B. Arfer
- UCLA Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, CA, US
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, South Africa
| | - Andile Mayekiso
- Department of Psychology, Stellenbosch University, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, South Africa
| | - Alastair van Heerden
- Human and Social Development Research Programme, Human Sciences Research Council, South Africa
| | - Mary Jane Rotheram-Borus
- UCLA Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, CA, US
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36
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Nikolakaros G, Kurki T, Paju J, Papageorgiou SG, Vataja R, Ilonen T. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients. Variable Cognitive Presentation and Impaired Frontotemporal Connectivity. Front Psychiatry 2018; 9:204. [PMID: 29910747 PMCID: PMC5992887 DOI: 10.3389/fpsyt.2018.00204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI) data are scarce. Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men) with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems. Results: All patients had abnormal neuropsychological test results, predominantly in memory. Thus, the neuropsychological findings were compatible with Korsakoff syndrome. However, the neuropsychological findings were not uniform. The impairment of delayed verbal memory of the first patient was evident only when the results of the memory tests were compared to her general cognitive level. In addition, the logical memory test and the verbal working memory test were abnormal, but the word list memory test was normal. The second patient had impaired attention and psychomotor speed in addition to impaired memory. In the third patient, the word list memory test was abnormal, but the logical memory test was normal. All patients had intrusions in the neuropsychological examination. Executive functions were preserved, except for planning and foresight, which were impaired in two patients. Conventional MRI examination was normal. DTI showed reduced fractional anisotropy values in the uncinate fasciculus in two patients, and in the corpus callosum and in the subgenual cingulum in one patient. Conclusions: Non-alcoholic Korsakoff syndrome can have diverse neuropsychological findings. This may partly explain its marked underdiagnosis. Therefore, a strong index of suspicion is needed. The presence of intrusions in the neuropsychological examination supports the diagnosis. Damage in frontotemporal white matter tracts, particularly in the uncinate fasciculus, may be a feature of non-alcoholic Korsakoff syndrome in psychiatric patients.
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Affiliation(s)
- Georgios Nikolakaros
- "Specialists in Psychiatry" Medical Center, Turku, Finland.,Satakunta Hospital District, Psychiatric Care Division, General Psychiatry Outpatient Clinic, Pori, Finland.,Turku University Central Hospital, Salo Psychiatry Outpatient Clinic, Salo, Finland
| | - Timo Kurki
- Terveystalo Pulssi Medical Center, Turku, Finland.,Department of Radiology, University of Turku, Turku, Finland
| | - Janina Paju
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Sokratis G Papageorgiou
- Cognitive Disorders/Dementia Unit, 2nd University Department of Neurology, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - Risto Vataja
- Division of Neuropsychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Tuula Ilonen
- Department of Psychiatry, University of Turku, Turku, Finland
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37
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Loijen A, Rinck M, Walvoort SJW, Kessels RPC, Becker ES, Egger JIM. Modification of Automatic Alcohol-Approach Tendencies in Alcohol-Dependent Patients with Mild or Major Neurocognitive Disorder. Alcohol Clin Exp Res 2017; 42:153-161. [PMID: 29034489 DOI: 10.1111/acer.13529] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/08/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND To examine the applicability of an alcohol-avoidance training procedure in patients with alcohol dependence and alcohol-induced neurocognitive disorders (NDs), we trained 2 groups that differed in the degree of cognitive impairment: One group fulfilled the DSM-5 criteria for alcohol-induced mild ND, and 1 group was diagnosed with Korsakoff's syndrome (KS) (alcohol-induced major ND, confabulatory/amnesic subtype; DSM-5). The intervention is assumed to match the preserved cognitive capacity for implicit learning in both groups. METHODS Fifty-one inpatients with a mild ND and 54 inpatients with KS were trained. Six training sessions (including pre- and posttests) of a computerized implicit alcohol approach-avoidance task were applied. Neurocognitive variables were available from the standard assessment procedure of the clinic. RESULTS Training of alcohol-avoidance tendencies is feasible in a population with alcohol-related NDs. The alcohol-approach bias decreased for both groups in each session. Better learning results over time were obtained in participants with a larger baseline alcohol-approach tendency. Learning effects were positively related to age and implicit (nondeclarative) memory functioning. No relation between training effects and executive or explicit memory functions was found. CONCLUSIONS Training of an alcohol-avoidance tendency can be successfully applied in patients with alcohol dependence including those with alcohol-induced NDs.
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Affiliation(s)
- Anke Loijen
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Serge J W Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Jos I M Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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38
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Vivar C, van Praag H. Running Changes the Brain: the Long and the Short of It. Physiology (Bethesda) 2017; 32:410-424. [PMID: 29021361 PMCID: PMC6148340 DOI: 10.1152/physiol.00017.2017] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 11/22/2022] Open
Abstract
Exercise is a simple intervention that profoundly benefits cognition. In rodents, running increases neurogenesis in the hippocampus, a brain area important for memory. We describe the dynamic changes in new neuron number and afferent connections throughout their maturation. We highlight the effects of exercise on the neurotransmitter systems involved, with a focus on the role of glutamate and acetylcholine in the initial development of new neurons in the adult brain.
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Affiliation(s)
- Carmen Vivar
- Department of Physiology, Biophysics and Neuroscience, Centro de Investigacion y de Estudios Avanzados del IPN, Mexico; and
| | - Henriette van Praag
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
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Bubb EJ, Kinnavane L, Aggleton JP. Hippocampal - diencephalic - cingulate networks for memory and emotion: An anatomical guide. Brain Neurosci Adv 2017; 1:2398212817723443. [PMID: 28944298 PMCID: PMC5608081 DOI: 10.1177/2398212817723443] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/21/2017] [Indexed: 11/17/2022] Open
Abstract
This review brings together current knowledge from tract tracing studies to update and reconsider those limbic connections initially highlighted by Papez (1937) for their presumed role in emotion. These connections link hippocampal and parahippocampal regions with the mammillary bodies, the anterior thalamic nuclei, and the cingulate gyrus, all structures now strongly implicated in memory functions. An additional goal of this review is to describe the routes taken by the various connections within this network. The original descriptions of these limbic connections saw their interconnecting pathways forming a serial circuit that began and finished in the hippocampal formation. It is now clear that, with the exception of the mammillary bodies, these various sites are multiply interconnected with each other, including many reciprocal connections. In addition, these same connections are topographically organised, creating further subsystems. This complex pattern of connectivity helps to explain the difficulty of interpreting the functional outcome of damage to any individual site within the network. For these same reasons, Papez' initial concept of a loop beginning and ending in the hippocampal formation needs to be seen as a much more complex system of hippocampal-diencephalic-cingulate connections. The functions of these multiple interactions might be better viewed as principally providing efferent information from the posterior medial temporal lobe. Both a subcortical diencephalic route (via the fornix) and a cortical cingulate route (via retrosplenial cortex) can be distinguished. These routes provide indirect pathways for hippocampal interactions with prefrontal cortex, with the preponderance of both sets of connections arising from the more posterior hippocampal regions. These multi-stage connections complement the direct hippocampal projections to prefrontal cortex, which principally arise from the anterior hippocampus, thereby creating longitudinal functional differences along the anterior-posterior plane of the hippocampus.
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Affiliation(s)
- Emma J. Bubb
- Behavioural Neuroscience Laboratory, School of Psychology, Cardiff University, Cardiff, UK
| | - Lisa Kinnavane
- Behavioural Neuroscience Laboratory, School of Psychology, Cardiff University, Cardiff, UK
| | - John P. Aggleton
- Behavioural Neuroscience Laboratory, School of Psychology, Cardiff University, Cardiff, UK
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40
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Planas-Ballvé A, Grau-López L, Morillas RM, Planas R. Neurological manifestations of excessive alcohol consumption. GASTROENTEROLOGIA Y HEPATOLOGIA 2017; 40:709-717. [PMID: 28651796 DOI: 10.1016/j.gastrohep.2017.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 05/10/2017] [Accepted: 05/19/2017] [Indexed: 12/28/2022]
Abstract
This article reviews the different acute and chronic neurological manifestations of excessive alcohol consumption that affect the central or peripheral nervous system. Several mechanisms can be implicated depending on the disorder, ranging from nutritional factors, alcohol-related toxicity, metabolic changes and immune-mediated mechanisms. Recognition and early treatment of these manifestations is essential given their association with high morbidity and significantly increased mortality.
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Affiliation(s)
- Anna Planas-Ballvé
- Unidad de Neurociencias, Servicio de Neurología, Hospital Germans Trias i Pujol, Badalona (Barcelona), España.
| | - Laia Grau-López
- Unidad de Neurociencias, Servicio de Neurología, Hospital Germans Trias i Pujol, Badalona (Barcelona), España
| | - Rosa María Morillas
- Unidad de Hepatología, CIBERehd, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona (Barcelona), España
| | - Ramón Planas
- Unidad de Hepatología, CIBERehd, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona (Barcelona), España
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41
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Gerridzen IJ, Moerman-van den Brink WG, Depla MF, Verschuur EML, Veenhuizen RB, van der Wouden JC, Hertogh CMPM, Joling KJ. Prevalence and severity of behavioural symptoms in patients with Korsakoff syndrome and other alcohol-related cognitive disorders: a systematic review. Int J Geriatr Psychiatry 2017; 32:256-273. [PMID: 27918121 DOI: 10.1002/gps.4636] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 10/06/2016] [Accepted: 11/08/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Experiences from clinical practice suggest that behavioural symptoms in patients with Korsakoff syndrome (KS) are a frequent problem. Knowledge about behavioural symptoms is important in understanding and managing these symptoms. The aim of this study is to review the prevalence and severity of behavioural symptoms in KS. METHODS Relevant articles were identified by searching Medline (PubMed), PsycINFO, Embase and CINAHL up to 4 June 2014. Two reviewers independently selected the studies, extracted their baseline data and assessed methodological quality using a standardized checklist. RESULTS Fifteen studies fulfilled the inclusion criteria. A diversity of diagnoses was used indicating that KS and other alcohol-related cognitive disorders and terms were used interchangeably. None of the studies were primarily designed to estimate the prevalence or severity of behavioural symptoms in patients with KS. Most studies had serious methodological limitations. The reported prevalence estimates of behavioural symptoms in the included studies varied strongly. Most prevalent were depressive symptoms and disorders (2-50%, median 27%) and agitation and aggression (10-54%, median 27%). None of the reported, mean severity estimates met pathological thresholds. The highest severity estimates were found for apathy. CONCLUSIONS Good quality studies on behavioural symptoms in patients with KS are lacking. Observational research designed to provide reliable estimates of the prevalence and severity of behavioural symptoms in patients with KS is needed. This could improve understanding and managing these symptoms and help care staff to better support the needs of this specific patient group. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ineke J Gerridzen
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Nursing Home Markenhof, Atlant Care Group, Beekbergen, The Netherlands
| | | | - Marja F Depla
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Els M L Verschuur
- Nursing Home Markenhof, Atlant Care Group, Beekbergen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Ruth B Veenhuizen
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes C van der Wouden
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Karlijn J Joling
- Department of General Practice and Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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42
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Moustafa AA, McMullan RD, Rostron B, Hewedi DH, Haladjian HH. The thalamus as a relay station and gatekeeper: relevance to brain disorders. Rev Neurosci 2017; 28:203-218. [DOI: 10.1515/revneuro-2016-0067] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 10/21/2016] [Indexed: 01/18/2023]
Abstract
AbstractHere, we provide a review of behavioural, cognitive, and neural studies of the thalamus, including its role in attention, consciousness, sleep, and motor processes. We further discuss neuropsychological and brain disorders associated with thalamus function, including Parkinson’s disease, Alzheimer’s disease, Korsakoff’s syndrome, and sleep disorders. Importantly, we highlight how thalamus-related processes and disorders can be explained by the role of the thalamus as a relay station.
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Affiliation(s)
- Ahmed A. Moustafa
- 1School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
- 2Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Ryan D. McMullan
- 3School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Bjorn Rostron
- 3School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Doaa H. Hewedi
- 4Psychogeriatric Research Center, Department of Psychiatry, School of Medicine, Ain Shams University, 11566 Cairo, Egypt
| | - Harry H. Haladjian
- 5Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, 75270 Paris Cedex 06, France
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Abstract
In this review, we present a survey on Korsakoff's syndrome (KS), a residual syndrome in patients who suffered from a Wernicke encephalopathy (WE) that is predominantly characterized by global amnesia, and in more severe cases also by cognitive and behavioral dysfunction. We describe the history of KS and its definition, its epidemiology, and the lack of consensus criteria for its diagnosis. The cognitive and behavioral symptoms of KS, which include anterograde and retrograde amnesia, executive dysfunction, confabulation, apathy, as well as affective and social-cognitive impairments, are discussed. Moreover, recent insights into the underlying neurocognitive mechanisms of these symptoms are presented. In addition, the evidence so far on the etiology of KS is examined, highlighting the role of thiamine and alcohol and discussing the continuity hypothesis. Furthermore, the neuropathology of KS is reviewed, focusing on abnormalities in the diencephalon, including the mammillary bodies and thalamic nuclei. Pharmacological treatment options and nonpharmacological interventions, such as those based on cognitive rehabilitation, are discussed. Our review shows that thiamine deficiency (TD) is a crucial factor in the etiology of KS. Although alcohol abuse is by far the most important context in which TD occurs, there is no convincing evidence for an essential contribution of ethanol neurotoxicity (EN) to the development of WE or to the progression of WE to KS. Future research on the postmortem histopathological analysis of brain tissues of KS patients is crucial for the advancement of our knowledge of KS, especially for associating its symptoms with lesions in various thalamic nuclei. A necessary requirement for the advancement of studies on KS is the broad acceptance of a comprehensive definition and definite diagnostic criteria. Therefore, in this review, we propose such a definition of KS and draft outlines for prospective diagnostic criteria.
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Affiliation(s)
- Nicolaas Jm Arts
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Neuropsychiatry Center Thalamus, Institution for Integrated Mental Health Care Pro Persona, Wolfheze
| | - Serge Jw Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray
| | - Roy Pc Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Department of Neuropsychology and Rehabilitation Psychology, Donders Institute for Brain, Cognition and Behaviour, Radboud University.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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Inaba H, Kishimoto T, Oishi S, Nagata K, Hasegawa S, Watanabe T, Kida S. Vitamin B1-deficient mice show impairment of hippocampus-dependent memory formation and loss of hippocampal neurons and dendritic spines: potential microendophenotypes of Wernicke-Korsakoff syndrome. Biosci Biotechnol Biochem 2016; 80:2425-2436. [PMID: 27576603 PMCID: PMC5213968 DOI: 10.1080/09168451.2016.1224639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Patients with severe Wernicke-Korsakoff syndrome (WKS) associated with vitamin B1 (thiamine) deficiency (TD) show enduring impairment of memory formation. The mechanisms of memory impairment induced by TD remain unknown. Here, we show that hippocampal degeneration is a potential microendophenotype (an endophenotype of brain disease at the cellular and synaptic levels) of WKS in pyrithiamine-induced thiamine deficiency (PTD) mice, a rodent model of WKS. PTD mice show deficits in the hippocampus-dependent memory formation, although they show normal hippocampus-independent memory. Similarly with WKS, impairments in memory formation did not recover even at 6 months after treatment with PTD. Importantly, PTD mice exhibit a decrease in neurons in the CA1, CA3, and dentate gyrus (DG) regions of the hippocampus and reduced density of wide dendritic spines in the DG. Our findings suggest that TD induces hippocampal degeneration, including the loss of neurons and spines, thereby leading to enduring impairment of hippocampus-dependent memory formation.
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Affiliation(s)
- Hiroyoshi Inaba
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan
| | - Takuya Kishimoto
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan
| | - Satoru Oishi
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan
| | - Kan Nagata
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan
| | - Shunsuke Hasegawa
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan.,b Core Research for Evolutional Science and Technology , Japan Science and Technology Agency , Saitama , Japan
| | - Tamae Watanabe
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan
| | - Satoshi Kida
- a Faculty of Applied Bioscience, Department of Bioscience , Tokyo University of Agriculture , Tokyo , Japan.,b Core Research for Evolutional Science and Technology , Japan Science and Technology Agency , Saitama , Japan
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45
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Stacey PS, Sullivan KA. Preliminary Investigation of Thiamine and Alcohol Intake in Clinical and Healthy Samples. Psychol Rep 2016; 94:845-8. [PMID: 15217037 DOI: 10.2466/pr0.94.3.845-848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Insufficient thiamine intake during heavy alcohol dependence has been well established as a precursor to alcohol-related brain damage, including Wernicke-Korsakoff syndrome. This study compared the alcohol and thiamine intakes of 35 alcohol-dependent patients upon admission for detoxification with 49 healthy young undergraduates. Subjects were interviewed using a retrospective diary that recorded alcohol and food and vitamin consumption for the previous seven days. As predicted, the clinical group consumed significantly less thiamine than the healthy group, and well below the minimum safe daily intakes. Findings have implications for the prevention of alcohol-related brain damage and public health policy.
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46
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Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory. Neuropsychol Rev 2016; 26:420-431. [PMID: 27447979 DOI: 10.1007/s11065-016-9323-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/22/2016] [Indexed: 01/27/2023]
Abstract
In addiction, notably Alcohol Use Disorder (AUD), patients often have a tendency to fail to acknowledge the reality of the disease and to minimize the physical, psychological, and social difficulties attendant to chronic alcohol consumption. This lack of awareness can reduce the chances of initiating and maintaining sobriety. Presented here is a model focusing on compromised awareness in individuals with AUD of mild to moderate cognitive deficits, in particular, for episodic memory impairment-the ability to learn new information, such as recent personal experiences. Early in abstinence, alcoholics can be unaware of their memory deficits and overestimate their mnemonic capacities, which can be investigated with metamemory paradigms. Relevant neuropsychological and neuroimaging results considered suggest that the alcoholics' impairment of awareness of their attenuated memory function can be a clinical manifestation explained mechanistically by neurobiological factors, including compromise of brain systems that result in a mild form of mnemonic anosognosia. Specifically, unawareness of memory impairment in AUD may result from a lack of personal knowledge updating attributable to damage in brain regions or connections supporting conscious recollection in episodic memory. Likely candidates are posterior parietal and medial frontal regions known to be integral part of the Default Mode Network (DMN) and the insula leading to an impaired switching mechanism between the DMN and the Central-Executive Control (i.e., Lateral Prefronto-Parietal) Network. The cognitive concepts and neural substrates noted for addictive disorders may also be relevant for problems in self-identification of functional impairment resulting from injury following war-related blast, sport-related concussion, and insidiously occurring dementia.
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Differential compromise of prospective and retrospective metamemory monitoring and their dissociable structural brain correlates. Cortex 2016; 81:192-202. [PMID: 27244277 DOI: 10.1016/j.cortex.2016.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/05/2016] [Accepted: 05/04/2016] [Indexed: 11/23/2022]
Abstract
Metamemory refers to personal knowledge about one's own memory ability that invokes cognitive processes relevant to monitoring and controlling memory. An impaired monitoring system can potentially result in unawareness of symptoms as can occur in addiction denial. Monitoring processes can be assessed with prospective measures such as Feeling-Of-Knowing (FOK) judgments on prediction of future recognition performance, or retrospective confidence judgments (RCJ) made on previous memory performance. Alcoholic patients with amnesia showed poor FOK but intact RCJ. The neuropsychological continuum from mild to moderate deficits in nonamnesic to amnesic alcoholism raised the possibility that alcoholics uncomplicated by clinically-detectable amnesia may suffer anosognosia for their mild memory deficits. Herein 24 abstinent alcoholics and 26 age-matched controls completed an episodic memory paradigm including prospective FOK and retrospective RCJ monitoring measures and underwent 3T structural magnetic resonance imaging. Alcoholics were less accurate than controls in recognition and in assessing their future recognition performance, which was marked by overestimation, but were as accurate as controls on confidence ratings of actual recognition performance. Examination of brain structure-function relations revealed a double dissociation where FOK accuracy was selectively related to insular volume, and retrospective confidence accuracy was selectively related to frontolimbic structural volumes. Impaired FOK with intact RCJ was consistent with mild anosognosia and suggested evidence for neuropsychological and neural mechanisms of unawareness in addiction.
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Tedder J, Miller L, Tu S, Hornberger M, Lah S. Into the future with little past: exploring mental time travel in a patient with damage to the mammillary bodies/fornix. Clin Neuropsychol 2016; 30:351-66. [PMID: 26928513 DOI: 10.1080/13854046.2016.1142612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Remembering the past and imaging the future are both manifestations of 'mental time travel'. These processes have been found to be impaired in patients with bilateral hippocampal lesions. Here, we examined the question of whether future thinking is affected by other Papez circuit lesions, namely: damage to the mammillary bodies/fornix. METHOD Case (SL) was a 43-year-old woman who developed dense anterograde and retrograde amnesia suddenly, as a result of Wernicke-Korsakoff's syndrome. A region of interest volumetric Magnetic resonance imaging (MRI) analysis was performed. We assessed past and future thinking in SL and 11 control subjects of similar age and education with the adapted Autobiographical Interview (AI). Participants also completed a battery of neuropsychological tests. RESULTS Volumetric MRI analyses revealed severely reduced fornix and mammillary body volumes, but intact hippocampi. SL showed substantial, albeit temporally graded retrograde memory deficits on the adapted AI. Strikingly, whilst SL could not provide any specific details of events from the past two weeks or past two years and had impaired recall of events from her late 30s, her descriptions of potential future events were normal in number of event details and plausibility. CONCLUSIONS This dissociation of past and future events' performance after mammillary body and fornix damage is at odds with the findings of the majority of patients with adult onset hippocampal amnesia. It suggests that these non-hippocampal regions of the Papez circuit are only critical for past event retrieval and not for the generation of possible future events.
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Affiliation(s)
- Jacqui Tedder
- a School of Psychology, University of Sydney , Sydney , Australia
| | - Laurie Miller
- b ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia.,c Neuropsychology Unit , Royal Prince Alfred Hospital and Central Clinical School, University of Sydney , Sydney , Australia
| | - Sicong Tu
- b ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia.,d Neuroscience Research Australia , Sydney , Australia.,e Faculty of Medicine, School of Medical Sciences , University of New South Wales , Sydney , Australia
| | - Michael Hornberger
- b ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia.,d Neuroscience Research Australia , Sydney , Australia.,f Norwich Medical School , University of East Anglia , Norwich , UK
| | - Suncica Lah
- a School of Psychology, University of Sydney , Sydney , Australia.,b ARC Centre of Excellence in Cognition and its Disorders , Sydney , Australia
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Vivar C, Peterson BD, van Praag H. Running rewires the neuronal network of adult-born dentate granule cells. Neuroimage 2015; 131:29-41. [PMID: 26589333 DOI: 10.1016/j.neuroimage.2015.11.031] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 11/11/2015] [Accepted: 11/12/2015] [Indexed: 01/06/2023] Open
Abstract
Exercise improves cognition in humans and animals. Running increases neurogenesis in the dentate gyrus of the hippocampus, a brain area important for learning and memory. It is unclear how running modifies the circuitry of new dentate gyrus neurons to support their role in memory function. Here we combine retroviral labeling with rabies virus mediated trans-synaptic retrograde tracing to define and quantify new neuron afferent inputs in young adult male C57Bl/6 mice, housed with or without a running wheel for one month. Exercise resulted in a shift in new neuron networks that may promote sparse encoding and pattern separation. Neurogenesis increased in the dorsal, but not the ventral, dentate gyrus by three-fold, whereas afferent traced cell labeling doubled in number. Regional analysis indicated that running differentially affected specific inputs. Within the hippocampus the ratio of innervation from inhibitory interneurons and glutamatergic mossy cells to new neurons was reduced. Distal traced cells were located in sub-cortical and cortical regions, including perirhinal, entorhinal and sensory cortices. Innervation from entorhinal cortex (EC) was augmented, in proportion to the running-induced enhancement of adult neurogenesis. Within EC afferent input and short-term synaptic plasticity from lateral entorhinal cortex, considered to convey contextual information to the hippocampus was increased. Furthermore, running upregulated innervation from regions important for spatial memory and theta rhythm generation, including caudo-medial entorhinal cortex and subcortical medial septum, supra- and medial mammillary nuclei. Altogether, running may facilitate contextual, spatial and temporal information encoding by increasing adult hippocampal neurogenesis and by reorganization of new neuron circuitry.
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Affiliation(s)
- Carmen Vivar
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, United States
| | - Benjamin D Peterson
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, United States
| | - Henriette van Praag
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, United States.
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Zubkov S, Del Bene VA, MacAllister WS, Shepherd TM, Devinsky O. Disabling amnestic syndrome following stereotactic laser ablation of a hypothalamic hamartoma in a patient with a prior temporal lobectomy. EPILEPSY & BEHAVIOR CASE REPORTS 2015; 4:60-2. [PMID: 26288758 PMCID: PMC4536301 DOI: 10.1016/j.ebcr.2015.07.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/04/2015] [Indexed: 11/18/2022]
Abstract
A 19-year-old man with cortical dysplasia and intractable focal seizures underwent a right temporal lobectomy. A hypothalamic hamartoma was subsequently recognized, and he then underwent MRI-guided stereotactic laser ablation. Unfortunately, he sustained damage to the bilateral medial mammillary bodies and suffered significant memory loss. We review laser ablation therapy for hypothalamic hamartomas and the anatomy of the memory network. We postulate that his persistent memory disorder resulted from a combination of the right temporal lobectomy and injury to the bilateral medial mammillary bodies.
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Affiliation(s)
- Sarah Zubkov
- NYU Langone Medical Center, New York, NY 10016, USA
| | - Victor A. Del Bene
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY 10461, USA
| | | | | | - Orrin Devinsky
- NYU Langone Medical Center, New York, NY 10016, USA
- Corresponding author at: Comprehensive Epilepsy Center, 223 East 34th Street, New York, NY 10016, USA. Tel.: + 1 646 558 0800; fax: + 1 646 385 7164.
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