Cortical and diencephalic lesions in Korsakoff's syndrome: a clinical and scan study

Abstract

SYNOPSISTwenty-five male alcoholic Korsakoff patients were compared with age and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers on clinical and CT brain scan parameters. The scans were assessed by planimetry, visual grading procedures and computerized analysis. Reliable measures of third ventricular size were developed.The Korsakoff patients had wider third ventricles, larger lateral ventricles and wider interhemispheric fissures than the comparison groups; but sulcal and Sylvian fissure widths were equivalent in Korsakoff and non-Korsakoff alcoholics.The results suggest that, in addition to their well-established diencephalic lesions, many Korsakoff patients have sustained widespread cerebral damage. Shrinkage in the frontal brain regions appears to be especially pronounced. The implications for a dual aetiology of alcoholic Korsakoff's syndrome involving thiamine deficiency and features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.

The relation between global and limbic brain volumes on MRI and cognitive performance in healthy individuals across the age range

“…However, other authors have failed to find such a decline in medial temporal lobe volumes [24,31,37]. Linear increases with advancing age were found for the volume of the third ventricle (taken as an index for atrophy of the dorsomedial thalamus [19]). This is consistent with previous reports (e.g.…”

“…Based upon what is known from patient studies (e.g. [17,33,38,39]), it was expected that reductions in total brain volume would be related to a decline in performance on global cognitive tests measuring speed of mental processing, whereas atrophy of limbic structures (hippocampus, parahippocampal gyrus and mamillary bodies; and third ventricle as an index for the dorsomedial thalamus [19]) would be specifically associated with a deterioration on memory tests. We found a somewhat different pattern.…”

“…Secondly, we investigated whether normal agerelated cognitive decline can be explained by volume changes. The general hypothesis was that volume reductions in limbic structures (hippocampus, parahippocampal gyrus and mamillary bodies; and dorsomedial thalamus as indexed by the third ventricle [19]) are especially related to lower scores on memory tests, whereas decreases in total brain volume are related to slower performance on speed tasks. Furthermore, although advancing age is accompanied by decreases both in brain volumes and in test performance, it was expected that the volume-performance associations were only partially mediated by age.…”

Revisão dos instrumentos de diagnóstico médico-forense no alcoolismo

“…Discutiram a idéia de que existe no lobo frontal dos alcoolistas atrofia por eles considerada como típica e que progressivamente os doentes apresentariam lesões atróficas que iniciariam pela região frontal. Jacobson & Lishman (1990) …”

Polysubstance abuse and traumatic brain injury: Quantitative magnetic resonance imaging and neuropsychological outcome in older adolescents and young adults

“…Neuroimaging studies have shown ventricular and sulcal enlargement in both Korsakoff and non-Korsakoff alcoholics (Aasly et al, 1993;Christie et al, 1988;Jernigan et al, 1991aJernigan et al, , 1991bLitton et al, 1993;Nicolas et al, 1997;Pfefferbaum et al, 1992;Rosse et al, 1997). Additionally, lesions or parenchymal volume loss have been noted in the diencephalon (Jernigan et al, 1991a;Paller et al, 1997), mamillary bodies (Bigler et al, 1989), cerebellum (Cala et al, 1978), orbital frontal regions (Jacobson & Lishman, 1990;Jernigan et al, 1991aJernigan et al, , 1991b, parietal and superior frontal cortex along with mesial temporal cortex (Jernigan et al, 1991b;Sullivan et al, 1996), and corpus callosum (Hommer et al, 1996). In addition, using MR imaging and neuropathological analysis some research suggests that white matter is more adversely affected than gray matter structures (Charness, 1993;Harper et al, 1985;Pfefferbaum et al, 1992;Sullivan et al, 1996).…”