“Vascular” Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of “Acute” Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia

Yoneoka, Yuichiro; Seki, Yasuhiro; Akiyama, Katsuhiko

doi:10.7759/cureus.19472

Cited by 3 publications

(4 citation statements)

References 18 publications

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Section: Ad Comparison Resultsmentioning

confidence: 99%

“…The MTT effectively connects the mammillary bodies, which itself receives input from the hippocampus, to the anterior thalamic nuclei (ATN) 39 . Lesions to the MTT bilaterally, accompanied by damage to the ATN, have been sufficient to cause acute and irreversible memory disorder that is very similar to alcoholic KS 40 . Furthermore, another study 41 showed that 7 out of 12 patients with thalamic infarct who had damage to the MTT performed worse in verbal episodic memory task than the 5 patients with preserved MTT.…”

Section: Discussionmentioning

confidence: 99%

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Diencephalic or hippocampal amnesia – different etiologies, common mechanisms

Segobin

Ambler

Lanièpce

et al. 2022

Preprint

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Objectives: To compare regional volume deficits within the Papez circuit in Alzheimer s disease (AD) and Korsakoff s syndrome (KS), taking into account the neurodegenerative nature of AD. Methods: 18 KS patients, 40 AD patients (20 with Moderate AD (MAD) matched on cognitive deterioration with KS patients and 20 with Severe AD (SAD)), and 70 healthy controls underwent structural MRI examination. Volumes of the hippocampi, thalami, cingulate gyri, mammillary bodies (MB) and mammillothalamic tracts (MTT) were extracted. Results: For the anterior and posterior cingulate gyri, and anterior thalamic nuclei, all patient groups were significantly affected compared to controls but did not differ between each other. Lower volumes were observed in all patient groups compared to controls in the entire thalamus, mediodorsal thalamic nuclei and MB, but these regions were more severely damaged in KS compared to AD. MTT volumes were significantly damaged in KS only. Hippocampi were affected in all patient groups but more severely in the SAD than in the KS and MAD. Interpretation: The specificity of KS compared to AD relies on the severity of the MB and mediodorsal nuclei shrinkage, as well as the atrophy of the MTT. Several nodes of the Papez circuit were damaged to the same extent in AD and KS: the anterior thalamic nuclei, the cingulate cortex and the hippocampus (in MAD only). Our results encourage considering common mechanisms in the pathophysiology of amnesia regardless of etiology and question the relevance of the classical distinction between hippocampal and diencephalic amnesia.

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Section: Ad Comparison Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diencephalic or hippocampal amnesia – different etiologies, common mechanisms

Segobin

Ambler

Lanièpce

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The MTT effectively connects the mammillary bodies, which itself receives input from the hippocampus, to the anterior thalamic nuclei [45]. Lesions to the MTT bilaterally, accompanied by damage to the anterior thalamic nuclei, have been sufficient to cause acute and irreversible memory disorder that is very similar to KS [46]. Furthermore, another study [47] showed that 7 out of 12 patients with thalamic infarct who had damage to the MTT performed worse in the verbal episodic memory task than the 5 patients with preserved MTT.…”

Section: Discussionmentioning

confidence: 99%

Korsakoff’s Syndrome and Alzheimer’s Disease—Commonalities and Specificities of Volumetric Brain Alterations within Papez Circuit

Segobin

Ambler

Lanièpce

et al. 2023

JCM

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Background: Alzheimer’s disease (AD) and Korsakoff’s syndrome (KS) are two major neurocognitive disorders characterized by amnesia but AD is degenerative while KS is not. The objective is to compare regional volume deficits within the Papez circuit in AD and KS, considering AD progression. Methods: 18 KS patients, 40 AD patients (20 with Moderate AD (MAD) matched on global cognitive deficits with KS patients and 20 with Severe AD (SAD)), and 70 healthy controls underwent structural MRI. Volumes of the hippocampi, thalami, cingulate gyri, mammillary bodies (MB) and mammillothalamic tracts (MTT) were extracted. Results: For the cingulate gyri, and anterior thalamic nuclei, all patient groups were affected compared to controls but did not differ between each other. Smaller volumes were observed in all patient groups compared to controls in the mediodorsal thalamic nuclei and MB, but these regions were more severely damaged in KS than AD. MTT volumes were damaged in KS only. Hippocampi were affected in all patient groups but more severely in the SAD than in the KS and MAD. Conclusions: There are commonalities in the pattern of volume deficits in KS and AD within the Papez circuit with the anterior thalamic nuclei, cingulate cortex and hippocampus (in MAD only) being damaged to the same extent. The specificity of KS relies on the alteration of the MTT and the severity of the MB shrinkage. Further comparative studies including other imaging modalities and a neuropsychological assessment are required.

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“…Many studies have shown that amnesia is produced after bilateral lesions to any of these sites (72)(73)(74)(75)(76)(77)(78). However, they have also shown that there can be some variation in the nature of the amnesia and its associated presentation.…”

Section: Psychoanalysis and Amnesiamentioning

confidence: 99%

Like a rolling stone: Psychotherapy without (episodic) memory

Moore

Turnbull²

2022

Front. Psychiatry

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People with profound amnesia still retain the capacity to learn about the emotional value of experiences, which is crucial in developing and sustaining interpersonal relationships. In a 2017 paper, we demonstrated for the first time (with patient JL) that transferential feelings develop across the therapeutic process, despite profound episodic memory impairment after medial temporal lesions. This paper reports a second case (GA) of a profoundly amnesic patient in psychotherapy, this time after lesions to the anterior fornix. The work with GA opens issues such as the differences and similarities to the previous case, counter-transference phenomena, and the effects of hyperphagia. The findings make it clear that many phenomena are common to both GA and JL, such as forgetfulness, various types of repetition, the importance of the therapeutic alliance, and the ability to make therapeutic gain. However, there were differences between the cases, for example as regards confabulation, which may relate to either pre-morbid personality or lesion site. The paper also discusses the way in which patients of this type bear the very status of psychotherapeutic work with profoundly amnesic patients. Where others have seen barriers and in principle problems in working with such patients, we see many opportunities.

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“Vascular” Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of “Acute” Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia

Cited by 3 publications

References 18 publications

Diencephalic or hippocampal amnesia – different etiologies, common mechanisms

Diencephalic or hippocampal amnesia – different etiologies, common mechanisms

Korsakoff’s Syndrome and Alzheimer’s Disease—Commonalities and Specificities of Volumetric Brain Alterations within Papez Circuit

Like a rolling stone: Psychotherapy without (episodic) memory

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